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2.
BMC Health Serv Res ; 21(1): 91, 2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33499868

RESUMO

BACKGROUND: Non-communicable diseases are leading causes of death and disability across the world. Countries with the highest non-communicable disease (NCD) burden in the WHO European Region are often those that have some of the greatest health system challenges for achieving good outcomes in prevention and care. The aim of this study was to evaluate the effect of an interprofessional capacity building intervention carried out in Ukraine to improve the management non-communicable diseases in primary health care. METHODS: A mixed-methods evaluation study was performed in 2018 to analyse the effect of a capacity building intervention carried out for over 10,000 primary care professionals in Ukraine in 2018. Quantitative data were collected from primary health care records of intervention and control areas preceding the intervention and 1.5 to 2 years after the intervention. Altogether 2798 patient records before and 2795 after the intervention were reviewed. In control areas, 1202 patient records were reviewed. Qualitative data were collected carrying out focus group interviews for health professionals, clinic managers and patients. Also, observations of clinical practice and patient pathways were performed. RESULTS: The capacity building intervention improved the capacity of professionals in detection and management of non-communicable disease risk factors. Significant improvement was seen in detection rates of both behavioural and biological risk factors and in medication prescription rates in the intervention areas. However, almost similar improvement in prescription rates was also observed in control clinics. Improvements in control of blood pressure, blood glucose and cholesterol were not seen during the evaluated implementation period. Qualitative analyses highlighted the improved knowledge and skills but challenges in changing the current practice. CONCLUSIONS: A large scale capacity building intervention improved primary health care professionals' knowledge, skills and clinical practice on NCD risk detection and reduction. We were not able to detect improvements in treatment outcomes - at least within 1.5 to 2 years follow-up. Improvement of treatment outcomes would most likely need more comprehensive systems change.


Assuntos
Fortalecimento Institucional , Atenção Primária à Saúde , Grupos Focais , Pessoal de Saúde , Humanos , Doenças não Transmissíveis , Ucrânia
3.
Health Res Policy Syst ; 19(1): 5, 2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33461564

RESUMO

The COVID-19 pandemic has created urgent demand around the world for knowledge generation about a novel coronavirus, its transmission, and control, putting academic institutions at the frontline of politics. While many academic institutions are well poised to conduct research, there are well-documented barriers for these institutions, particularly in low- and middle-income countries (LMICs), to further conduct strategic synthesis and dissemination to promote knowledge utilization among policy-makers. These systemic barriers to knowledge translation (KT) pose significant challenges for academic institutions seeking to take advantage of unprecedented policy windows to inform evidence-based decision-making. Global health funding organizations should prioritize the support of academic institutions' activities along the KT pathway, including both knowledge generation and strategic dissemination, to improve knowledge uptake for decision-making to improve health. Institutional capacity-building initiatives for KT have the potential to profoundly impact responses to this and future pandemics.


Assuntos
Fortalecimento Institucional , Países em Desenvolvimento , Saúde Global , Política de Saúde , Pandemias , Pesquisa Médica Translacional , Planejamento em Desastres , Prática Clínica Baseada em Evidências , Organização do Financiamento , Humanos , Conhecimento , Formulação de Políticas , Apoio à Pesquisa como Assunto , Instituições Acadêmicas , Pesquisa Médica Translacional/economia
4.
Health Commun ; 36(1): 42-49, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33225758

RESUMO

COVID-19 created a substantial set of challenges for health communication practitioners in the process of planning, implementing, and evaluating entertainment-education (EE) campaigns. EE is a theory and evidence-based communication strategy that employs entertainment media for educational messaging. Here, we briefly review EE campaigns in response to previous health emergencies and present three cases of EE responses to the COVID-19 pandemic from leading global organizations (PCI Media, BBC Media Action, and Sesame Workshop). Responses ranged from adaptation and re-distribution of existing content to creating new content under social-distancing restrictions and utilizing transmedia. These cases demonstrate that EE initiatives responding to future pandemics may be well served by starting with existing infrastructure to quickly build capacity, support, and trust; working with partners to tailor programs to the local context; and continuing to focus on good storytelling while simultaneously considering evolving media formats and theory.


Assuntos
/epidemiologia , Comunicação em Saúde/métodos , Educação em Saúde/organização & administração , Meios de Comunicação de Massa , Narração , Fortalecimento Institucional , Competência Cultural , Humanos , Estudos de Casos Organizacionais , Pandemias , Mídias Sociais , Confiança
5.
Global Health ; 16(1): 120, 2020 12 30.
Artigo em Inglês | MEDLINE | ID: mdl-33380341

RESUMO

BACKGROUND: The importance of integrating the social sciences in epidemic preparedness and response has become a common feature of infectious disease policy and practice debates. However to date, this integration remains inadequate, fragmented and under-funded, with limited reach and small initial investments. Based on data collected prior to the COVID-19 pandemic, in this paper we analysed the variety of knowledge, infrastructure and funding gaps that hinder the full integration of the social sciences in epidemics and present a strategic framework for addressing them. METHODS: Senior social scientists with expertise in public health emergencies facilitated expert deliberations, and conducted 75 key informant interviews, a consultation with 20 expert social scientists from Africa, Asia and Europe, 2 focus groups and a literature review of 128 identified high-priority peer reviewed articles. We also analysed 56 interviews from the Ebola 100 project, collected just after the West African Ebola epidemic. Analysis was conducted on gaps and recommendations. These were inductively classified according to various themes during two group prioritization exercises. The project was conducted between February and May 2019. Findings from the report were used to inform strategic prioritization of global investments in social science capacities for health emergencies. FINDINGS: Our analysis consolidated 12 knowledge and infrastructure gaps and 38 recommendations from an initial list of 600 gaps and 220 recommendations. In developing our framework, we clustered these into three areas: 1) Recommendations to improve core social science response capacities, including investments in: human resources within response agencies; the creation of social science data analysis capacities at field and global level; mechanisms for operationalizing knowledge; and a set of rapid deployment infrastructures; 2) Recommendations to strengthen applied and basic social sciences, including the need to: better define the social science agenda and core competencies; support innovative interdisciplinary science; make concerted investments in developing field ready tools and building the evidence-base; and develop codes of conduct; and 3) Recommendations for a supportive social science ecosystem, including: the essential foundational investments in institutional development; training and capacity building; awareness-raising activities with allied disciplines; and lastly, support for a community of practice. INTERPRETATION: Comprehensively integrating social science into the epidemic preparedness and response architecture demands multifaceted investments on par with allied disciplines, such as epidemiology and virology. Building core capacities and competencies should occur at multiple levels, grounded in country-led capacity building. Social science should not be a parallel system, nor should it be "siloed" into risk communication and community engagement. Rather, it should be integrated across existing systems and networks, and deploy interdisciplinary knowledge "transversally" across all preparedness and response sectors and pillars. Future work should update this framework to account for the impact of the COVID-19 pandemic on the institutional landscape.


Assuntos
Fortalecimento Institucional/organização & administração , Controle de Doenças Transmissíveis/organização & administração , Epidemias/prevenção & controle , Saúde Global , Ciências Sociais/organização & administração , Humanos , Pesquisa Qualitativa
8.
Washington; D.C.; OPS; 2020-11-16. (OPS/PHE/HEO/20-0044).
Não convencional em Espanhol | PAHO-IRIS | ID: phr-53028

RESUMO

La finalidad de este documento de información es presentar información actualizada sobre la respuesta que ha brindado la Oficina Sanitaria Panamericana (la Oficina) desde noviembre del 2016 hasta julio del 2020 a fin de mantener una agenda eficaz de cooperación técnica en la República Bolivariana de Venezuela y en los Estados Miembros vecinos.


Assuntos
Infecções por Coronavirus , Coronavirus , Infecções por Coronavirus , Transmissão de Doença Infecciosa , Pandemias , Doenças Transmissíveis , Doenças não Transmissíveis , Doença Crônica , Saúde Mental , Fatores de Risco , Acesso a Medicamentos Essenciais e Tecnologias em Saúde , Cooperação Técnica , Hipertensão , Diabetes Mellitus , Fortalecimento Institucional , Emergências , Venezuela
9.
Washington, D.C.; OPS; 2020-11-02. (PAHO/PHE/HEO/20-0044).
Não convencional em Inglês | PAHO-IRIS | ID: phr-52969

RESUMO

This information document provides an update on the Pan American Sanitary Bureau’s response to maintaining an effective technical cooperation agenda in the Bolivarian Republic of Venezuela and neighboring Member States, from November 2016 to July 2020. The Bolivarian Republic of Venezuela has been facing a sociopolitical and economic situation that has negatively impacted social and health indicators. There have been intensified population movements both within the country and to other countries, particularly to Argentina, Brazil, Chile, Colombia, Costa Rica, Curaçao, Dominican Republic, Ecuador, Guyana, Mexico, Panama, Paraguay, Peru, Trinidad and Tobago, and Uruguay. Since 2017, an estimated 5.2 million Venezuelans have migrated to other countries, including an estimated 4.3 million who have gone to countries in Latin America and the Caribbean.


Assuntos
Infecções por Coronavirus , Coronavirus , Transmissão de Doença Infecciosa , Pandemias , Doenças não Transmissíveis , Doença Crônica , Saúde Mental , Fatores de Risco , Acesso a Medicamentos Essenciais e Tecnologias em Saúde , Cooperação Técnica , Hipertensão , Diabetes Mellitus , Fortalecimento Institucional , Emergências , Venezuela
12.
PLoS One ; 15(10): e0240150, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33057389

RESUMO

The spread of COVID-19 implied a large and fast increase of demand for intensive care services. To face this increase in demand, health care systems need to adapt their response by increasing hospital beds, intensive care unit (ICU) capacity and by (re-)deploying doctors and other personnel. This paper proposes a forecast approach based on the Vector Error Correction model for the daily counts of hospitalized patients with symptoms and of patients in ICU, using publicly available data on the current COVID-19 outbreak in Italy, Switzerland and Spain. The level of analysis is the local government managing the health care system response, which corresponds to regions for Italy. The one-week-ahead forecasts are validated with out-of-sample data over successive weeks; they are found to provide timely and robust prediction of ICU capacity needs in Lombardy, the most-affected Italian region, starting from the sample of the first 2 weeks of data. The same methodology is successfully validated on other Italian regions, Switzerland and Spain. This approach may be used in other countries/regions/provinces to help adapt the health care system response to COVID-19 (or other similar disease); for this purpose, the open-source software code to produce the forecasts is provided with the paper.


Assuntos
Fortalecimento Institucional/métodos , Infecções por Coronavirus/epidemiologia , Alocação de Recursos para a Atenção à Saúde/métodos , Unidades de Terapia Intensiva/estatística & dados numéricos , Modelos Teóricos , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/terapia , Humanos , Itália , Pandemias , Pneumonia Viral/terapia , Software , Espanha , Suíça
13.
Sci Rep ; 10(1): 18422, 2020 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-33116179

RESUMO

We use an individual based model and national level epidemic simulations to estimate the medical costs of keeping the US economy open during COVID-19 pandemic under different counterfactual scenarios. We model an unmitigated scenario and 12 mitigation scenarios which differ in compliance behavior to social distancing strategies and in the duration of the stay-home order. Under each scenario we estimate the number of people who are likely to get infected and require medical attention, hospitalization, and ventilators. Given the per capita medical cost for each of these health states, we compute the total medical costs for each scenario and show the tradeoffs between deaths, costs, infections, compliance and the duration of stay-home order. We also consider the hospital bed capacity of each Hospital Referral Region (HRR) in the US to estimate the deficit in beds each HRR will likely encounter given the demand for hospital beds. We consider a case where HRRs share hospital beds among the neighboring HRRs during a surge in demand beyond the available beds and the impact it has in controlling additional deaths.


Assuntos
Infecções por Coronavirus/economia , Custos de Cuidados de Saúde/estatística & dados numéricos , Pandemias/economia , Pneumonia Viral/economia , Fortalecimento Institucional/economia , Fortalecimento Institucional/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Instalações de Saúde/economia , Instalações de Saúde/estatística & dados numéricos , Humanos , Controle de Infecções/economia , Controle de Infecções/estatística & dados numéricos , Modelos Estatísticos , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Estados Unidos
14.
Pediatrics ; 146(Suppl 2): S218-S222, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33004643

RESUMO

Data from the past decade have revealed that neonatal mortality represents a growing burden of the under-5 mortality rate. To further reduce these deaths, the focus must expand to include building capacity of the workforce to provide high-quality obstetric and intrapartum care. Obstetric complications, such as hypertensive disorders and obstructed labor, are significant contributors to neonatal morbidity and mortality. A well-prepared workforce with the necessary knowledge, skills, attitudes, and motivation is required to rapidly detect and manage these complications to save both maternal and newborn lives. Traditional off-site, didactic, and lengthy training approaches have not always yielded the desired results. Helping Mothers Survive training was modeled after Helping Babies Breathe and incorporates further evidence-based methodology to deliver training on-site to the entire team of providers, who continue to practice after training with their peers. Research has revealed that significant gains in health outcomes can be reached by using this approach. In the coronavirus disease 2019 era, we must look to translate the best practices of these training programs into a flexible and sustainable model that can be delivered remotely to maintain quality services to women and their newborns.


Assuntos
Pessoal de Saúde/educação , Capacitação em Serviço/organização & administração , Assistência Perinatal/organização & administração , Fortalecimento Institucional , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Serviços de Saúde Materno-Infantil/organização & administração , Assistência Perinatal/normas , Gravidez , Complicações na Gravidez/prevenção & controle , Complicações na Gravidez/terapia
15.
S Afr Med J ; 110(9): 835-836, 2020 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-32880262

RESUMO

The stated objective of the COVID-19 lockdown was to allow time to prepare healthcare facilities. Preparation must include administrative and environmental measures, which when combined with personal protective equipment, minimise the risk of the spread of infection to patients and healthcare workers (HCWs) in facilities, allowing HCWs to safely provide essential services during the pandemic and limit the indirect effects of COVID-19 caused by healthcare disruption. We present our model for facility preparation based on colour-coded zones, social distancing, hand hygiene, rapid triage and separate management of symptomatic patients, and attention to infection transmission prevention between HCWs in communal staff areas. This model specifically addresses the challenges in preparing a facility for COVID-19 in a low-resource setting and in rural areas. In addition, we include links to resources to allow workers in low-resource settings to prepare their facilities adequately.


Assuntos
Infecções por Coronavirus/epidemiologia , Assistência à Saúde/organização & administração , Instalações de Saúde , Pessoal de Saúde , Pneumonia Viral/epidemiologia , Instituições de Assistência Ambulatorial , Betacoronavirus , Fortalecimento Institucional , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Desinfecção , Planejamento Ambiental , Desinfecção das Mãos , Hospitais , Humanos , Controle de Infecções , Unidades Móveis de Saúde , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , África do Sul/epidemiologia , Ventiladores Mecânicos/provisão & distribução
16.
PLoS One ; 15(9): e0237380, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32986698

RESUMO

OBJECTIVE: The objective of this study was to develop a measurement tool to capture local public health department (LHD) organizational characteristics that align with implementation of equity-oriented practice, which may be used to gauge progress in building public health structures and functions that address the needs of vulnerable populations and reduce health inequities. METHODS: We developed and tested a measurement tool, with practitioner input, based on an implementation science framework and informed by previous work defining public health essential services and practice recommendations for health equity. Measures assessed types of vulnerable populations served by the LHD, organizational climate, and four equity-oriented practice areas, including: assessment and planning, monitoring and analysis, leadership support, and obesity prevention. We also assessed opportunities for capacity building by identifying training needs of practitioners. Primary data were collected from Missouri local health department practitioners (n = 92, 80% response rate) via an online questionnaire, with a subset of the sample providing data for test-retest reliability. RESULTS: Measures of equity-oriented implementation climate indicated areas of variability with respect to strengths and gaps across LHDs. While implementation climate was strong with respect to perceived importance (86%), a substantial proportion of LHDs cited concern over other priorities conflicting with equity-oriented implementation (32%). Likewise, a strong internal push (67%) was often accompanied by limited external political (25%) and community support (40%). Implementation climate measures generally had good to excellent reliability and were significantly associated with areas of equity-oriented practice. Frequently identified (>70%) training needs included improving skills in applying frameworks, assessment methods, and evaluating collaborations around equity. CONCLUSION: We developed a theory-based, practitioner-informed questionnaire to assess capacity for equity-oriented practice and identify opportunities for capacity building in local public health departments to engage in effective change toward health equity.


Assuntos
Fortalecimento Institucional , Equidade em Saúde , Governo Local , Obesidade/prevenção & controle , Administração em Saúde Pública/métodos , Saúde Pública/métodos , Feminino , Humanos , Masculino , Missouri , Inquéritos e Questionários
17.
PLoS One ; 15(9): e0239808, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32986778

RESUMO

To mitigate the movement of non-native organisms with trade, phytosanitary systems have been implemented within and between countries. In some countries such as Cuba, little is known about the within-state plant health system. To facilitate the development of future trade partnership between Cuba and the United States, agencies need to understand the organizational structure and diagnostic capacity of the Cuban Plant Protection System, identify potential synergies between the United States and Cuban systems, and identify steps towards cooperation. This paper fills this critical void by presenting a descriptive analysis of the plant health system in Cuba. Information was integrated from available literature, informal interviews with Cuban experts, and workshops focused on Cuban policies, risk, and potential collaboration attended by Cuban and American experts. We identify the next practical steps in improving cooperation, including building trust and capacity. Mutual understanding of phytosanitary systems will be crucial for the regional economic and environmental stability of a post-embargo United States-Cuban relationship.


Assuntos
Produção Agrícola/métodos , Proteção de Cultivos/métodos , Cooperação Internacional , Controle de Pragas/métodos , Doenças das Plantas/prevenção & controle , Formulação de Políticas , Fortalecimento Institucional , Cuba , Previsões , Humanos , Confiança , Estados Unidos
18.
Emerg Infect Dis ; 26(11): 2549-2554, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32956612

RESUMO

In many settings, the ongoing coronavirus disease (COVID-19) pandemic coincides with other major public health threats, in particular tuberculosis. Using tuberculosis (TB) molecular diagnostic infrastructure, which has substantially expanded worldwide in recent years, for COVID-19 case-finding might be warranted. We analyze the potential of using TB diagnostic and research infrastructures for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. We focused on quality control by adapting the 12 Quality System Essentials framework to the COVID-19 and TB context. We conclude that diagnostic infrastructures for TB can in principle be leveraged to scale-up SARS-CoV-2 testing, in particular in resource-poor settings. TB research infrastructures also can support sequencing of SARS-CoV-2 to study virus evolution and diversity globally. However, fundamental principles of quality management must be followed for both TB and SARS-CoV-2 testing to ensure valid results and to minimize biosafety hazards, and the continuity of TB diagnostic services must be guaranteed at all times.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/normas , Infecções por Coronavirus/diagnóstico , Laboratórios/organização & administração , Pneumonia Viral/diagnóstico , Tuberculose/diagnóstico , Fortalecimento Institucional , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Controle de Qualidade , Tuberculose/epidemiologia
19.
PLoS One ; 15(9): e0238365, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32881986

RESUMO

INTRODUCTION: Health care decision makers require capacity to demand and use research evidence for effective decision making. Capacity to undertake health policy and systems research (HPSR) and teaching is low in developing countries. Strengthening the capacity of producers and users of research is a more sustainable strategy for developing the field of HPSR in Africa, than relying on training in high-income countries. METHODS: Data were collected from 118 participants who had received the capacity building, using a pre-tested questionnaire. Respondents included health research scientists from institutions (producers) and decision makers (users) in the public health sector, in Anambra and Enugu states, southeast Nigeria. Data were collected on participants' progress with proposed group activities in their short- term goals; effects of these activities on evidence-informed decision making and constraints to implementing activities. Univariate analysis was done using SPSS version 16. FINDINGS: All prioritised activities were carried out. However, responses were low. Highest response for an activity amongst producers was 39.1%, and 44.4% for users. Some of the activities implemented positively influenced changes in practice; like modification of existing policies and programme plans. There was a wide range of responses between producers of evidence (0.0-39.1%) and users (2.7-44.4%) across both study states. Lack of authority to implement activities was the major constraint (42-9-100.0% across activities), followed by financial constraints (70.6%). CONCLUSION: Capacity building intervention improved skills of a critical mass of research scientists, policymakers and practitioners, towards evidence-based decision making. Participants committed to undertake proposed activities but faced a number of constraints. These need to be addressed, especially the decision space and authority, improving funding to implement activities that influence Getting Research into Policy & Practice (GRIPP). Being at different stages of planning and implementing proposed activities; participants require continuous technical and financial support to successfully implement activities and engage meaningfully within and across professional boundaries and roles, in order to achieve short-, medium- and long- term goals.


Assuntos
Pessoal Administrativo/psicologia , Tomada de Decisões , Política de Saúde , Avaliação de Programas e Projetos de Saúde , Adulto , Fortalecimento Institucional , Conferências de Consenso como Assunto , Prática Clínica Baseada em Evidências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Inquéritos e Questionários
20.
Sante Publique ; 32(1): 103-111, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32985967

RESUMO

BACKGROUND: Outreach HIV testing strategies have significantly contributed to the increase in the number of people knowing their HIV status in sub-Saharan Africa. This article analyzes the articulation of donor and field constraints on the implementation of outreach HIV testing strategies in Côte d’Ivoire. METHODS: Qualitative research was conducted in three health districts (Man, Cocody-Bingerville and Aboisso) in Côte d’Ivoire in 2015-2016, through in-depth interviews with community providers, local leaders and people tested and through observation of outreach HIV testing activities. RESULTS: Implementing organizations feel “under pressure” to meet donors’ objectives that are deemed unattainable, as well as the lack of training and funding. As a result, providers do not observe systematically the rules of the “three Cs” (counselling, informed consent, confidentiality), and propose testing to individuals who are “off-target” (in terms of locations and populations). DISCUSSION: Implementing NGOs experience two types of constraints those resulting from the functioning of international aid (inadequate funding compared to actual costs, objectives too high, the important chain of intermediaries) and those related to the local context (spaces not adapted to guarantee confidentiality and the professional activity of target populations). CONCLUSION: The pressure that is exerted at different levels on implementing NGOs is detrimental to the quality of HIV testing. It is now essential to develop a more qualitative approach in defining strategies and evaluation criteria.


Assuntos
Agentes Comunitários de Saúde , Aconselhamento , Infecções por HIV/diagnóstico , Programas de Rastreamento/métodos , Serviços Preventivos de Saúde/organização & administração , Fortalecimento Institucional , Costa do Marfim , Infecções por HIV/prevenção & controle , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa
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