WONCA E-Update
Friday 10th June 2016

WONCA News – June 2016
The latest WONCA News is available via the WONCA website, packed with WONCA news, views and events.

Policy Bite – Can you measure quality?
“I was invited to a policy summit in Washington last month. Hosted by the Robert Graham Centre, and attended by many family medicine leads from the U.S.A., its declared purpose was to look at how changes in the payment structures for health care in the U.S.A. may, or may not, incentivise the ‘triple aim’ of first contact, coordinated, continuous, comprehensive primary care.”

This month Amanda Howe discusses whether it’s possible to measure quality, and highlights some experiences from the UK.

WONCA mhGAP Consultancy Programme
Members of the WONCA Working Party on Mental Health are participating in a major policy initiative to help Moldova move from institutional to community-based mental health care. In collaboration with the European Association for Communication in Healthcare (EACH) and NIVEL in the Netherlands members are running a series of ‘train the trainer’ courses. The objective is to equip more than 1000 Moldovan GPs and nurses with essential skills in primary mental health care.

Featured Doctor – Professor Chris Dowrick
Keeping to the theme of mhGAP consultancy, one of this month’s featured doctors is Professor Chris Dowrick, who is the WONCA mhGAP consultancy coordinator.  Chris is Professor of Primary Medical Care in the University of Liverpool and has been a general practitioner in north Liverpool for the past 25 years. He’s also Professorial Research Fellow in the University of Melbourne in Australia, member of the WONCA Working Party on Mental Health, and a technical expert for the World Health Organisation’s mhGAP programme. 

WONCA News in Spanish and French
A brief reminder to everyone that each month some of the key articles in WONCA News are translated into Spanish and French.  Just go to http://globalfamilydoctor.com/News and scroll to the side bar menu, then click on either “Espanol” or “Francais”.

CITATION: Sustaining a Global Social Network: a quasi-experimental study

D.C. Benton and S.L. Ferguson. Int Nursing Review

DOI: 10.1111/inr.12270

http://onlinelibrary.wiley.com/doi/10.1111/inr.12270/abstract?campaign=wolearlyview

ABSTRACT

Aim: To examine the longer term impact on the social network of participating nurses in the Global Nursing Leadership Institute (GNLI2013) through using differing frequencies of follow-up to assess impact on maintenance of network cohesion.

Background: Social network analysis is increasingly been used by nurse researchers, however, studies tend to use single point-in-time descriptive methods.

Method: This study utilizes a repeated measures, block group, control-intervention, quasi-experimental design. Twenty-eight nurse leaders, competitively selected through a double-blind peer review process, were allocated to five action learning–based learning groups. Network architecture, measures of cohesion and node degree frequency were all used to assess programme impact.

Results: The programme initiated and sustained connections between nurse leaders drawn from a geographically dispersed heterogeneous group. Modest inputs of two to three e-mails over a 6-month period seem sufficient to maintain connectivity as indicated by measures of network density, diameter and path length.

Limitations: Due to the teaching methodology used, the study sample was relatively small and the follow-up data collection took place after a relatively short time. Replication and further cohort data collection would be advantageous.

Conclusions and policy implications: In an era where many policy solutions are being debated and initiated at the global level, action learning leadership development that utilizes new technology follow-up appears to show significant impact and is worthy of wider application. The approach warrants further inquiry and testing as to its longer term effects on nursing’s influence on policy formulation and implementation.

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Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

Thanks to Peter Benjamin for posting the link to these excellent digital health dashboards [http://healthenabled.org/index.php/healthe-africa/country-dashboards]. They really are a marvel of compression and a wonderfully condensed source of considerable information. I look forward to the landscape report when it is released.

One thing I find missing is any reference to WHO’s many activities in digital health in the region – notably those of the African Health Observatory (http://www.aho.afro.who.int/) and the relevant sections of the Global Observatory for eHealth (http://www.who.int/topics/ehealth/en/) which contain plenty of information relevant to “digital health” in these countries. It would be good to include these resources as well.

Chris Zielinski chris@chriszielinski.com

Voluntary family planning brings transformational benefits to women, families, communities, and countries. Investing in family planning is a development ‘‘best buy’’ that can accelerate achievement across the 5 Sustainable Development Goal themes of People, Planet, Prosperity, Peace, and Partnership.’

CITATION: Investing in Family Planning: Key to Achieving the Sustainable Development Goals

Ellen Starbird, Maureen Norton, Rachel Marcus.

Global Health: Science and Practice

http://www.ghspjournal.org/content/early/2016/06/10/GHSP-D-15-00374.full.pdf

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

CITATION: Strategies for disseminating recommendations or guidelines to patients: a systematic review. K. Schipper et al. Implementation Science 2016 11:82 DOI: 10.1186/s13012-016-0447-x. Published: 7 June 2016

http://implementationscience.biomedcentral.com/articles/10.1186/s13012-016-0447-x

ABSTRACT

Background: The aim of this systematic literature review was to assess what dissemination strategies are feasible to inform and educate patients about recommendations (also known as guidelines).

Methods: The search was performed in February 2016 in PubMed, Ebsco/PsycINFO, Ebsco/CINAHL and Embase. Studies evaluating dissemination strategies, involving patients and/or reaching patients, were included. A hand search and a search in the grey literature, also done in February 2016, were added. Searches were not restricted by language or publication type.

Publications that referred to (1) guideline(s) or recommendation(s), (2) dissemination, (3) dissemination with patients/patient organisations and (4) dissemination to patients/patient organisations were included in this article. Criteria 1 AND 2 were mandatory together with criteria 3 OR 4.

Results: The initial search revealed 3753 unique publications. Forty-seven articles met the inclusion criteria and were selected for detailed review. The hand search and grey literature resulted in four relevant articles. After reading the full text of the 47 articles, 21 were relevant for answering our research question. Most publications had low levels of evidence, 3 or 4 of the Oxford levels of evidence. One article had a level of evidence of 2(b).

This article gives an overview of tools and strategies to disseminate recommendations to patients. Key factors of success were a dissemination plan, written at the start of the recommendation development process, involvement of patients in this development process and the use of a combination of traditional and innovative dissemination tools. The lack of strong evidence calls for more research of the effectiveness of different dissemination strategies as well as the barriers for implementing a strategic approach of dissemination.

Conclusion: Our findings provide the first systematic overview of tools and strategies to disseminate recommendations to patients and patient organisations. Participation of patients in the whole process is one of the most important findings. These findings are relevant to develop, implement and evaluate more (effective) dissemination strategies which can improve health care.

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Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

Makhura was one of the speakers at the Gauteng Economic Indaba in Sandton on Wednesday. A group of businesspeople were at the final stages of setting up the exchange and he was confident that the announcement would be made soon‚ said Makhura on the sidelines of the indaba. “There were a lot more black business people who were interested in supporting the township economy. They have done extensive work‚ including applying for a licence. I’m very confident that they are close to announcing (the exchange) in June or July‚” he said. In October 2015 economic development MEC Lebogang Maile announced that work was being done on establishing the exchange…..more

Doctors’ organisations and NGOs have warned that South Africa could face a mass exodus of doctors if the national health insurance policy is implemented in its present format. They have also warned about the cost, saying how it will be funded has not been made clear. The Times reports that they were responding to the Health Department’s white paper on the National Health Insurance (NHI) – intended to bridge the gap between private and public healthcare. The report says that more than 100 submissions were received by the 31 May deadline and the department is still responding to those submitted just before the deadline. The NHI plan proposes major infrastructure upgradings for hospitals and clinics…..more

Join the “Chiawelo Community Practice” FB Group and get a window into our work with CHWs posts and FB Live broadcasts.

Chiawelo Community Practice is a Family Medicine and Community-Oriented Primary Care (COPC) model for National Health Insurance. The Department of Family Medicine in Johannesburg has set up CCP, as a small unit in Chiawelo CHC. It is currently focused on managing a registered population of 15934 people in the Soweto half of Ward 11 in the area of Chiawelo. Dr S. Moosa, a family physician supervises CCP with a community service doctor and clinical associate. The team integrate all elements of care at the CHC into patient-centred family practice with good record-keeping systems and integrated chronic care. Interns rotate through CCP to assist. There are many Wits students rotating through CCP around learning about Community-Oriented Primary Care.

See more

Dear WONCA Colleagues,

Greetings from WHA69!  I hope you are well.  We are expecting the framework on integrated people-centered health services to be discussed today and are pleased to share the attached the Integrated People Centered Health Services communication toolkit, with suggested social media content and graphics for approval of the framework at the World Health Assembly and the launch of the IntegratedCare4People.org web platform.  

Please feel free to use as you see fit and share with others!  Of course one could draw liberally on the “reorienting models of care toward systems that revalue prevention and promotion and are based on primary care” strategic direction.

Thanks for considering.

Kind Regards,

Shannon

COMMsToolkit

See details here

Over 50% of Grade 4 learners in South Africa do not understand what they read‚ while almost 30% are illiterate. That’s according to research conducted by Stellenbosch University’s department of economics on behalf of the Zenex Foundation. The findings of the two-year study‚ titled “Laying Firm Foundations: Getting Reading Right”‚ have now been published. The focus of the research was to investigate the causes of weak South African student performance in literacy and numeracy in the Foundation Phases of Grades 1 to 3….more

The South African International Ballet Competition launched the Training Teachers in the Townships programme at one of the classrooms in Thesele Secondary School in White City Jabavu, Soweto. This programme was initiated by former Joburg Ballet chief executive Dirk Badenhorst to train and empower teachers in townships on how to coach dancers in classical ballet using the Cuban method. The idea is that the teachers will go on to start their own ballet school in a township…..more

THE government’s antipathy towards public-private partnerships is holding up implementation of the National Health Insurance (NHI), according to the head of the Independent Practitioners Association Foundation (IPAF), which represents doctors. IPAF chairman Morgan Chetty, speaking at a media summit on Wednesday organised by medical scheme administrator Discovery Health, said: “The government sees the private sector as a threat. “It fears divestiture and that the public health sector will give up its right to provide healthcare.” NHI envisages a universal health system to which everyone contributes according to their ability and which provides services that are free at the point of care. The latest government policy on NHI, published in a white paper in December 2015, says services will be procured from accredited public and private sector providers….more

The Universal Health Coverage (UHC) system envisaged by South Africa’s National Health Insurance (NHI) White Paper won’t work. Amongst other things: it’s too ambitious; too hostile to the private sector; too reliant on complex bureaucratic structures inherently ripe for inefficiency and abuse; and it totally ignores the many pitfalls that face single payer financing mechanisms. But, writes Andrew Barlow, a researcher at the Helen Suzman Foundation,there’s also much to be said for some of the ideas within it. Barlow writes: “One potentially promising idea is the re-engineering of the Primary Health Care (PHC) platform. PHC begins, it says, ‘in the communities and is the first level of contact with the health system by individuals, the family and community’. It is the ‘heart-beat of NHI. The PHC services include health promotion, disease prevention, curative (acute and chronic clinical) services, rehabilitation and palliative services.’ …more

Community service in the medical field is meeting its objectives‚ with about half of South Africa’s 1,200 doctors who graduate annually working in rural and underserved areas for their compulsory year of community service. Business Day reports, however, that according to University of Cape Town’s (UCT) Professor Steve Reid is should be more. He noted that the number of doctors working in far-flung areas is double the number who did their community service year in 2001. He said 15 years of surveys showed that doctors were increasingly experiencing the community service year as “positive”….more

Medical Aid Films, in partnership with InStrat Global Health Solutions, Digital Campus and mPowering Frontline Health Workers, are working with Ondo State Primary Health Care Development Board, to launch a new tablet-based maternal and child health training curriculum for nurses, midwives, and community health workers in Ondo State, Nigeria.

The 12-week pilot programme supports in-service training for 200 health workers in 18 health centres in Ondo State, by providing high quality film-based training in both English and Yoruba.   Covering topics such as antenatal care,managing obstructed labour and how to resuscitate a newborn, the goal is to scale this programme to all 550 health facilities across Ondo State, training 5,400 health workers who deliver services to 1.4 million women. …more

See here

WHO Sierra Leone is managing the recruitment of a new leader for Sierra Leone’s medical school. I’ve copied and pasted some background on the institution and our support below. The job vacancy is available now on e-recruit here: https://erecruit.who.int/public/hrd-cl-vac-view.asp?o_c=1000&jobinfo_uid_c=33550&vaclng=en. Might you be able to pass this on to relevant and interested colleagues? We are looking forward to recruiting an excellent candidate. 

Robert Marten

Technical Officer

Health Systems Strengthening
World Health Organization, Sierra Leone

E-mail: martenr@who.int

Mobile: + 232 (0) 79 813 258
WhatsApp: +1-347-439-3578

GPN: 33070 / Twitter: @martenrobert

21 A&B Riverside Drive, off Kingharman Road
Brookfields, Freetown | P.O. Box 529

Background

The College of Medicine and Allied Health Sciences (COMAHS) is the first and only medical school in Sierra Leone. It was founded in 1988 by the Sierra Leonean Government with support from the Nigerian Government and the World Health Organization (WHO). Following the 2005 University Act, COMAHS was incorporated as one of three constituent colleges, alongside Fourah Bay College (FBC) and the Institute of Public Administration and Management (IPAM), into the University of Sierra Leone (USL). USL is owned by the Government, and its Chancellor is the President of Sierra Leone. COMAHS is mandated to train doctors, nurses, pharmacists, biomedical scientists and laboratory technicians to improve Sierra Leone’s health system.

COMAHS recently developed a five-year strategic plan to transform into a top university in West Africa. Currently, however, there are challenges: courses are limited because of staff shortages; equipment and supplies are outdated or not available; and space is limited resulting in many able students—who have the necessary exam scores—denied admissions and or going abroad to study.

Planned support

To begin to address these gaps, WHO has been requested by the MOHS, with close to $3.3 million in funding from the World Bank and the African Development Bank, to support COMAHS to achieve its strategic objectives by assisting with the recruitment of teachers and key senior staff, specifically a Deputy Vice Chancellor and 18 instructors in basic sciences (4 positions), basic medical sciences (5 positions), pharmaceutical sciences (2 positions), clinical sciences (4 positions) and nursing (3 positions). WHO will also supporting COMAHS to procure teaching materials and upgrade and rehabilitate ICT and other equipment.  The time period for this support is 2016-2017.

TERMS OF REFERENCE FOR PRINCIPAL AND DEPUTY VICE CHANCELLOR, COLLEGE OF MEDICINE AND ALLIED HEALTH SCIENCES

 —

David de Ferranti,  President

Results for Development Institute (R4D)

1111 19th Street, N.W., Suite 700 | Washington, DC  20036

Email: ddeferranti@r4d.org.  For confidential or private messages: ConfidentialtoDavid@r4d.org

Mobile:  +1-202-468-1301          Office: call Joan Santini at +1-202-470-5721

Skype: david.deferranti | Fax: +1-202-470-5712 | Confidential Fax: +1-678-716-2554

R4D Website: www.r4d.org

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