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The REstarting Safe Education and Testing program for children with medical complexity was implemented in May 2021 at the University of Wisconsin to evaluate the feasibility of in-home rapid antigen COVID-19 testing among neurocognitively affected children. Parents or guardians administered BinaxNOW rapid antigen self-tests twice weekly for three months and changed to symptom and exposure testing or continued surveillance. In-home testing was feasible: nearly all (92.5%) expected tests were conducted. Symptomatic testing identified seven of nine COVID-19 cases. School safety perceptions were higher among those opting for symptom testing. Clinical Trials.gov identifier: NCT04895085. (Am J Public Health. 2022;112(S9):S878-S882. https://doi.org/10.2105/AJPH.2022.306971).
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Prueba de COVID-19 , COVID-19 , Niño , Humanos , COVID-19/diagnóstico , COVID-19/prevención & control , Estudios de Factibilidad , Instituciones Académicas , UniversidadesRESUMEN
OBJECTIVE: To determine whether international experience is associated with greater comfort in providing care to US children who are immigrants, refugees, and traveling internationally. STUDY DESIGN: Following enrollment into the 2018 American Board of Pediatrics Maintenance of Certification program, general pediatricians and subspecialists received a voluntary, online survey with questions about their experience and self-reported comfort caring for immigrant, refugee, and internationally traveling children and previous international experiences. Using multivariable logistic regression, we examined how previous international experiences, and other personal characteristics, were associated with self-reported comfort. RESULTS: A total of 5461 eligible participants completed the survey; 76.3%, (n = 4168) reported caring for immigrant children, 35.8% (n = 1957) cared for refugee children, and 79.8% (n = 4358) cared for children traveling internationally. High levels of comfort caring for immigrant children were reported by 68.5% (n = 3739), for refugee children by 50.1% (n = 2738), and for children traveling internationally by 72.7% (n = 3968). One-third of respondents (34.1%, n = 1866) reported past international experiences. In multivariable analysis, respondents with previous international experience and of Hispanic origin were significantly more likely to report high levels of comfort caring for all 3 populations. CONCLUSIONS: The majority of pediatricians report caring for children in the US who are immigrants, refugees, and traveling internationally, and previous international experience was associated with greater comfort with care. Training programs and professional organizations should consider ways to encourage a more diverse workforce and to support all pediatricians in achieving the skills and confidence required to care for children in our highly mobilized society.
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Asistencia Sanitaria Culturalmente Competente , Emigrantes e Inmigrantes/estadística & datos numéricos , Pediatras/estadística & datos numéricos , Refugiados/estadística & datos numéricos , Viaje/estadística & datos numéricos , Adulto , Actitud del Personal de Salud , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pediatras/educación , Encuestas y Cuestionarios , Estados UnidosRESUMEN
OBJECTIVE: Web sites describing residency programs are initial sources of information for applicants. The correlation of global health content on pediatric residency program Web sites with reported curricula is unknown. To determine the accuracy of global health education, information on program Web sites was compared with queried program content responses. STUDY DESIGN: The Fellowship and Residency Electronic Interactive Database was used to assess pediatric residency programs' Web sites for global health education, applying American Academy of Pediatrics consensus guidelines. The authors developed a questionnaire using these consensus guidelines and contacted each program to assess Web site findings, and χ(2) tests were used to compare data from these 2 sources. RESULTS: Of 194 programs, 177 had operational Web sites, of which 98 participated in the questionnaire (55%). Ninety-three of 177 programs (53%) reported global health education on Web sites, whereas 80 of 98 programs (82%) reported global health education through direct questioning (P < .001). Results include provision of resident salaries during global health elective (Web site 5% vs questionnaire 98%, P < .001), mandatory training before global health elective (8% vs 20%, P = .02), presence of global health elective curriculum (24% vs 75%, P < .001), postexperience debriefing (16% vs 29%, P = .05), and bidirectional resident exchange (2% vs 13%, P = .01). CONCLUSIONS: Results indicate continued expansion of pediatric global health education, but significant differences exist between information on Web sites and data obtained through direct questioning. Accurate representation of global health opportunities would allow for more informed decision-making among prospective applicants. Findings also suggest substantial variability in global health curricula that needs to be addressed through improved planning and cooperation among training programs.
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Curriculum , Salud Global/educación , Difusión de la Información , Internet , Internado y Residencia , Pediatría/educación , Encuestas y CuestionariosRESUMEN
More than a decade ago, two faculty met at a conference. Each talked about how they were charged with leading global health education efforts at their institutions and longed to have an opportunity to share resources and learn from each other. After reaching out to a few other Midwestern colleagues and finding a date, the first Midwest Consortium of Global Child Health Educators meeting was held in Madison, WI. Now, after a dozen annual meetings, more than 30 articles, chapters, abstracts, and workshops, as well as the creating, piloting, and sharing of several widely used curricula in global health education, the founding consortium members share the practical steps for faculty looking to form similar regional consortia around shared interests. In this article, the authors provide a recipe for the successful formation of an academic consortium based on the lessons learned from their experience. [Pediatr Ann. 2023;52(9):e351-e356.].
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Ansia , Educación en Salud , Niño , Humanos , Salud InfantilRESUMEN
OBJECTIVE: School attendance by children with medical complexity (CMC) may be influenced by parent perceptions of their child's risk for coronavirus disease 2019 (COVID-19). The authors of this study aimed to quantify in-person school attendance and identify attendance predictors. METHODS: From June to August 2021, surveys were collected from English- and Spanish-speaking parents of children aged 5 to 17 years with ≥1 complex chronic condition who received care at an academic tertiary children's hospital in the Midwestern United States and who attended school prepandemic. The outcome, in-person attendance, was defined dichotomously as any in-person attendance versus none. We evaluated parent-perceived school attendance benefits, barriers, motivation, and cues, COVID-19 severity and susceptibility using survey items derived from the health belief model (HBM). Latent HBM constructs were estimated with exploratory factor analysis. Associations between the outcome and the HBM were evaluated with multivariable logistic regression and structural equation models. RESULTS: Among 1330 families (response rate 45%), 19% of CMC were not attending in-person school. Few demographic and clinical variables predicted school attendance. In adjusted models, family-perceived barriers, motivation, and cues predicted in-person attendance, whereas benefits, susceptibility, and severity did not. The predicted probability (95% confidence interval) of attendance ranged from 80% (70% to 87%) for high perceived barriers to 99% (95% to 99%) for low perceived barriers. Younger age (P <.01) and previous COVID-19 infection (P = .02) also predicted school attendance. CONCLUSIONS: Overall, 1 in 5 CMC did not attend school at the end of the 2020 to 2021 academic year. Family perceptions of schools' mitigation policies and encouragement of attendance may be promising avenues to address this disparity.
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COVID-19 , Humanos , Niño , Instituciones Académicas , Padres , Encuestas y Cuestionarios , Medio Oeste de Estados UnidosRESUMEN
Pediatric residents participating in global health electives (GHEs) report an improved knowledge of medicine and health disparities. However, GHEs may pose challenges that include cost, personal safety, or individual mental health issues. The objective of this study was to describe the use of guided reflections to understand resident resilience during GHEs. Forty-five residents enrolled in two pediatric training programs were asked to respond in writing to weekly prompts during a GHE and to complete a post-trip essay. Analysis of the reflections and essays, including an inductive thematic analysis, was completed. Two coders performed a second analysis to support classification of themes within the Flinders Student Resilience (FSR) framework. Four themes emerged from the initial analysis: 1) benefits, 2) stresses and challenges, 3) career development, and 4) high-value care. Analysis using the FSR framework revealed the following themes: acknowledgment of personal limitations, importance of relationships in coping throughout the GHE, and discernment of career focus. Reflective writing provided insight into how residents mitigate GHE challenges and develop resilience. Despite statements of initial distress, residents focused on their personal benefits and growth during the GHE. The FSR framework revealed the residents' robust self-awareness of limitations and that strong relationships on the ground and at home were associated with perceived benefits and growth. Programs should consider helping residents to identify healthy coping practices that can promote personal resilience during GHEs as part of pre-departure preparation and debriefing, as well as providing for supportive communities during the GHE.
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Salud Global , Internado y Residencia , Niño , Humanos , EscrituraRESUMEN
OBJECTIVES: We evaluated the impact of distancing practices on secondary transmission of severe acute respiratory syndrome coronavirus 2 and the degree of sports-associated secondary transmission across a large diverse cohort of schools during spring 2021. METHODS: Participating districts in North Carolina and Wisconsin and North Carolina charter schools offering in-person instruction between March 15, 2021 and June 25, 2021 reported on distancing policies, community- and school-acquired infections, quarantines, and infections associated with school-sponsored sports. We calculated the ratio of school-acquired to community-acquired infection, secondary attack rates, and the proportion of secondary transmission events associated with sports. To estimate the effect of distancing and bus practices on student secondary transmission, we used a quasi-Poisson regression model with the number of primary student cases as the denominator. RESULTS: During the study period, 1 102 039 students and staff attended in-person instruction in 100 North Carolina school districts, 13 Wisconsin school districts, and 14 North Carolina charter schools. Students and staff had 7865 primary infections, 386 secondary infections, and 48 313 quarantines. For every 20 community-acquired infections, there was 1 within-school transmission event. Secondary transmissions associated with school sports composed 46% of secondary transmission events in middle and high schools. Relaxed distancing practices (<3 ft, 3 ft) and increased children per bus seat were not associated with increased relative risk of secondary transmission. CONCLUSIONS: With universal masking, in-person education was associated with low rates of secondary transmission, even with less stringent distancing and bus practices. Given the rates of sports-associated secondary transmission, additional mitigation may be warranted.
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COVID-19/epidemiología , COVID-19/transmisión , Instituciones Académicas , Adolescente , Niño , Preescolar , Control de Enfermedades Transmisibles , Humanos , North Carolina/epidemiología , Distanciamiento Físico , Cuarentena/estadística & datos numéricos , Deportes , Wisconsin/epidemiologíaRESUMEN
OBJECTIVES: To identify factors associated with the decision to provide in-person, hybrid, and remote learning in kindergarten through 12th grade school districts during the 2020-2021 school year. METHODS: We performed a retrospective study evaluating school district mode of learning and community coronavirus 2019 (COVID-19) incidence and percentage positivity rates at 3 time points during the pandemic: (1) September 15, 2020 (the beginning of the school year, before Centers for Disease Control and Prevention guidance); (2) November 15, 2020 (midsemester after the release of Centers for Disease Control and Prevention guidance and an increase of COVID-19 cases); and (3) January 15, 2021 (start of the second semester and peak COVID-19 rates). Five states were included in the analysis: Michigan, Missouri, North Carolina, Ohio, and Wisconsin. The primary outcome was mode of learning in elementary, middle, and high schools during 3 time points. The measures included community COVID-19 incidence and percentage positivity rates, school and student demographics, and county size classification of school location. RESULTS: No relationship between mode of learning and community COVID-19 rates was observed. County urban classification of school location was associated with mode of learning with school districts in nonmetropolitan and small metropolitan counties more likely to be in-person. CONCLUSIONS: Community COVID-19 rates did not appear to influence the decision of when to provide in-person learning. Further understanding of factors driving the decisions to bring children back into the classroom are needed. Standardizing policies on how schools apply national guidance to local decision-making may decrease disparities in emergent crises.
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COVID-19 , Educación a Distancia/estadística & datos numéricos , Población Urbana , Adolescente , Niño , Preescolar , Humanos , Estudios Retrospectivos , Estados UnidosRESUMEN
OBJECTIVES: The chronic conditions and functional limitations experienced by children with medical complexity (CMC) place them at disproportionate risk for COVID-19 transmission and poor outcomes. To promote robust vaccination uptake, specific constructs associated with vaccine hesitancy must be understood. Our objective was to describe demographic, clinical, and vaccine perception variables associated with CMC parents' intention to vaccinate their child against COVID-19. METHODS: We conducted a cross-sectional survey (June-August 2021) for primary caregivers of CMC between ages 5 to 17 at an academic medical center in the Midwest. Multivariable logistic regression examined associations between vaccination intent and selected covariates. RESULTS: Among 1330 families, 65.8% indicated vaccination intent. In multivariable models, demographics had minimal associations with vaccination intent; however, parents of younger children (<12 years) had significantly lower adjusted odds of vaccination intent (adjusted odds ratio [95% confidence interval]: 0.26 [0.17-0.3]) compared to parents of older children (≥12 years). CMC with higher severity of illness, ie, those with ≥1 hospitalization in the previous year (versus none) or >1 complex chronic condition (vs 1), had higher adjusted odds of vaccination intent (1.82 [1.14-2.92] and 1.77 [1.16-2.71], respectively). Vaccine perceptions associated with vaccine intention included "My doctor told me to get my child a COVID-19 vaccine" (2.82 [1.74-4.55]); and "I'm concerned about my child's side effects from the vaccine" (0.18 [0.12-0.26]). CONCLUSIONS: One-third of CMC families expressed vaccine hesitation; however, constructs strongly associated with vaccination intent are potentially modifiable. Pediatrician endorsement of COVID-19 vaccination and careful counseling on side effects might be promising strategies to encourage uptake.
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Vacunas contra la COVID-19 , COVID-19 , Adolescente , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19/uso terapéutico , Niño , Preescolar , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Intención , Padres/psicología , VacunaciónRESUMEN
The coronavirus disease 2019 (COVID-19) pandemic forced the suspension of in-person education in schools serving students in kindergarten through 12th grade (K-12) across the United States. As time passed, teachers, students, and parents struggled with remote education. With limited guidance at the federal level, physicians and school leaders across the country collaborated to develop local solutions for schools. This article describes the lessons learned from the development of 4 academic-community partnerships and collaboration among these partnerships to provide national leadership on managing COVID-19 mitigation in the K-12 environment. In addition, we describe a pathway forward for using academic-community partnerships to improve child health.
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Centros Médicos Académicos , COVID-19 , Relaciones Comunidad-Institución , Pandemias , Instituciones Académicas , HumanosRESUMEN
OBJECTIVES: To establish statewide consensus priorities for safer in-person school for children with medical complexity (CMC) during the coronavirus disease 2019 (COVID-19) pandemic using a rapid, replicable, and transparent priority-setting method. METHODS: We adapted the Child Health and Nutrition Research Initiative Method, which allows for crowdsourcing ideas from diverse stakeholders and engages technical experts in prioritizing these ideas using predefined scoring criteria. Crowdsourcing surveys solicited ideas from CMC families, school staff, clinicians and administrators through statewide distribution groups/listservs using the prompt: "It is safe for children with complex health issues and those around them (families, teachers, classmates, etc.) to go to school in-person during the COVID-19 pandemic if/when " Ideas were aggregated and synthesized into a unique list of candidate priorities. Thirty-four experts then scored each candidate priority against 5 criteria (equity, impact on COVID-19, practicality, sustainability, and cost) using a 5-point Likert scale. Scores were weighted and predefined thresholds applied to identify consensus priorities. RESULTS: From May to June 2021, 460 stakeholders contributed 1166 ideas resulting in 87 candidate priorities. After applying weighted expert scores, 10 consensus CMC-specific priorities exceeded predetermined thresholds. These priorities centered on integrating COVID-19 safety and respiratory action planning into individualized education plans, educating school communities about CMC's unique COVID-19 risks, using medical equipment safely, maintaining curricular flexibility, ensuring masking and vaccination, assigning seats during transportation, and availability of testing and medical staff at school. CONCLUSIONS: Priorities for CMC, identified by statewide stakeholders, complement and extend existing recommendations. These priorities can guide implementation efforts to support safer in-person education for CMC.
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COVID-19/prevención & control , Control de Infecciones/métodos , Afecciones Crónicas Múltiples , Seguridad , Instituciones Académicas , Adolescente , Adulto , Niño , Salud Infantil , Consenso , Colaboración de las Masas , Femenino , Política de Salud , Humanos , Masculino , Persona de Mediana Edad , Participación de los Interesados , Wisconsin , Adulto JovenRESUMEN
PURPOSE OF REVIEW: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), continues to affect individuals, communities, and health systems worldwide. Here, we highlight how COVID-19 threatens to jeopardize the tremendous gains made over the last few decades on improving children's health globally. RECENT FINDINGS: In contrast to adults, children with COVID-19 are less likely to develop severe disease requiring hospitalization or die as a direct result of infection. However, the pandemic will likely have other important health impacts disproportionately affecting vulnerable children globally. Possible effects include worsening of poverty and food insecurity; disruption of already strained routine child health services; damage to already imperiled healthcare workforces; a wave of mental health challenges; interruption of education; and increased risks of violence, abuse, exploitation, and neglect. These challenges notwithstanding, the response to COVID-19 may also provide opportunities, such as for health system strengthening, that could improve child health after the pandemic. SUMMARY: The negative impacts of COVID-19 on global child health may be substantial. However, these are not foregone conclusions and much can be done to mitigate the worst outcomes. Child health providers should advocate for an equitable response to COVID-19 that prioritizes the health of vulnerable children and furthers the gains made in global child health.
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BACKGROUND: Interest in global health (GH) among pediatric residents continues to grow. GH opportunities in pediatric fellowship programs in the United States are poorly described. We aimed to evaluate GH offerings among accredited general and subspecialty pediatric fellowship programs and identify implementation barriers. METHODS: This was a cross-sectional study by pediatric GH educators from the Association of Pediatric Program Directors Global Health Learning Community and the American Board of Pediatrics Global Health Task Force. Fellowship program directors and GH educators at accredited US pediatric fellowship programs were surveyed. Data were analyzed by using descriptive and comparative statistics. RESULTS: Data were obtained from 473 of 819 (57.8%) fellowship programs, representing 111 institutions. Nearly half (47.4%) offered GH opportunities as GH electives only (44.2%) or GH tracks and/or fellowships (3.2%) (GHT/Fs). Pretravel preparation and supervision were variable. Programs offering GH opportunities, compared to those without, were more likely to report that GH training improves fellow education (81.9% vs 38.3%; P < .001) and recruitment (76.8% vs 35.9%; P < .001). Since 2005, 10 programs with GHT/Fs have graduated 46 fellows, most of whom are working in GH. Of those with GHT/Fs, 71% believe national accreditation of GH fellowships would define minimum programmatic standards; 64% believe it would improve recruitment and legitimize GH as a subspecialty. CONCLUSIONS: GH experiences are prevalent in accredited US pediatric fellowship programs, and programs offering GH perceive that these opportunities improve fellow education and recruitment. Responses suggest that standards for GH opportunities during fellowship would be useful, particularly regarding pretravel preparation and mentorship for trainees.
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Becas , Salud Global/educación , Pediatría/educación , Canadá , Estudios Transversales , Becas/estadística & datos numéricos , Humanos , Tutoría/estadística & datos numéricos , Pediatría/estadística & datos numéricos , Estados UnidosRESUMEN
PROBLEM: Approximately 25% of trainees participate in a global health elective during their undergraduate or graduate medical education. Increasingly, educators in the United States and international partners are calling for improved predeparture preparation training for global health experiences. Yet, freely available, easily modifiable curricula are rare. APPROACH: Educators who created the Simulation Use for Global Away Rotations (SUGAR) curriculum formed a workgroup in September 2017 to develop the SUGAR Pre-Departure Activities Curricular Kit (S-PACK). Using Kern's 6-step approach to curriculum development, they identified 10 essential domains for global health preparation, developed learning objectives, created interactive activities pertinent to those domains using different education strategies, piloted and refined the curriculum, packaged it for online facilitator training, and disseminated it in March 2018. OUTCOMES: The S-PACK curriculum includes 6 interactive, modifiable modules that use a variety of educational strategies to enable educators to comprehensively prepare trainees for global health electives. Modules incorporate simulations, procedural training, small-group case-based discussions, and reflection exercises on topics ranging from providing treatment when resources are limited to mitigating culture shock to considering wellness while away. Each module includes a facilitator training packet, curricular resources, and introduction videos. All are freely available at sugarprep.org. NEXT STEPS: Since an initial in-person workshop at a national conference, the S-PACK curriculum has been available online. Further evaluation is underway, including developing assessments for educators to measure trainee readiness for global health electives. Piloting the feasibility of regional S-PACK preparation bootcamps to support training programs with limited global health resources is planned.
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Curriculum , Educación de Postgrado en Medicina/métodos , Educación de Pregrado en Medicina/métodos , Salud Global/educación , Humanos , Desarrollo de Programa , Estados UnidosRESUMEN
BACKGROUND: A significant and growing proportion of US children have immigrant parents, an issue of increasing importance to pediatricians. Training globally minded pediatric residents to address health inequities related to globalization is an important reason to expand educational strategies around local global health (LGH). METHODS: We developed a curriculum in the pediatric global health residency track at the University of Wisconsin in an effort to address gaps in LGH education and to increase resident knowledge about local health disparities for global community members. This curriculum was founded in asset-based community development (ABCD), a strategy used in advocacy training but not reported in global health education. RESULTS: The initial curriculum outputs have provided the foundation for a longitudinal LGH curriculum and a community-academic partnership. Supported by a community partnership grant, this partnership is focused on establishing a community-based postpartum support group for local Latinos, with an emphasis on building capacity in the Latino community. CONCLUSIONS: Aspects of this curriculum can serve other programs looking to develop LGH curricula rooted in building local partnerships and capacity using an ABCD model.
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Relaciones Comunidad-Institución , Educación de Postgrado en Medicina/métodos , Hispánicos o Latinos , Internado y Residencia , Curriculum , Emigrantes e Inmigrantes , Medicina Familiar y Comunitaria/educación , Salud Global , Disparidades en el Estado de Salud , Humanos , Pediatría/educación , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Facultades de Medicina , WisconsinRESUMEN
Pediatric practitioners whose expertise is primarily focused on the care of children within health settings in the United States are increasingly engaged in global child health (GCH). The wide spectrum of this involvement may include incorporating short-term or longer-term GCH commitments in clinical care, teaching and training, mentoring, collaborative research, health policy, and advocacy into a pediatric career. We provide an overview of routes of engagement, identify resources, and describe important considerations for and challenges to better equipping US pediatric practitioners to participate in meaningful GCH experiences. This article is part of a series on GCH describing critical issues relevant to caring for children from an international perspective.
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Salud Global/tendencias , Pediatras/psicología , Pediatras/tendencias , Relaciones Médico-Paciente , Niño , HumanosRESUMEN
STATEMENT: Providers and educators increasingly participate in global health work during their careers. Simulation can play an important role in both preparing learners for work in resource-limited settings and training providers in these countries. However, little guidance exists for educators interested in creating and implementing scenarios for these settings. We discuss several key considerations unique to global health simulation ranging from addressing common cultural differences surrounding healthcare and varied regional approaches to disease identification and management to understanding precisely what resources exist in the setting and what strategies can be used to provide care when the expected resources are not available. We also discuss specific strategies for considering sustainability and for facilitating scenarios in these settings. We developed our recommendations on the basis of existing literature and our own work designing and implementing simulation curricula in resource-limited countries and preparing providers for work in these settings.
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Competencia Cultural , Países en Desarrollo , Salud Global , Entrenamiento Simulado/organización & administración , Conducta Cooperativa , Equipos y Suministros de Hospitales/provisión & distribución , Asignación de Recursos para la Atención de Salud/métodos , Humanos , Preparaciones Farmacéuticas/provisión & distribución , Terminología como AsuntoRESUMEN
Although there has been rapid growth in global health educational experiences over the last two decades, the flow of learners remains overwhelmingly one directional; providers from high-resourced settings travel to limited-resourced environments to participate in clinical care, education, and/or research. Increasingly, there has been a call to promote parity in partnerships, including the development of bidirectional exchanges, where trainees from each institution travel to the partner's setting to learn from and teach each other. As global health educators and steering committee members of the Association of Pediatric Program Directors Global Health Pediatric Education Group, we endorse the belief that we must move away from merely sending learners to international partner sites and instead become true global health partners offering equitable educational experiences. In this article, we summarize the benefits, review common challenges, and highlight solutions to hosting and providing meaningful global health experiences for learners from limited-resourced partner institutions to academic health centers in the United States.
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Conducta Cooperativa , Educación Médica/organización & administración , Salud Global/educación , Cooperación Internacional , Intercambio Educacional Internacional , Pediatría/educación , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados UnidosRESUMEN
The authors describe a multiinstitutional collaborative project to address a gap in global health training by creating a free online platform to share a curriculum for performing procedures in resource-limited settings. This curriculum called PEARLS (Procedural Education for Adaptation to Resource-Limited Settings) consists of peer-reviewed instructional and demonstration videos describing modifications for performing common pediatric procedures in resource-limited settings. Adaptations range from the creation of a low-cost spacer for inhaled medications to a suction chamber for continued evacuation of a chest tube. By describing the collaborative process, we provide a model for educators in other fields to collate and disseminate procedural modifications adapted for their own specialty and location, ideally expanding this crowd-sourced curriculum to reach a wide audience of trainees and providers in global health.
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Curriculum , Educación en Salud , Internet , Conducta Cooperativa , Colaboración de las Masas , Salud Global , Recursos en Salud , HumanosRESUMEN
Child mortality remains a global health challenge and has resulted in demand for expanding the global child health (GCH) workforce over the last 3 decades. Institutional partnerships are the cornerstone of sustainable education, research, clinical service, and advocacy for GCH. When successful, partnerships can become self-sustaining and support development of much-needed training programs in resource-constrained settings. Conversely, poorly conceptualized, constructed, or maintained partnerships may inadvertently contribute to the deterioration of health systems. In this comprehensive, literature-based, expert consensus review we present a definition of partnerships for GCH, review their genesis, evolution, and scope, describe participating organizations, and highlight benefits and challenges associated with GCH partnerships. Additionally, we suggest a framework for applying sound ethical and public health principles for GCH that includes 7 guiding principles and 4 core practices along with a structure for evaluating GCH partnerships. Finally, we highlight current knowledge gaps to stimulate further work in these areas. With awareness of the potential benefits and challenges of GCH partnerships, as well as shared dedication to guiding principles and core practices, GCH partnerships hold vast potential to positively impact child health.