Examining partnerships within an international knowledge translation network focused on youth mental health promotion.

BACKGROUND: Systems transformation for health promotion, involving engagement from multiple disciplines and levels of influence, requires an investment in partnership development. Integrated youth service is a collaborative model that brings organisations together to provide holistic care for youth. Frayme is an international knowledge translation network designed to support the uptake and scaling of integrated youth service. Social network analysis (SNA) is the study of relationships among social units and is useful to better understand how partners collaborate within a network to achieve major objectives. The purpose of this paper is to apply SNA to the Frayme network in order to (1) examine the level and strength of partnerships, (2) identify the strategies being employed to promote the main objectives and (3) apply the findings to current research in youth mental health and system transformation. METHODS: The PARTNER tool includes a validated survey and analysis software designed to examine partner interconnections. This tool was used to perform the SNA and 51 of the 75 partners completed the survey (14 researchers, 2 advisory groups and 35 organisations). A network map was created and descriptive frequencies were calculated. RESULTS: The overall network scores for the Frayme network were 20.6% for density, 81.5% for centralisation and 71.7% for overall trust. The Frayme secretariat received a 3.84 out of a possible 4 for value. In addition, the youth and family advisories each received a value score of 4 and all Leadership Team organisations received a score of 2.97 or above. CONCLUSIONS: The Frayme secretariat links many partners who would otherwise be disconnected and acts as a significant conduit for novel information. Frayme may have the opportunity to enhance value perceptions among broader network members by profiling individual organisations and the potential leveraging opportunities that might exist through their work. These findings increase understanding with respect to the mechanisms of network development and will be helpful to inform partnership development in the future. In addition, they contribute to the literature with respect to knowledge translation practice as well as the scaling of collaborative interventions within youth mental health.

Towards reframing health service delivery in Uganda: the Uganda Initiative for Integrated Management of Non-Communicable Diseases.

BACKGROUND: The burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) is accelerating. Given that the capacity of health systems in LMICs is already strained by the weight of communicable diseases, these countries find themselves facing a double burden of disease. NCDs contribute significantly to morbidity and mortality, thereby playing a major role in the cycle of poverty, and impeding development. METHODS: Integrated approaches to health service delivery and healthcare worker (HCW) training will be necessary in order to successfully combat the great challenge posed by NCDs. RESULTS: In 2013, we formed the Uganda Initiative for Integrated Management of NCDs (UINCD), a multidisciplinary research collaboration that aims to present a systems approach to integrated management of chronic disease prevention, care, and the training of HCWs. DISCUSSION: Through broad-based stakeholder engagement, catalytic partnerships, and a collective vision, UINCD is working to reframe integrated health service delivery in Uganda.

Achievements of the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences in South-Southeast Asia.

Since 2008, the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences has contributed to ensuring the substitution of sharp curettage by manual vacuum aspiration (MVA) and medical abortion in selected hospitals in participating countries of South-Southeast Asia. This initiative facilitated the registration of misoprostol in Pakistan and Bangladesh, and the approval of mifepristone for "menstrual regulation" in Bangladesh. The Pakistan Nursing Council agreed to include MVA and medical abortion in the midwifery curriculum. The Bangladesh Government has approved the training of nurses and paramedics in the use of MVA to treat incomplete abortion in selected cases. The Sri Lanka College of Obstetricians and Gynaecologists, in collaboration with partners, has presented a draft petition to the relevant authorities appealing for them to liberalize the abortion law in cases of rape and incest or when lethal congenital abnormalities are present. Significantly, the initiative has introduced or strengthened the provision of postabortion contraception.

Primary mental health care for survivors of collective sexual violence in Rwanda.

This paper draws attention to the obligation and opportunity to respond to the mental health impacts of collective sexual violence (CSV) among genocide-rape survivors in post-genocide Rwanda. Qualitative data gathered from CSV survivors who were members of Rwandan women's genocide survivor associations are presented to illustrate how they strive to overcome adversity while seeking access to quality mental health care and using informal community mental health services. The results reveal that a system of high quality, holistic health and mental health care is yet needed to meet Rwandan CSV survivors' complex and serious health and mental health needs. Given that a rural health system, modelled on community-based, comprehensive HIV/AIDS care and treatment, is currently being implemented in Rwanda, we recommend enhancements to this model that would contribute to meeting the mental health care needs of CSV survivors while benefiting the health and mental health system as a whole within Rwanda.

The NGDO Co-ordination Group for Onchocerciasis Control.

Since the beginning of the donation of Mectizan by Merck & Co., Inc., non-governmental development organizations (NGDO) have been actively involved in the mass distribution of this drug to control onchocerciasis. In 2006, the network of NGDO involved in onchocerciasis control assisted in the treatment of over 62 million people. The current strategy that is used for distribution in Africa, community-directed treatment with ivermectin (CDTI), is very well suited for integration with other health activities. NGDO have been the pioneers in integrating comprehensive eye care, insecticide-treated nets for malaria, the control of multiple 'neglected' tropical diseases, and vitamin-A supplementation. These expanded activities bring with them new challenges, which need to be addressed by all partners and where the NGDO will play an active role.

Visceral leishmaniasis control in Thi Qar Governorate, Iraq, 2003.

Since 1991, visceral leishmaniasis has extended to new areas rarely affected before in Iraq, such as the southern governorates. In 2003, in the aftermath of the invasion of the Coalition Forces, Thi Qar Governorate was at high risk for an outbreak of visceral leishmaniasis. This paper describes the cooperation of an international nongovernmental organization and a district primary health care department to restore the visceral leishmaniasis control programme in Thi Qar in 2003 and prevent a major outbreak of visceral leishmaniasis. It also discusses the lessons learned and presents recommendations for the future.

Donor agencies' involvement in reproductive health: saying one thing and doing another?

The debates about what services constitute reproductive health, how these services should be organized, managed, and delivered, and what the role of donor agencies' support should be mirror the long-standing debates on how best to implement primary health care. After briefly reviewing the development of the discourse on primary health care and reproductive health, the authors present results of qualitative research in Ghana, Kenya, and Zambia that indicate a range of factors influencing and explaining the way donors operate in these countries and consider the implications of these results for the delivery of comprehensive reproductive health services. These findings are compared with South Africa, a country with limited donor activity. In the light of the complex interplay of factors, the authors suggest that donors' words and actions frequently do not correlate. Conclusions are drawn as to the potential for donor support for integrated reproductive health service delivery in sub-Saharan Africa, drawing on the research to provide lessons and a reappraisal of the role of donors in health sector aid.

Health sector reform in Argentina: a cautionary tale.

In November 2002 the World Bank published a report on the Argentine health sector. The report accurately portrays the complexity and severity of the problems facing the health care system. It stresses that these problems are not purely a product of the country's economic collapse, noting that the system has suffered from long-standing structural problems and inefficiencies. Curiously, the report makes no mention of the leading role played by the World Bank in health reform efforts during the 1990s. This paper demonstrates that these reforms did much to worsen pre-existing weaknesses of the sector. The paper criticises the content of the reform agenda and the manner in which it was produced, arguing that these were reforms in which considerations of public health were less significant than conformity to the wider model of neo-liberal social and economic development prevailing at the time. It also highlights problems of implementing the reform agenda, which reduced the coherency of the reforms. The paper goes on to examine the impact of the crisis, noting links with the preceding reforms. It identifies a number of insights and lessons of potential value to other countries which are pursuing similar policies.

The Nordic Council for Arctic Medical Research. History, aims and achievements.

The Organization of Nordic Council for Arctic Medical Research (NCAMR, or NoSAMF in Scandinavian languages) was initiated by the governmental Nordic Council in 1966. The new council was charged with the task of promoting arctic medical research in the Nordic countries. It began its duties in 1969. Originally the council covered Denmark, Finland, Norway and Sweden; Iceland joined as a member in 1977. During the first years the NCAMR held two to three conferences a year, the proceedings of which were communicated in the Nordic Council for Arctic Medical Research Reports series, distributed in about 1500 copies, free of charge. In 1971, 1981, 1987 and 1993, the NCAMR hosted the International Congress on Circumpolar Health and played a pivotal role in the establishment of the International Union for Circumpolar Health (IUCH) in 1986. Thereafter, the activities of the NCAMR developed a much more international character. Accident prevention, cold research, pollution, family health and, in later years, the health of indigenous peoples, became priorities, along with the establishment of international research networks. The NCAMR's report series soon developed into an established international journal under the title Arctic Medical Research. The inter-governmental financial support to the NCAMR was discontinued at the end of 1996. Thereafter, the secretariat operated under the auspices of the University of Oulu. The International Journal for Circumpolar Health, as it was named from 1997, continued to flourish, being published by the IUCH, the Nordic Society for Circumpolar Health and the University of Oulu.

[Fight against doping--national and international developments after Tour de France 1998]. / Dopingbekämpfung--nationale und internationale Entwicklungen seit der Tour de France 1998.

After the scandal at the Tour de France 1998, the fight against doping was intensified on national as well as international levels. In particular, the foundation of the new World Anti-Doping Agency (WADA) has been a landmark: for the first time in the history of the fight against doping, there exists now an international structure that includes partners from the Olympic movement as well as from the governments. The importance of the WADA has already been demonstrated during the Olympic Games 2000 in Sydney. First, it conducted several thousands of un-announced doping tests internationally and second, members of the WADA acted as independent observers to judge the carrying out of doping controls during the games. In Switzerland, important new measures were taken in the past years: The introduction of an independent attorney for the judgment of sanctions or the employment of four professional doping control officers had a clear effect on the quality of doping controls. In addition, research--e.g. a survey on the perception of doping among the population or the development of new technologies for doping analysis--was intensified. In the fields of information and prevention, the existing printed material was extended with a website on doping (www.dopinginfo.ch). Furthermore, international cooperation to develop new didactical material for schools is intended. On the legal level, Switzerland will introduce a new law in mid 2001. It will enable the government to fight against the entourage of athletes when it provides doping substances to athletes. The sanctioning of athletes using doping will still be in the jurisdiction of the sports federations.

Baby massage classes and the work of the International Association of Infant Massage.

This article describes the role of the International Association of Infant Massage (IAIM) in promoting the importance of touch for the developing relationship between the parents and infants. Infants are unique personalities and it is important that the parent learns how to respond appropriately to the infant's needs. Infant massage classes can demonstrate and promote interaction with infants using eye-to-eye contact, recognizing infant cues, talking and singing, and responding in a loving and sensitive manner. The photographs are of an infant massage class held recently in Leicestershire.

Evaluation of cancer-preventive agents and strategies a new program at the International Agency for Research on Cancer.

About five years ago, the International Agency for Research on Cancer (IARC) initiated a new program, IARC Handbooks of Cancer Prevention, aimed at evaluating the evidence base for the cancer-preventive activity of various agents and strategies. To date (2001) 5 volumes have been published--1. Non-steroidalAnti-inflammatory Drugs, 2. Carotenoids, 3. Vitamin A, 4. Retinoids, and 5. Sunscreens--and volume 6 (Weight Control and Physical Activity) is in press. Future volumes will include evaluations of breast cancer screening (vol. 7) and fruits and vegetables (vol. 8).

[Principles and organization of tuberculosis control]. / Principes et organisation de la lutte antituberculeuse.

Tuberculosis control must be organized by establishing programmes that are then implemented rigorously. The aim is to eradicate tuberculosis by applying a set of treatment procedures. These include, in particular, the detection of infectious cases in symptomatic patients who present to health services and their rapid treatment with chemotherapy, which makes them non-infectious and ensures their full recovery. An essential part of the programme is the information system, which enables treatment results to be evaluated and the efficacy of the treatment to be monitored. The model of the International Union against Tuberculosis and Lung Disease (IUATLD) for low income countries has proved to be effective, and has been recognized as one of the most efficient health interventions. The eradication of tuberculosis is possible: tuberculosis has a slow endemic cycle and tuberculosis can be reduced faster than drug resistance can emerge. In addition, all the tools required for tuberculosis control are already available and HIV infection is not yet widespread in several of the countries where tuberculosis is prevalent. Nevertheless, there is an urgent need for the rigorous and standardized application of the methods we have developed.

The International Prisoners Aid Association and drug abuse control.

The International Prisoners Aid Association (IPAA) is concerned with the rehabilitation of offenders, including drug offenders. IPAA does not have the financial and human resources to establish working programmes for drug abuse control or for the treatment of drug-dependent persons. It does, however, contribute to efforts at the international level to combat the drug problem by supporting non-governmental agencies in different countries involved in the rehabilitation of drug-dependent persons and the prevention of drug abuse, by disseminating knowledge and information on current developments in the field among concerned members of the world community and by promoting and publishing cross-cultural research dealing with the drug problem at the preventive/control and treatment levels. IPAA has participated in international and regional conferences and seminars dealing with drug abuse, and numerous items on drug-related issues have been published in the IPAA Newsletter and in occasional reports. The present article provides a brief overview of the work of IPAA as it relates to drug control.