Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 597
Filtrar
1.
BMC Public Health ; 19(1): 815, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234831

RESUMO

BACKGROUND: In 2017, the G20 health ministers convened for the first time to discuss global health and issued a communiqué outlining their health priorities, as the BRICS and G7 have done for years. As these political clubs hold considerable political and economic influence, their respective global health agendas may influence both global health priorities and the priorities of other countries and actors. METHODS: Given the rising salience of global health in global summitry, we analyzed the health ministerial communiqués issued by the BRICS, G7 and G20 after the SDGs were adopted in 2015. We compared the stated health priorities of the BRICS, G7 and G20 against one another and against the targets of SDG 3 on health, using a traffic light system to assess the quality of their commitments. RESULTS: With regard to the SDG 3 targets, the BRICS, G7 and G20 priorities overlapped in their focus on emergency preparedness and universal health coverage, but diverged in areas of environmental pollution, mental health, and maternal and child health. Health issues with considerable associated burdens of disease, including substance use, road traffic injuries and sexual health, were missing from the agendas of all three political clubs. In terms of SDG 3 principles and ways of working, the BRICS, G7 and G20 varied in their emphasis on human rights, equity and engagement with non-state actors, but all expressed their explicit commitment to Agenda 2030. CONCLUSIONS: The leadership of BRICS, G7 and G20 on global health is welcome. However, their relatively narrow focus on the potential impact of ill-health primarily in relation to the economy and trade may not be sufficiently comprehensive to achieve the Agenda 2030 vision of promoting health equity and leaving no-one behind. Recommendations for the BRICS, G7 and G20 based on this analysis include: 1) expanding focus to the neglected SDG 3 health targets; 2) placing greater emphasis on upstream determinants of health; 3) greater commitment to equity and leaving no-one behind; 4) adopting explicit commitments to rights-based approaches; and 5) making commitments that are of higher quality and which include time-bound quantitative targets and clear accountability mechanisms.


Assuntos
Saúde Global/tendências , Objetivos , Equidade em Saúde/tendências , Prioridades em Saúde/tendências , Desenvolvimento Sustentável/tendências , Prioridades em Saúde/organização & administração , Humanos
3.
Alcohol Alcohol ; 54(2): 123-127, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30801630

RESUMO

AIM: This paper briefly reviews the history of alcohol policy development in Europe leading to the current consensus in the health field on strategic priorities. There is a review of recent policy developments in selected European countries, both EU and non-EU members. METHODS: Narrative review of published journal articles, publications from WHO, and other health organisations and government publications. RESULTS: The implementation of the WHO policy priorities has been variable across Europe. At EU level, there has been a recent pattern of trade considerations taking priority over health and a disinvestment in alcohol research and advocacy. Among EU member states new implementation of WHO strategies have been limited to a few smaller countries and regions. In Russia, there have been considerable falls in mortality following the introduction of controls on price, availability and marketing. CONCLUSION: The implementation of WHO strategy at national level in Europe is highly dependent on the local political circumstances. Where there is concern about alcohol harm and political will, the WHO strategic priorities have been highly influential.In order to build public and political support for prevention, alcohol policy advocates should ensure that there is good data on trends within age, gender, and income groups and develops policies to respond to these trends. The concept of proportionate universalism, where interventions are understood to have a broad population effect but the effect is greater on the groups most in need, may be more useful than the traditional alcohol policy field conceptualisations of whole population and targeted measures.


Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Prioridades em Saúde/tendências , Formulação de Políticas , Política Pública/tendências , Europa (Continente) , Humanos , Política Pública/economia
7.
Lancet ; 392(10160): 2229-2236, 2018 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-30309621

RESUMO

Will the Sustainable Development Goal 3 sub-goal "Achieve universal health coverage, including financial risk protection, access to quality essential health care services and…safe, effective, quality and affordable essential medicines and vaccines for all" be judged a breakthrough or a great white elephant in implementation, when we look back with the clear eyes of hindsight in 2030? What are the ways in which this agenda might play out in implementation and why might it do so? Drawing on a desk review, this Essay explores dominant ideas, ideology, institutions, and interests in relation to global versus Ghana national health priorities since the WHO constitution came into effect in 1948, to reflect on these questions.


Assuntos
Programas Gente Saudável/tendências , Cobertura Universal do Seguro de Saúde/tendências , Gana , Saúde Global/tendências , Política de Saúde/tendências , Prioridades em Saúde/tendências , Humanos , Desenvolvimento Sustentável/tendências
9.
J Health Organ Manag ; 32(3): 444-462, 2018 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-29771204

RESUMO

Purpose Current conditions have intensified the need for health systems to engage in the difficult task of priority setting. As the search for a "magic bullet" is replaced by an appreciation for the interplay between evidence, interests, culture, and outcomes, progress in relation to these dimensions requires assessment of achievements to date and identification of areas where knowledge and practice require attention most urgently. The paper aims to discuss these issues. Design/methodology/approach An international survey was administered to experts in the area of priority setting. The survey consisted of open-ended questions focusing on notable achievements, policy and practice challenges, and areas for future research in the discipline of priority setting. It was administered online between February and March of 2015. Findings "Decision-making frameworks" and "Engagement" were the two most frequently mentioned notable achievements. "Priority setting in practice" and "Awareness and education" were the two most frequently mentioned policy and practical challenges. "Priority setting in practice" and "Engagement" were the two most frequently mentioned areas in need of future research. Research limitations/implications Sampling bias toward more developed countries. Future study could use findings to create a more concise version to distribute more broadly. Practical implications Globally, these findings could be used as a platform for discussion and decision making related to policy, practice, and research in this area. Originality/value Whilst this study reaffirmed the continued importance of many longstanding themes in the priority setting literature, it is possible to also discern clear shifts in emphasis as the discipline progresses in response to new challenges.


Assuntos
Tomada de Decisões , Prioridades em Saúde/tendências , Estudos Transversais , Política de Saúde , Administração Hospitalar , Inquéritos e Questionários
10.
Pediatrics ; 141(4)2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29519956

RESUMO

Electronic health record (EHR) use throughout the United States has advanced considerably, but functionality to support the optimal care of children has been slower to develop and deploy. A previous team of experts systematically identified gaps in EHR functionality during collaborative work from 2010 to 2013 that produced the Children's EHR Format (Format), funded under the Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3. After that, a team of practitioners, software developers, health policy leaders, and other stakeholders examined the Format's exhaustive list of 547 EHR functional requirements in 26 topic areas and found them to be valuable but in need of further refinement and prioritization. Work began in 2014 to develop a shortened high priority list of requirements and provide guidance to improve their use. Through a modified Delphi process that included key document review, selection criteria, multiple rounds of voting, and small group discussion, a multistakeholder work group identified and refined 47 items on the basis of earlier requirements to form the 2015 Children's EHR Format Priority List and developed 16 recommended uses of the Format. The full report of the Format enhancement activities is publicly available. In this article, we aim to promote awareness of these high priority EHR functional requirements for the care of children, sharpen industry focus on adopting these changes, and align all stakeholders in prioritizing specific health information technology functionalities including those essential for well-child preventive care, medication management, immunization tracking, and growth data for specific pediatric subgroups.


Assuntos
Children's Health Insurance Program/tendências , Registros Eletrônicos de Saúde/tendências , Prioridades em Saúde/tendências , Informática Médica/tendências , Criança , Children's Health Insurance Program/normas , Registros Eletrônicos de Saúde/normas , Prioridades em Saúde/normas , Humanos , Informática Médica/normas , Estados Unidos/epidemiologia
11.
BMC Psychiatry ; 18(1): 39, 2018 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-29415710

RESUMO

BACKGROUND: Limited knowledge exists to inform the selection and introduction of locally relevant, feasible, and effective mental health interventions in diverse socio-cultural contexts and health systems. We examined stakeholders' perspectives on mental health-related priorities, help-seeking behaviors, and existing resources to guide the development of a maternal mental health component for integration into non-specialized care in Soroti, eastern Uganda. METHODS: We employed rapid ethnographic methods (free listing and ranking; semi-structured interviews; key informant interviews and pile sorting) with community health workers (n = 24), primary health workers (n = 26), perinatal women (n = 24), traditional and religious healers (n = 10), and mental health specialists (n = 9). Interviews were conducted by trained Ateso-speaking interviewers. Two independent teams conducted analyses of interview transcripts following an inductive and thematic approach. Smith's Salience Index was used for analysis of free listing data. RESULTS: When asked about common reasons for visiting health clinics, the most salient responses were malaria, general postnatal care, and husbands being absent. Amongst the free listed items that were identified as mental health problems, the three highest ranked concerns were adeka na aomisio (sickness of thoughts); ipum (epilepsy), and emalaria (malaria). The terms epilepsy and malaria were used in ways that reflected both biomedical and cultural concepts of distress. Sickness of thoughts appeared to overlap substantially with major depression as described in international classification, and was perceived to be caused by unsupportive husbands, intimate partner violence, chronic poverty, and physical illnesses. Reported help-seeking for sickness of thoughts included turning to family and community members for support and consultation, followed by traditional or religious healers and health centers if the problem persisted. CONCLUSION: Our findings add to existing literature that describes 'thinking too much' idioms as cultural concepts of distress with roots in social adversity. In addition to making feasible and effective treatment available, our findings indicate the importance of prevention strategies that address the social determinants of psychological distress for perinatal women in post-conflict low-resource contexts.


Assuntos
Conflitos Armados/etnologia , Recursos em Saúde , Comportamento de Busca de Ajuda , Saúde Materna/etnologia , Saúde Mental/etnologia , Pesquisa Qualitativa , Adulto , Conflitos Armados/psicologia , Conflitos Armados/tendências , Família/etnologia , Família/psicologia , Feminino , Prioridades em Saúde/tendências , Recursos em Saúde/tendências , Humanos , Saúde Materna/tendências , Saúde Mental/tendências , Pobreza/etnologia , Pobreza/psicologia , Pobreza/tendências , Gravidez , Maus-Tratos Conjugais/etnologia , Maus-Tratos Conjugais/psicologia , Maus-Tratos Conjugais/tendências , Uganda/etnologia
13.
Toxicol In Vitro ; 47: 213-227, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29203341

RESUMO

In vitro chemical safety testing methods offer the potential for efficient and economical tools to provide relevant assessments of human health risk. To realize this potential, methods are needed to relate in vitro effects to in vivo responses, i.e., in vitro to in vivo extrapolation (IVIVE). Currently available IVIVE approaches need to be refined before they can be utilized for regulatory decision-making. To explore the capabilities and limitations of IVIVE within this context, the U.S. Environmental Protection Agency Office of Research and Development and the National Toxicology Program Interagency Center for the Evaluation of Alternative Toxicological Methods co-organized a workshop and webinar series. Here, we integrate content from the webinars and workshop to discuss activities and resources that would promote inclusion of IVIVE in regulatory decision-making. We discuss properties of models that successfully generate predictions of in vivo doses from effective in vitro concentration, including the experimental systems that provide input parameters for these models, areas of success, and areas for improvement to reduce model uncertainty. Finally, we provide case studies on the uses of IVIVE in safety assessments, which highlight the respective differences, information requirements, and outcomes across various approaches when applied for decision-making.


Assuntos
Segurança Química/métodos , Tomada de Decisões Assistida por Computador , Tomada de Decisões Gerenciais , Prioridades em Saúde , Ensaios de Triagem em Larga Escala , Modelos Biológicos , Testes de Toxicidade/métodos , Alternativas ao Uso de Animais/tendências , Animais , Segurança Química/instrumentação , Segurança Química/legislação & jurisprudência , Segurança Química/tendências , Biologia Computacional , Simulação por Computador , Sistemas Especialistas , Guias como Assunto , Prioridades em Saúde/tendências , Ensaios de Triagem em Larga Escala/tendências , Humanos , National Institute of Environmental Health Sciences (U.S.) , Testes de Toxicidade/instrumentação , Testes de Toxicidade/tendências , Estados Unidos , United States Dept. of Health and Human Services , United States Environmental Protection Agency
14.
J Public Health Manag Pract ; 24(4): 318-325, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28650413

RESUMO

CONTEXT: Internal revenue service provisions require not-for-profit hospitals to provide "community benefit." In addition, the Affordable Care Act requires these hospitals to conduct community health needs assessments that involve appropriate stakeholders. These requirements signal government interest in creating opportunities for developing programs that are well tailored and responsive to the needs of the communities served. Gaining meaningful input from residents is a critical aspect of these processes. OBJECTIVE: To implement public deliberations that explore local resident priorities for use of a hospital's community benefit resources to prevent chronic disease. METHODS: Public deliberation is a method of community engagement that can provide guidance to decision makers on value-laden issues when technical solutions alone are inadequate to provide direction or set priorities. Three deliberations featuring presentations by experts and discussions among participants were convened with a cross section of residents in Brooklyn, New York. Participants were asked whether new hospital initiatives should prioritize: clinical prevention, community-based interventions, or action on broader policies affecting population health. Pre- and postsurveys, as well as qualitative methods, were used to assess knowledge and attitudes. RESULTS: Postdeliberation, participants had significant changes in knowledge, particularly on the impact of education on health. Participants prioritized community-based and policy interventions over expanding clinical prevention capacity. CONCLUSIONS: Public deliberation offers a method to probe informed constituent views of how a hospital can best promote its community's health. Informed local residents felt that hospitals should frame health-promoting activities more broadly than is current practice. Not-for-profit hospitals gain significant tax advantages. Increased insurance rates suggest that some hospitals will experience savings in uncompensated care that can be used to promote health more broadly. Vetting priorities for the use of new resources with informed community members can be accomplished through public deliberation. These results suggest community support for nonclinical approaches to disease prevention.


Assuntos
Prioridades em Saúde/tendências , Prevenção Primária/métodos , Saúde Pública/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Promoção da Saúde/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque , Patient Protection and Affordable Care Act/organização & administração , Patient Protection and Affordable Care Act/estatística & dados numéricos , Prevenção Primária/estatística & dados numéricos , Saúde Pública/tendências
16.
Gesundheitswesen ; 79(11): 932-935, 2017 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-29172222

RESUMO

Evidence-based health policies and evidence-based measures need comprehensive information on the health of the population. The existing health surveillance system provides reliable answers to many health policy issues. Nonetheless, there are many information gaps not yet covered or are only covered via short-term project solutions. 1. We need to strengthen and expand existing health surveillance and monitoring to continuously collect information on the health status of all population groups, including those that are difficult to reach through the existing surveys and methods, such as people with a migration background, or socially disadvantaged. This information must be regularly available on the national, regional and also on the local level. 2. The use of existing data on health, for example from official statistics or social insurance, must be significantly expanded and strengthened. The infrastructure for scientific analyses of health data as well as the transfer of information to policy makers and the public must be strengthened. Through an expansion of the resources for scientific processing of health-relevant questions, Public Health can make an important contribution to effective health policies.


Assuntos
Política de Saúde/tendências , Prioridades em Saúde/tendências , Programas Nacionais de Saúde/tendências , Vigilância em Saúde Pública , Saúde Pública/tendências , Berlim , Previsões , Alemanha , Humanos
18.
Indian J Med Res ; 145(5): 611-622, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28948951

RESUMO

In India, research prioritization in Maternal, Newborn, and Child Health and Nutrition (MNCHN) themes has traditionally involved only a handful of experts mostly from major cities. The Indian Council of Medical Research (ICMR)-INCLEN collaboration undertook a nationwide exercise engaging faculty from 256 institutions to identify top research priorities in the MNCHN themes for 2016-2025. The Child Health and Nutrition Research Initiative method of priority setting was adapted. The context of the exercise was defined by a National Steering Group (NSG) and guided by four Thematic Research Subcommittees. Research ideas were pooled from 498 experts located in different parts of India, iteratively consolidated into research options, scored by 893 experts against five pre-defined criteria (answerability, relevance, equity, investment and innovation) and weighed by a larger reference group. Ranked lists of priorities were generated for each of the four themes at national and three subnational (regional) levels [Empowered Action Group & North-Eastern States, Southern and Western States, & Northern States (including West Bengal)]. Research priorities differed between regions and from overall national priorities. Delivery domain of research which included implementation research constituted about 70 per cent of the top ten research options under all four themes. The results were endorsed in the NSG meeting. There was unanimity that the research priorities should be considered by different governmental and non-governmental agencies for investment with prioritization on implementation research and issues cutting across themes.


Assuntos
Pesquisa Biomédica/tendências , Saúde da Criança/tendências , Saúde Materna/tendências , Estado Nutricional/fisiologia , Criança , Feminino , Prioridades em Saúde/tendências , Humanos , Índia/epidemiologia , Recém-Nascido , Gravidez
19.
BMJ Open ; 7(8): e016571, 2017 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-28838896

RESUMO

OBJECTIVES: To identify and prioritise important research questions for miscarriage. DESIGN: A priority setting partnership using prospective surveys and consensus meetings following methods advocated by the James Lind Alliance. SETTING: UK. PARTICIPANTS: Women and those affected by miscarriage working alongside healthcare professionals. RESULTS: In the initial survey, 1093 participants (932 women who have experienced miscarriage, 8 partners, 17 family members, friends or colleagues, 104 healthcare professionals and eight charitable organisations) submitted 3279 questions. A review of existing literature identified a further 64. Non-questions were removed, and the remaining questions were categorised and summarised into 58 questions. In an interim electronic survey, 2122 respondents chose their top 10 priorities from the 58 summary questions. The 25 highest ranked in the survey were prioritised at a final face-to-face workshop. In summary, the top 10 priorities were ranked as follows: research into preventative treatment, emotional aspects in general, investigation, relevance of pre-existing medical conditions, emotional support as a treatment, importance of lifestyle factors, importance of genetic and chromosomal causes, preconception tests, investigation after different numbers of miscarriage and male causal factors. CONCLUSIONS: These results should be the focus of future miscarriage research. Presently, studies are being conducted to address the top priority; however, many other priorities, especially psychological and emotional support, are less well researched areas. We hope our results will encourage both researchers and funders to focus on these priorities.


Assuntos
Aborto Espontâneo/psicologia , Prioridades em Saúde/tendências , Pesquisa Biomédica , Consenso , Emoções , Família , Feminino , Amigos , Pessoal de Saúde , Humanos , Masculino , Gravidez , Estudos Prospectivos , Apoio Social , Inquéritos e Questionários , Reino Unido
20.
Gac. sanit. (Barc., Ed. impr.) ; 31(4): 349-357, jul.-ago. 2017. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-164381

RESUMO

Objetivo: El presente trabajo surge con el propósito de desarrollar una metodología explícita para la selección de prioridades sanitarias que apoye la toma de decisiones sobre las tecnologías a evaluar de cara a su inclusión en la cartera de servicios del Sistema Nacional de Salud. El objetivo principal es identificar y analizar los criterios, procesos y marcos conceptuales empleados para la priorización de intervenciones sanitarias en el ámbito nacional e internacional. Método: Se ha llevado a cabo una revisión exhaustiva de la literatura. Para ello, se ha buscado en las principales bases de datos biomédicas y se han revisado las páginas web de las principales agencias de evaluación, entre otras fuentes. Resultados: En términos generales, se encontró que no existen criterios universales ni procedimientos estándar para la asignación de prioridades, aunque se han identificado algunos acuerdos y tendencias comunes respecto a aspectos fundamentales (criterios, modelos y estrategias, actores clave, etc.). Globalmente se identificaron ocho dominios críticos: 1) necesidad de la intervención; 2) resultados en salud; 3) tipo de beneficio de la intervención; 4) consecuencias económicas; 5) conocimiento existente sobre la intervención/calidad e incertidumbre de la evidencia; 6) implementación y complejidad de la intervención/factibilidad; 7) prioridad, justicia y ética; y 8) contexto global. Conclusiones: La revisión proporciona un análisis detallado de los aspectos relevantes y ofrece recomendaciones clave para el desarrollo de un marco de priorización nacional. Se plantea que esta información podría ser útil para diferentes organizaciones públicas que pretendan establecer prioridades sanitarias (AU)


Objective: This study was carried out to develop an explicit health priority setting methodology to support decision-making regarding the technologies to be assessed for inclusion in the National Health Service service portfolio. The primary objective is to identify and analyse the criteria, approaches and conceptual frameworks used for national/international priority setting. Method: An exhaustive review of the literature was carried out. For this purpose, a search of the main biomedical databases was performed and assessment agency websites were reviewed, among other sources. Results: In general terms, it was found that there are no standardised criteria for priority setting, although some consensus and common trends have been identified regarding key elements (criteria, models and strategies, key actors, etc.). Globally, 8 key domains were identified: 1) need for intervention; 2) health outcomes; 3) type of benefit of the intervention; 4) economic consequences; 5) existing knowledge on the intervention/quality of and uncertainties regarding the evidence; 6) implementation and complexity of the intervention/feasibility; 7) priority, justice and ethics; and 8) overall context. Conclusions: The review provides a thorough analysis of the relevant issues and offers key recommendations regarding considerations for developing a national prioritisation framework. Findings are envisioned to be useful for different public organisations that are aiming to establish healthcare priorities (AU)


Assuntos
Humanos , Prioridades em Saúde/tendências , Assistência à Saúde/tendências , Avaliação da Tecnologia Biomédica/tendências , Planos e Programas de Saúde/tendências , Necessidades e Demandas de Serviços de Saúde/tendências , Alocação de Recursos/tendências
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA