The Coalition of National Health Education Organizations: Recent Advances to Strengthen the Health Education Profession.

The Coalition of National Health Education Organizations (CNHEO) has existed since 1972, with a mission of bringing together national and international health education organizations who serve within the United States to seek joint actions in support of the health education profession. Much success and collaboration have occurred over the last 50 years, including developing and implementing the 2018-2025 strategic plan. The nine member organizations of the Coalition paused to review individual and collaborative work in addressing shared goals and objectives around policy and mandates, preparation and professional development, credentialing, identity and value of health education, health education workforce and diversity, and research and practice. Findings of this mid-progress strategic plan review suggest that great value is provided to the profession via the collaborative work of organizations (sharing of advocacy alerts and work, supporting training and certification efforts, etc.), but areas for improvement exist (more joint policy statements, better study and support for the profession, etc.). This article outlines important Coalition history for the profession, describes goal and objective accomplishments related to the CNHEO 2018-2025 strategic plan, and makes suggestions for future improvement designed to affect the health of the public and the health education profession.

Framing access to essential medicines in the context of Universal Health Coverage: a critical analysis of health sector strategic plans from eight countries in the WHO African region.

BACKGROUND: Framing affects how issues are understood and portrayed. This profoundly shapes the construction of social problems and how policy options are considered. While access to essential medicines (ATM) in the World Health Organization (WHO) African Region is often framed as a societal problem, there is dominance of medical and technically oriented approaches to analyze and remedy the situation. Hence, the systematic application of social science approaches, such as framing theory, remains under-explored. Through a framing analysis of National Strategic Plans (NSPs) from eight countries, this study explores the applicability and potential usefulness of framing theory to analyze essential medicines policies. METHODS: We inductively coded the relevant NSP textual fragments using the qualitative content analysis software ATLAS.ti.22. Benford and Snow's conceptualization of framing was used to organize the coded data into three frames: diagnostic (problems), prognostic (solutions) and motivational (values and ideological). RESULTS: The following five diagnostic frames were dominant or in-frame: medicine unavailability, ineffective regulation, weak supply chain management, proliferation of counterfeit (substandard or falsified) medicines and use of poor quality medicines. Diagnostic frames related to financing, affordability, efficiency and corruption were given limited coverage or out of frame. Prognostic frames corresponded with how these problems were framed. Whilst Universal Health Coverage (UHC) and its guiding principles was the dominant motivational frame, we identified some frame discordance between the global discourse and national level policies. CONCLUSIONS: Social science approaches such as framing analysis are applicable and useful to systematically analyze essential medicine aspects. By applying framing theory, we revealed that ATM aspects in the eight countries we analyzed are more often characterized in relation to availability at the expense of affordability which undermines UHC. We conclude that whilst UHC is a strong motivational frame to guide ATM aspects, it is insufficient to inform a comprehensive approach to address the problems related to ATM at country level. To effectively advance ATM, concerned actors need to realize such limitation and endeavor to gain a deeper understanding of how problems are framed and agendas are set at country level, the processes through which ideas and knowledge become policies, including the political demands, incentives and trade-offs facing decision-makers in selecting policy priorities.

SEAIC Specialty Forum: Analysis of the Current Situation of Allergology in Spain and Outlook for the Future.

BACKGROUND AND OBJECTIVES: Allergology has been a recognized medical specialty in Spain, with fully defined aims and competencies for more than 4 decades. However, in recent years, its visibility seems to have decreased somewhat. Objectives: To identify which specific factors have contributed to the waning of the importance of the specialty and find tangible solutions to consolidate its place as a front-line medical specialty. MATERIAL AND METHODS: An online population survey comprising 60 items of interest was prepared. The degree of agreement and the level of satisfaction with each item were assessed, and implementable initiatives in the short, medium, and long terms were defined in order to provide solutions to the issues identified. RESULTS: The survey was completed by a total of 167 specialists with an average of 18 years' experience. Most were from public reference hospitals, and 29.3% were heads of department. The line of action for which a good degree of agreement was achieved was to promote the inclusion of an allergist in multidisciplinary teams. The priority lines of action were to improve undergraduate and graduate training in allergology and specialized nursing, to identify curricula in Spain, and to develop robust teaching projects. CONCLUSIONS: The results revealed a high degree of homogeneity between professionals. The basic pillars highlighted were as follows: quality training, knowledge, and research in immunotherapy; an innovative portfolio of services endorsed by clinical practice guidelines; and presence in multidisciplinary teams and relevant hospital committees.

The 2019-2023 Strategic Plan of the Spanish Society of Radiological Protection (SEPR).

The Spanish Society for Radiological Protection (SEPR) is a scientific and technical organization that aims to bring together all radioprotection professionals from all the sectors of activity where ionizing and non-ionizing radiation is produced. The development of the SEPR's Strategic Plan every 5 years is the cornerstone of all the different activities that the Society carries out. This document establishes the SEPR goals and objectives for that period, as well as the activities planned to achieve them. It is a living and open document that draws on past experiences while looking to the future. The Strategic Plan 2019-2023, approved on June 2019, is the Third Strategic Plan of the SEPR. In its preparation, account has been taken of the experience obtained in the application of the two previous Strategic Plans, as well as of the new demands of the general public and of professionals in the area of radiological protection that have become apparent during the previous period. This paper describes the development of the current Strategic Plan, as well as the Plan itself, and briefly analyzes its implementation in the Conclusion.

College students' perceptions on sense of belonging and inclusion at the academic library during COVID-19.

This paper demonstrates how university students experienced and perceived inclusion in a public research university library context during COVID-19. Both quantitative (n = 3379) and qualitative data (n = 575) from the 2021 student survey were examined to explore students' library experiences and their perceptions of inclusion. The quantitative data revealed that students using both the physical and online library had the greatest sense of belonging, whereas students who never used any library resources had the least sense of belonging. The qualitative data further revealed that when students used the in-person library space they felt a sense of belonging, as well as feeling accepted and valued; on the other hand, it was hard for them to judge inclusion when they had not been in the library due to COVID-19. This finding suggests how academic libraries need to prepare for the hybrid environment (in-person and online) so that students using online resources and services feel connected to the library.

How actors, processes, context and evidence influenced the development of Malawi's Health Sector Strategic Plan II.

Health sector strategic plans are health policies outlining health service delivery in low- and middle- income countries, guiding health sectors to meet health needs while maximizing resources. However, little research has explored the formulation of these plans. This study utilized qualitative methods to explore the formulation of Malawi's Health Sector Strategic Plan II, including processes utilized, actors involved, important contextual factors and the use of evidence-based decision-making. Thirteen semi-structured key informant interviews with health policy actors were conducted to explore perceptions and experiences of formulating the policy. Data analysis used an inductive-deductive approach and interpretation of the data was guided by an adapted version of the Walt and Gilson Health Policy Triangle. Our results indicate that HSSP II formulation was complex and inclusive but that the Ministry of Health may have given up ownership of the formulation process to development partners to ensure their continued involvement. Disagreements between actors centered around inclusion of critical services in the Essential Health Package and selection of performance-based financing as purchasing strategy. Resource constraints and the Cashgate Scandal are critical contextual elements influencing the formulation and content of the policy. Evidence-based decision-making contributed to the plan's development despite respondents' divergent opinions regarding evidence availability, quality and the weight that evidence carried. The study raises questions regarding the roles of policy actors during health policy formulation, the inclusivity of health policy processes and their potential influence on government ownership of health policy, as well as the use of evidence in developing health sector strategic plans.

Charting the Path Forward: Development, Goals and Initiatives of the 2019 Infectious Diseases Society of America Strategic Plan.

In October 2018, the Infectious Diseases Society of America (IDSA) Board of Directors (BOD) decided to develop a 2019 IDSA Strategic Plan. The IDSA BOD has invested in strategic planning at regular intervals as part of an ongoing process to review and to renew the vision and direction of IDSA. Herein, the 2018-2019 strategic planning process and outcomes are described. The 2019 IDSA Strategic Plan presents 4 key initiatives: (1) optimize the development, dissemination, and adoption of timely and relevant ID guidance and guidelines that improve the outcomes of clinical care; (2) quantify, communicate, and advocate for the value of ID physicians to increase professional fulfillment and compensation; (3) facilitate the growth and development of the ID workforce to meet emerging scientific, clinical, and leadership needs; and (4) develop and position a new tool to serve as the leading US benchmark to measure and drive national progress on antimicrobial resistance. The BOD looks forward to developing, implementing, assessing, and advancing the 2019 IDSA Strategic Plan working with member volunteers, Society partners, and IDSA staff.

The American Gynecological and Obstetrical Society-reinvigorating for the 21st century.

The American Gynecological and Obstetrical Society (AGOS) has the potential to serve as a unifying organization to advocate for women's reproductive health care, education, and research. This report reviews a strategic plan designed to reinvigorate AGOS to address, together with our partner organizations, the ever more pressing issues and challenges in women's reproductive health.

Are new national malaria strategic plans informed by the previous ones? A comprehensive assessment of sub-Saharan African countries from 2001 to present.

BACKGROUND: New national malaria strategic plans (NMSPs) should build upon the achievements and challenges identified during the implementation of previous plans, but there is limited research on the transition process between NMSPs. This study aims to fill this gap through an assessment of NMSPs across sub-Saharan Africa. METHODS: The study reviewed the two most recent NMSPs for selected sub-Saharan African countries. Targets for six core malaria indicators were extracted from each NMSP and compared to the coverage achieved according to corresponding population-based surveys completed near the end of the NMSP term. Implementation challenges and proposed solutions identified through the NMSP analysis were documented. The current NMSP was reviewed to determine whether proposed solutions had been integrated into the strategy. RESULTS: Twenty-two countries in sub-Saharan Africa were included in the assessment. Of the 135 verified targets, only 4 were achieved. No country reached more than one of the six targets assessed in each NMSP. Despite this low success rate, only four of the 22 countries lowered a subsequent target, with most setting the next target at an equal or greater level. Most NMSPs identified solutions to address implementation challenges faced, but the solutions were not always fully incorporated in the new strategy. CONCLUSIONS: The results show a disconnect between NMSPs. Most targets were set according to global goals rather than the individual country's previous achievements and limitations. This indicates a need to revise the NMSP development process to guide programmes in defining targets based on their country context and incorporate strategies to address challenges identified in the previous NMSP. This will allow countries to set and meet achievable targets as they work toward global goals.

Consultative meeting that examined alignment and discrepancies between health facility and household survey data in Malawi.

Malawi is midway through its current Malaria Strategic Plan 2017-2022, which aims to reduce malaria incidence and deaths by at least 50% by 2022. Malariometric data are available with health surveillance data housed in District Health Information Software 2 (DHIS2) and household survey data from two recent Malaria Indicator Surveys (MIS) and a Demographic and Health Survey (DHS). Strengths and weaknesses of the data were discussed during a consultative meeting in Lilongwe, Malawi in July 2019. The first 3 days included in-depth exploration and analysis of surveillance and survey data by 13 participants from the National Malaria Control Programme, district health offices, and partner organizations. Key indicators derived from both DHIS2 and MIS/DHS sources were analysed with three case studies, and presented to stakeholders on the fourth day of the meeting. Applications of the findings to programmatic decision-making and strategic plan evaluation were critiqued and discussed.

Relating characteristics of global biodiversity targets to reported progress.

To inform governmental discussions on the nature of a revised Strategic Plan for Biodiversity of the Convention on Biological Diversity (CBD), we reviewed the relevant literature and assessed the framing of the 20 Aichi Biodiversity Targets in the current strategic plan. We asked international experts from nongovernmental organizations, academia, government agencies, international organizations, research institutes, and the CBD to score the Aichi Targets and their constituent elements against a set of specific, measurable, ambitious, realistic, unambiguous, scalable, and comprehensive criteria (SMART based, excluding time bound because all targets are bound to 2015 or 2020). We then investigated the relationship between these expert scores and reported progress toward the target elements by using the findings from 2 global progress assessments (Global Biodiversity Outlook and the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services). We analyzed the data with ordinal logistic regressions. We found significant positive relationships (p < 0.05) between progress and the extent to which the target elements were perceived to be measurable, realistic, unambiguous, and scalable. There was some evidence of a relationship between progress and specificity of the target elements, but no relationship between progress and ambition. We are the first to show associations between progress and the extent to which the Aichi Targets meet certain SMART criteria. As negotiations around the post-2020 biodiversity framework proceed, decision makers should strive to ensure that new or revised targets are effectively structured and clearly worded to allow the translation of targets into actionable policies that can be successfully implemented nationally, regionally, and globally.

Relación de las Características de los Objetivos Mundiales de Biodiversidad con el Progreso Reportado Resumen Para informar las discusiones gubernamentales sobre la naturaleza de una revisión del Plan Estratégico para la Biodiversidad del Convenio sobre la Diversidad Biológica (CBD, en inglés), revisamos la literatura relevante y evaluamos el marco de 20 Objetivos de Biodiversidad de Aichi en el plan estratégico actual. Le pedimos a expertos internacionales de organizaciones no gubernamentales, de la academia, de agencias gubernamentales, organizaciones internacionales, de institutos de investigación y de la CBD que puntuaran los Objetivos de Aichi y sus elementos constituyentes frente a un conjunto de criterios específicos, medibles, ambiciosos, realistas (basados en SMART [las iniciales en inglés] y excluyendo aquellos limitados por el tiempo, pues todos los objetivos están limitados al 2015 o al 2020), inequívocos, expansibles y completos (excluyendo aquellos limitados por el tiempo). Después investigamos la relación entre los puntajes de estos expertos y el progreso reportado hacia los elementos objetivo usando los resultados de dos valoraciones mundiales del progreso (el Pronóstico Mundial de la Biodiversidad y la Plataforma Intergubernamental de Ciencia y Política sobre la Biodiversidad y los Servicios Ambientales). Analizamos los datos con regresiones logísticas ordinales. Encontramos relaciones positivas significativas (p < 0.05) entre el progreso y el alcance al que fueron percibidos como medibles, realistas, inequívocos y expansibles los elementos objetivo. Hubo algo de evidencia de la relación entre el progreso y la ambición. Somos los primeros en mostrar las asociaciones entre el progreso y la extensión hasta la que los Objetivos de Aichi cumplen con ciertos criterios SMART. Conforme proceden las negociaciones en torno al marco de trabajo de biodiversidad post-2020, quienes toman las decisiones deberían esforzarse por asegurar que los objetivos nuevos o revisados estén estructurados efectivamente y redactados claramente para permitir la traducción de los objetivos hacia políticas factibles que puedan implementarse exitosamente a nivel nacional, regional y mundial.

Improving collaboration in the implementation of global biodiversity conventions.

Eight conventions make up the biodiversity cluster of multilateral environmental agreements (MEAs) that provide the critical international legal framework for the conservation and sustainable use of nature. However, concerns about the rate of implementation of the conventions at the national level have triggered discussions about the effectiveness of these MEAs in halting the loss of biodiversity. Two main concerns have emerged: lack of capacity and resources and lack of coherence in implementing multiple conventions. We focused on the latter and considered the mechanisms by which international conventions are translated into national policy. Specifically, we examined how the Strategic Plan for Biodiversity 2011-2020 and the associated Aichi Biodiversity Targets have functioned as a unifying grand plan for biodiversity conservation. This strategic plan has been used to coordinate and align targets to promote and enable more effective implementation across all biodiversity-related conventions. Results of a survey of 139 key stakeholders from 88 countries suggests streamlining across ministries and agencies, improved coordination mechanisms with all relevant stakeholders, and better knowledge sharing between conventions could improve cooperation among biodiversity-related conventions. The roadmap for improving synergies among conventions agreed to at the 13th Convention on Biological Diversity's Conference of Parties in 2016 includes actions such as mechanisms to avoid duplication in national reporting and monitoring on conventions and capacity building related to information and knowledge sharing. We suggest the scientific community can actively engage and contribute to the policy process by establishing a science-policy platform to address knowledge gaps; improving data gathering, reporting, and monitoring; developing indicators that adequately support implementation of national plans and strategies; and providing evidence-based recommendations to policy makers. The latter will be particularly important as 2020 approaches and work to develop a new biodiversity agenda for the next decade is beginning.

Mejora en la Colaboración en la Implementación de las Convenciones Mundiales sobre la Biodiversidad Resumen Ocho convenciones son las que forman la agrupación multilateral de acuerdos ambientales (MEAs, en inglés), los cuales proporcionan el marco de trabajo legal importante para la conservación y el uso sustentable de la naturaleza. Sin embargo, la preocupación por la tasa de implementación de estas convenciones a nivel nacional ha disparado discusiones sobre la efectividad de estas MEAs para detener la pérdida de la biodiversidad. Han surgido dos preocupaciones principales: la falta de capacidad y recursos y la falta de coherencia en la implementación de múltiples convenciones. Nos enfocamos en la segunda y consideramos los mecanismos mediante los cuales las convenciones internacionales se transforman en reglamentos y políticas nacionales. En específico, examinamos cómo el Plan Estratégico para la Biodiversidad 2011 - 2020 y los Objetivos de Biodiversidad de Aichi asociados han funcionado como un gran plan unificador para la conservación de la biodiversidad. Este plan estratégico se ha usado para coordinar y alinear los objetivos para promover y habilitar una implementación más efectiva a lo largo de todas las convenciones relacionadas con la biodiversidad. Los resultados de una encuesta entre 139 accionistas clave de 88 países sugieren la optimización en los ministerios y en las agencias, una coordinación mejorada de los mecanismos entre todos los accionistas relevantes, y una mejor partición del conocimiento entre las convenciones podría aumentar la cooperación entre las convenciones relacionadas con la biodiversidad. La hoja de ruta para mejorar las sinergias entre las convenciones, acordada en la Conferencia de Participantes de la 13ra Convención sobre la Diversidad Biológica en 2016, incluye acciones como los mecanismos para evitar la duplicación de reportes y monitoreos nacionales sobre las convenciones y la capacidad de construcción relacionada con la partición de la información y el conocimiento. Sugerimos que la comunidad científica pueda participar activamente y contribuir al proceso de políticas al establecer una plataforma política-científica que resuelva los vacíos en el conocimiento; mejore la recolección, reporte y monitoreo de datos, desarrolle indicadores que respalden adecuadamente a la implementación de planes y estrategias nacionales; y proporcione recomendaciones basadas en evidencia para los políticos. La última acción será de particular importancia conforme se aproxima el 2020 y se inicie la labor por desarrollar una nueva agenda de biodiversidad para la siguiente década.

Developing strategies for patient safety implementation: a national study in Iran.

PURPOSE: Today, healthcare organizations focus mainly on development and implementation of patient safety strategic plan to improve quality and ensure safety of provided services. The purpose of this paper is to recommend potential strategies for successful implementation of patient safety program in Iranian hospitals based on a strengths, weaknesses, opportunities, threats (SWOT) analysis. DESIGN/METHODOLOGY/APPROACH: In this qualitative study, key informant interviews and documentation review were done to identify strength and weakness points of Iranian hospitals in addition to opportunities and threats facing them in successful implementation of a patient safety program. Accordingly, the research team formulated main patient safety strategies and consequently prioritized them based on Quantitative Strategic Planning Matrix (QSPM) matrix. FINDINGS: The study recommended some of the potential patient safety strategies including provision of education for employees, promoting a safety culture in hospitals, managerial support and accountability, creating a safe and high-quality delivery environment, developing national legislations for hospital staff to comply with patient safety standards and developing a continuous monitoring system for quality improvement and patient safety activities to ensure the achievement of predetermined goals. PRACTICAL IMPLICATIONS: Developing a comprehensive and integrated strategic plan for patient safety based on accurate information about the health system's weaknesses, strengths, opportunities and threats and trying to implement the plan in accordance with patient safety principles can help hospitals achieve great success. ORIGINALITY/VALUE: Ministry of Health and Medical Education (MOHME) conducted a national study to recommend potential strategies for successful implementation of patient safety in Iranian hospitals based on a SWOT analysis and QSPM matrix.

Global rabies control: the role of international organisations and the Global Strategic Plan to eliminate dog-mediated human rabies.

International partners are united to reach the shared goal of zero dog-mediated human rabies deaths by 2030, worldwide. Under the Tripartite collaboration, the World Health Organization, the World Organisation for Animal Health and the Food and Agriculture Organization of the United Nations are prioritising rabies as a model for 'One Health' in action. In 2015, the Global Rabies Conference led to the development of the Global Framework for the Elimination of Dog-Mediated Human Rabies. This long-term strategy centres around five pillars of rabies elimination (STOP-R): i) Sociocultural; ii) Technical; iii) Organisational; iv) Political; and v) Resources. Together with their partners, the Tripartite are working to operationalise the Framework through: i) engaging communities to build rabies awareness; ii) strengthening human and animal health systems, surveillance, and providing proof of concept that rabies elimination is feasible; iii) promoting intersectoral and regional collaboration; iv) advocating for political engagement and support; and v) building the case for investment through public-private partnerships and a Global Strategic Plan to end human deaths from dog-mediated rabies. By creating an enabling environment for countries to prioritise rabies and implement existing tools, the Tripartite are committed to catalysing change, empowering nations and providing the necessary support to consign rabies to the history books.

Les partenaires internationaux agissent de concert afin d'atteindre l'objectif de réduire à zéro le nombre de décès dus à la rage humaine transmise par les chiens dans le monde d'ici 2030. Dans le cadre de leur collaboration tripartite, l'Organisation mondiale de la santé, l'Organisation mondiale de la santé animale et l'Organisation des Nations Unies pour l'alimentation et l'agriculture ont fait de la rage la maladie phare de leur action gouvernée par le principe « Une seule santé ¼. En 2015, la Conférence mondiale sur la rage a abouti à la création du Cadre stratégique mondial d'élimination de la rage humaine transmise par les chiens. Cette stratégie à long terme repose sur cinq piliers visant l'élimination de la rage (STOP-R) : i) aspects socioculturels ; ii) aspects techniques ; iii) aspects organisationnels ; iv) aspects politiques ; v) ressources. Avec ses partenaires, la Tripartite met tout en oeuvre pour rendre ce cadre opérationnel, notamment à travers i) la participation des communautés à des activités de sensibilisation sur la rage ; ii) le renforcement des systèmes de santé humaine et animale, l'application de la surveillance et la démonstration de la faisabilité de l'élimination de la rage ; iii) la promotion de la collaboration intersectorielle et régionale ; iv) l'appel actif en faveur d'un engagement et d'un soutien politiques ; v) la justification de la rentabilité des investissements à travers des partenariats public-privé et un plan d'activités pour l'élimination mondiale de la rage. En créant un environnement propice permettant aux pays de prioriser la rage et de mettre en application les instruments existants, la Tripartite s'est engagée à dynamiser le changement, à donner aux pays les capacités d'agir et à fournir le soutien nécessaire pour que le rage soit un jour reléguée dans les livres d'histoire.

Una serie de asociados internacionales trabajan codo a codo para alcanzar el objetivo común de que para 2030 no haya en el mundo ninguna persona que muera de rabia transmitida por perros. Como parte de una alianza tripartita, la Organización Mundial de la Salud (OMS), la Organización Mundial de Sanidad Animal (OIE) y la Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO) están otorgando prioridad a la lucha antirrábica como modelo para poner en práctica los postulados de «Una sola salud¼. En 2015, la conferencia mundial dedicada a la lucha contra la rabia culminó con la elaboración de un marco estratégico mundial para eliminar la rabia humana transmitida por perros. Se trata de una estrategia a largo plazo (STOP-R) edificada en torno a cinco grandes pilares: i) aspectos socioculturales; ii) aspectos técnicos; iii) aspectos organizativos; iv) políticas; y v) recursos. Junto con sus colaboradores, la alianza tripartita trabaja para llevar ese marco a la práctica: i) haciendo participar a las comunidades en la sensibilización respecto de la rabia; ii) fortaleciendo los sistemas sanitarios y zoosanitarios, efectuando labores de vigilancia y demostrando empíricamente que la eliminación de la rabia es un objetivo factible; iii) promoviendo la colaboración intersectorial y regional; iv) presionando para lograr el compromiso y apoyo políticos; y v) aportando argumentos en defensa de la inversión por la vía de alianzas publicoprivadas y elaborando un plan de trabajo para la eliminación de la rabia a escala mundial. La alianza tripartita, al crear condiciones propicias para que los países otorguen prioridad a la rabia y apliquen las herramientas existentes, está impulsando el cambio, dotando a las naciones de capacidad de acción y prestando el apoyo necesario para conseguir que un día la rabia quede relegada a los libros de historia.

Implementing national strategies on antimicrobial resistance in Thailand: potential challenges and solutions.

BACKGROUND: Thailand has developed a national strategic plan on antimicrobial resistance (NSP-AMR) and endorsed by the Cabinet in August 2016. This study reviewed the main contents of the NSP-AMR and the mandates of relevant implementing agencies and identified challenges and recommends actions to mitigate implementation gaps. METHODS: This study analysed the contents of NSP-AMR, reviewed institutional mandates and assessed the implementation gaps among agencies responsible for NSP-AMR. RESULTS: Two of six strategies are related to monitoring and surveillance of AMR and antimicrobial consumption in human and animal. Two other strategies aim to improve antibiotic stewardship and control the spread of AMR in both clinical and farm settings. The remaining two strategies aim to increase knowledge and public awareness on AMR and establish national governance for inter-sectoral actions. Strategies to overcome implementation challenges are sustaining cross-sectoral policy commitments, effective cross-sectoral coordination using One Health approach, generating evidence which guides policy implementation, and improving enforcement capacities in regulatory authorities. CONCLUSIONS: To address AMR, Thailand requires significant improvements in implementation capacities in two dimensions. First, technical capacities among implementing agencies are needed to translate policies into practice. Second, governance and organizational capacities enable effective multi-sectoral actions across human, animal, and environmental sectors.

The success of strategic planning in health care organizations of Iran.

Purpose Although strategic planning promised to boost organizational performance, many health care managers found it difficult to implement it successfully. The purpose of this paper is to investigate the success of strategic planning in health care organizations of Iran. Design/methodology/approach This descriptive and cross-sectional study was conducted in 2016 using a valid and reliable questionnaire completed by 99 health care managers in Tehran province, Iran. Findings Strategic planning was positively related to organizational performance including employees' and patients' satisfaction and organizational productivity. However, strategic planning was moderately successful in enhancing organizational performance of Iranian health care organizations (score of 2.84 out of 5). The most and least success was observed in the planning and employee management constructs of organizational performance. Process management, organizational culture and customer management constructs had the most effect on the success of strategic plans in health care organizations. Practical implications Strategic planning is effective and provides a clear focused direction for health care organizations. Understanding the success factors of strategic planning would enable managers to develop more effective methods for developing, implementing and evaluating strategic plans in health care organizations. Originality/value This paper highlights the relationship between strategic planning and organizational performance and offers suggestions on how to develop and implement strategic plans to achieve higher organizational performance.

Cost-effectiveness analysis of two treatment strategies for chronic hepatitis C before and after access to direct-acting antivirals in Spain. / Análisis coste-efectividad de dos estrategias de tratamiento para la hepatitis C crónica: antes y después del acceso a los agentes antivirales de acción directa en España.

OBJECTIVE: To evaluate the cost-effectiveness of a strategy based on direct-acting antivirals (DAAs) following the marketing of simeprevir and sofosbuvir (post-DAA) versus a pre-direct-acting antiviral strategy (pre-DAA) in patients with chronic hepatitis C, from the perspective of the Spanish National Health System. METHODS: A decision tree combined with a Markov model was used to estimate the direct health costs (€, 2016) and health outcomes (quality-adjusted life years, QALYs) throughout the patient's life, with an annual discount rate of 3%. The sustained virological response, percentage of patients treated or not treated in each strategy, clinical characteristics of the patients, annual likelihood of transition, costs of treating and managing the disease, and utilities were obtained from the literature. The cost-effectiveness analysis was expressed as an incremental cost-effectiveness ratio (incremental cost per QALY gained). A deterministic sensitivity analysis and a probabilistic sensitivity analysis were performed. RESULTS: The post-DAA strategy showed higher health costs per patient (€30,944 vs. €23,707) than the pre-DAA strategy. However, it was associated with an increase of QALYs gained (15.79 vs. 12.83), showing an incremental cost-effectiveness ratio of €2,439 per QALY. The deterministic sensitivity analysis and the probabilistic sensitivity analysis showed the robustness of the results, with the post-DAA strategy being cost-effective in 99% of cases compared to the pre-DAA strategy. CONCLUSIONS: Compared to the pre-DAA strategy, the post-DAA strategy is efficient for the treatment of chronic hepatitis C in Spain, resulting in a much lower cost per QALY than the efficiency threshold used in Spain (€30,000 per QALY).

Programmatic Implications of Acute and Early HIV Infection.

Human immunodeficiency virus (HIV) infection includes acute, early, chronic, and late stages. Acute HIV infection lasts approximately 3 weeks and early HIV infection, which includes acute HIV infection, lasts approximately 7 weeks. Many testing and blood screening algorithms detect HIV antibodies about 3 weeks after HIV infection. Incidence estimates are based on results of modeling, cohort studies, surveillance, and/or assays. Viral load is the key modifiable risk factor for HIV transmission and peaks during acute and early HIV infection. Empirical evidence characterizing the impact of acute and early HIV infection on the spread of the HIV epidemic are limited. Time trends of HIV prevalence collected from concentrated and generalized epidemics suggest that acute and early HIV infection may have a limited role in population HIV transmission. Collectively, these data suggest that acute and early HIV infection is relatively short and does not currently require fundamentally different programmatic approaches to manage the HIV/AIDS epidemic in most settings. Research and surveillance will inform which epidemic contexts and phases may require tailored strategies for these stages of HIV infection.

Allergy medical care network: a new model of care for specialties.

UNLABELLED: In 2005 the Althaia Foundation Allergy Department performed its daily activity in the Hospital Sant Joan de Deu of Manresa. Given the increasing demand for allergy care, the department's performance was analysed and a strategic plan (SP) for 2005-2010 was designed. The main objective of the study was to assess the impact of the application of the SP on the department's operations and organisational level in terms of profitability, productivity and quality of care. MATERIAL AND METHODS: Descriptive, retrospective study which evaluated the operation of the allergy department. The baseline situation was analysed and the SP was designed. Indicators were set to perform a comparative analysis after application of the SP. RESULTS: The indicators showed an increase in medical care activity (first visits, 34%; successive visits, 29%; day hospital treatments, 51%), high rates of resolution, reduced waiting lists. Economic analysis indicated an increase in direct costs justified by increased activity and territory attended. Cost optimisation was explained by improved patient accessibility, minimised absenteeism in the workplace and improved cost per visit. CONCLUSIONS: After application of the SP a networking system was established for the allergy speciality that has expanded the territory for which it provides care, increased total activity and the ability to resolve patients, optimised human resources, improved quality of care and streamlined medical costs.

The faculty of pain medicine of the Australian and New Zealand college of anaesthetists - history and strategic plan.

Since its formation, the Faculty of Pain Medicine (FPM) has grown into an organization with 369 fellows. It has 29 accredited pain medicine training units in Australia, New Zealand, Hong Kong, and Singapore. This article reviews the history of its birth and subsequent growth. The FPM fellowship is widely recognized as a high-quality qualification, based on a sound curriculum, excellent clinical exposure, and robust continuing professional development. But how does the Faculty position itself for the future? The Faculty's 5-year Strategic Plan (from 2013 to 2017) sets out its vision "to reduce the burden of pain in society through education, advocacy, training and research."