Below is the citation and abstract of a new paper in Global Health Action. The full text is freely available here:

http://www.globalhealthaction.net/index.php/gha/article/view/25709

The paper points out that ‘health for all and health equity are the main goals of global health’, and calls for integration of global health into primary medical education, recommending ‘interdisciplinary approaches and interprofessional collaboration’. As a personal comment, I would add that global health education should be integrated also into nursing, midwifery and health science education – indeed the basic concepts (including health equity and the right to health) should be introduced into primary and secondary school education for all children.

CITATION: Glob Health Action. 2015 Apr 21;8:25709. doi: 10.3402/gha.v8.25709. eCollection 2015.

Gaps in studies of global health education: an empirical literature review.

Liu Y, Zhang Y, Liu Z, Wang J.

ABSTRACT

Background: Global health has stimulated a lot of students and has attracted the interest of many faculties, thereby initiating the establishment of many academic programs on global health research and education. global health education reflects the increasing attention toward social accountability in medical education.

Objective: This study aims to identify gaps in the studies on global health education.

Design: A critical literature review of empirical studies was conducted using Boolean search techniques.

Results: A total of 238 articles, including 16 reviews, were identified. There had been a boom in the numbers of studies on global health education since 2010. Four gaps were summarized. First, 94.6% of all studies on global health education were conducted in North American and European countries, of which 65.6% were carried out in the United States, followed by Canada (14.3%) and the United Kingdom (9.2%). Only seven studies (2.9%) were conducted in Asian countries, five (2.1%) in Oceania, and two (0.8%) in South American/Caribbean countries. A total of 154 studies (64.4%) were qualitative studies and 64 studies (26.8%) were quantitative studies. Second, elective courses and training or programs were the most frequently used approach for global health education. Third, there was a gap in the standardization of global health education. Finally, it was mainly targeted at medical students, residents, and doctors. It had not granted the demands for global health education of all students majoring in medicine-related studies.

Conclusions: Global health education would be a potentially influential tool for achieving health equity, reducing health disparities, and also for future professional careers. It is the time to build and expand education in global health, especially among developing countries. Global health education should be integrated into primary medical education. Interdisciplinary approaches and interprofessional collaboration were recommended. Collaboration and support from developed countries in global health education should be advocated to narrow the gap and to create further mutual benefits.

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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  

Below is the citation and abstract of a new paper in the open-access journal Implementation Science. The authors note that research in Cambodia is not fully aligned with health priorities, and call for abstracts of all research undertaken in Cambodia to be available in the local language.

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CITATION: Gaps between research and public health priorities in low income countries: evidence from a systematic literature review focused on Cambodia.

Goyet S1, Touch S2, Ir P3, SamAn S4, Fassier T5, Frutos R6,7, Tarantola A8, Barennes H9,10,11.

Implement Sci. 2015 Mar 11;10(1):32. doi: 10.1186/s13012-015-0217-1.

ABSTRACT

Background: Evidence-based public health requires that research provides policymakers with reliable and accessible information reflecting the disease threats. We described the scientific production of research in Cambodia and assessed to what extent it provides appropriate insights and implications for practice to guide health policymakers and managers and knowledge relevant for translation.

Methods: We conducted a systematic review of scientific articles published on biomedical research in Cambodia. Regression analysis assessed the trends over time and factors associated with actionable messages in the articles’ abstracts.

Results: From 2000 to 2012, 628 articles were published in 237 journals with a significant increase over time (from 0.6/million population to 5.9/million population, slope coefficient 7.6, 95% CI 6.5-8.7, p?<?0.001). Most publications on diseases addressed communicable diseases (n?=?410, 65.3%). Non-communicable diseases (NCD) were under-addressed (7.7% of all publications) considering their burden (34.5% of the disease burden). Of all articles, 67.8% reported descriptive studies and 4.3% reported studies with a high level of evidence; 27.4% of studies were led by an institution based in Cambodia. Factors associated with an actionable message (n?=?73, 26.6%) were maternal health (OR 3.08, 95% CI 1.55-6.13, p?=?0.001), the first author’s institution being Cambodian (OR 1.78, 95% CI 1.06-2.98, p?=?0.02) and a free access to full article (OR 3.07, 95% CI 1.08-8.70, p?=?0.03). Of all articles, 87% (n?=?546) were accessible in full text from Cambodia.

Conclusions: Scientific publications do not fully match with health priorities. Gaps remain regarding NCD, implementation studies, and health system research. A health research agenda would help align research with health priorities. We recommend 1) that the health authorities create an online repository of research findings with abstracts in the local language; 2) that academics emphasize the importance of research in their university teaching; and 3) that the researcher teams involve local researchers and that they systematically provide a translation of their abstracts upon submission to a journal. We conclude that building the bridge between research and public health requires a willful, comprehensive strategy rather than relying solely only publications.

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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  

This is a remarkable study that examines in depth the complexities and difficulties of updating clinical guidelines in a low-income country. This process is critical for WHO and other international health recommendations to be translated into improvements in policy and practice.

‘In September 2011, the IPC researchers were informed by the World Health Organization (WHO) Cambodian office that a revision of the national guidelines was being undertaken. Although there was no official demand for it from the MoH, the IPC researchers endeavored to provide the MoH with locally relevant and evidence-based knowledge on pneumonia…’

CITATION: Knowledge translation: a case study on pneumonia research and clinical guidelines in a low- income country.

Goyet S1, Barennes H, Libourel T, van Griensven J, Frutos R, Tarantola A.

Implement Sci. 2014 Jun 26;9:82. doi: 10.1186/1748-5908-9-82.

http://www.implementationscience.com/content/9/1/82

ABSTRACT

Background: The process and effectiveness of knowledge translation (KT) interventions targeting policymakers are rarely reported. In Cambodia, a low-income country (LIC), an intervention aiming to provide evidence-based knowledge on pneumonia to health authorities was developed to help update pediatric and adult national clinical guidelines. Through a case study, we assessed the effectiveness of this KT intervention, with the goal of identifying the barriers to KT and suggest strategies to facilitate KT in similar settings.

Methods: An extensive search for all relevant sources of data documenting the processes of updating adult and pediatric pneumonia guidelines was done. Documents included among others, reports, meeting minutes, and email correspondences. The study was conducted in successive phases: an appraisal of the content of both adult and pediatric pneumonia guidelines; an appraisal of the quality of guidelines by independent experts, using the AGREE-II instrument; a description and modeling of the KT process within the guidelines updating system, using the Unified Modeling Language (UML) tools 2.2; and the listing of the barriers and facilitators to KT we identified during the study.

Results: The first appraisal showed that the integration of the KT key messages in pediatric and adult guidelines varied with a better efficiency in the pediatric guidelines. The overall AGREE-II quality assessments scored 37% and 44% for adult and pediatric guidelines, respectively. Scores were lowest for the domains of ‘rigor of development’ and ‘editorial independence.’ The UML analysis highlighted that time frames and constraints of the involved stakeholders greatly differed and that there were several missed opportunities to translate on evidence into the adult pneumonia guideline. Seventeen facilitating factors and 18 potential barriers to KT were identified. Main barriers were related to the absence of a clear mandate from the Ministry of Health for the researchers and to a lack of synchronization between knowledge production and policy-making.

Conclusions: Study findings suggest that stakeholders, both researchers and policy makers planning to update clinical guidelines in LIC may need methodological support to overcome the expected barriers.

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A couple of us at Johns Hopkins and beyond are creating an online platform that uses storytelling as a medium of social reform and dialog in health ethics in low and middle-income countries.

We believe that amidst growing inequality in access to medical treatment, malpractice, lack of accountability, loss of human dignity and capricious health policy and practice, a global discourse on the values driving healthcare in the “global south” has become necessary.

Our online forum, which is to launch soon, examines ethical failures, achievements and everything in between. The stories we hope to publish simultaneously probe, heal and offer food for thought without being punitive or judgmental.

Have a story? We are looking for ingenious writers based in a developing country (or with strong ties to one) who can produce first-person (non-fiction) vignettes (150 words or less) that illustrate: an ethical dilemma faced by a person in a health profession (broadly defined) in a developing country, the context, how the person acted and why, and what the aftermath was.

Potential stories of interest could cover a wide range of health issues and come from individuals in hospitals, medical campuses, businesses all along the pharmaceutical supply chain, public health workers, members of NGOs or other public/private health groups, lawyers and lawmakers, and beyond. We also accept narratives and qualitative material that derive from your research and other professional and personal experiences.

While some stories will be squarely entrenched in the “right” or “wrong” ethical camp, we expect the best narratives to straddle the fine line in between. A representative picture or two to accompany your short story would be ideal.

This is an all-volunteer project for the moment (we aren’t paying ourselves either); however, we plan to compensate our regular contributors retroactively upon receiving funding.

Should you be interested, feel free to contact me at pagrawa6@jhu.edu or at valueofabeing@gmail.com. Send us a brief bio and how you think you can contribute.

Regards,

Priyanka

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Value Of A Being

Skype ID: valueofabeing

HIFA profile: Priyanka Agrawal  is a doctor at the Johns Hopkins Bloomberg School of Public Health in the USA. Email address: valueofabeing AT gmail.com

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SMS Contraception Messages Reach Thousands of Mozambican Youth

http://www.thehealthcompass.org/sbcc-spotlights/mcenas-sms-client-education-among-youth

New Health COMpass Spotlight  – learn about how Pathfinder International and its partners worked with Mozambican groups to create SMS messages that reached youth and informed them about the family planning options available to them.

Best regards,

Susan

Susan Leibtag

Health COMpass Curator

Below is part of the text of a feature on the WHO website. The full text is freely available here: http://www.who.int/features/2015/hand-hygiene-ebola/en/

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Sierra Leone: Helping health workers protect patients with clean hands

May 2015

In Ebola-affected countries, like Sierra Leone, the lack of running water can make hand hygiene a challenge. Hand hygiene is so important in public health that 5 May every year is marked as Hand Hygiene Day.

Dr Komba Songu-Mbriwa is a doctor on the frontlines of the Ebola fight in Sierra Leone who also knows the challenges of the disease firsthand. He is an Ebola survivor. But today, he says his most important role extends beyond Ebola as a protector of other health workers. His specialty: teaching his colleagues how to protect themselves and other patients from the spread of all infectious diseases when patients are being cared for in health facilities.

“Hands are the main way in which germs spread in health care settings,” says Dr Songu-Mbriwa.

Hand Hygiene Day

Not just in Sierra Leone but across the world, the simplest and most important action to block the spread of disease in health facilities is ensuring that health workers consistently clean their hands properly. It is so important in public health that 5 May every year is marked as Hand Hygiene Day.

More information on Hand hygiene in the control of Ebola and health system strengthening

Overcoming the lack of running water

“More and more of our health workers colleagues understand this,” says Dr Songu-Mbriwa. “But beyond understanding, we must make it easy and accessible for them to clean their hands often. It’s one thing to repeat ‘Wash your hands’, but what if there is no running water?”…

Creating a culture of infection prevention and hand hygiene among health workers in Sierra Leone is essential for stopping the Ebola outbreak. But, he [Dr Komba Songu-Mbriwa] adds, with the right skills consistently applied, his colleagues will be better placed to respond to future outbreaks.

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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  

Below are extracts from a BBC article by David Heymann (professor of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine), with thanks to Global Health NOW. The full text is avialable here:

http://www.bbc.co.uk/news/health-32551089

……..

It has now been over a year since the Ebola outbreak in West Africa was first reported… So what has the outbreak taught us and how prepared are we for the next global health crisis?…

We have learned that the initial response to an outbreak must be robust and complete…

We have also learned that community engagement is of the utmost importance – helping village elders, paramount chiefs and others understand how the disease is transmitted and how it can be stopped, including emphasis on safe burial practices…

The best means of dealing with an international health crisis is prevention – it has been known, for example, since 1976 that it is sub-standard health facility infection control that permits Ebola to spread, yet sub-standard infection control continues in many facilities. Emphasis must be placed on helping health facilities understand and use infection control measures as part of their routine activities…

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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  

On HIFA we have discussed the problem of research being unavailable in the language of the country where it was undertaken. For example, much research undertaken in Portuguese-speaking Mozambique is published in English-language journals and is therefore inaccessible to many of those who need it most.

A few days ago I was interested to read the following new paper in the open-access journal Human Resources for Health:

Perspectives of key stakeholders regarding task shifting of care for HIV patients in Mozambique

I wrote to the lead author and asked whether there is a Portuguese translation available, either of the full text or the abstract, and received a reply saying “we don’t have the resources to translate the abstract or article into Portuguese at this time, though I do agree it would be useful”.

I offered to help to get the abstract translated via HIFA while at the same time raising awareness of this issue so that – eventually – we can build a world where the abstracts of all health research undertaken in Mozambique is available in Portuguese (and the same for other non-English-speaking countries).

I would like to invite expressions of interest to translate the abstract from English to Portuguese, and comments on how we can move towards a world where abstracts are routinely available in the language of the country where the research was undertaken.

Here is the abstract in English:

Abstract

Background: Task shifting is a common strategy to deliver antiretroviral therapy (ART) in resource-limited settings and is safe and effective if implemented appropriately. Consensus among stakeholders is necessary to formulate clear national policies that maintain high-quality care. We sought to understand key stakeholders’ opinions regarding task shifting of HIV care in Mozambique and to characterize which specific tasks stakeholders considered appropriate for specific cadres of health workers.

Methods: National and provincial Ministry of Health leaders, representatives from donor and non-governmental organizations (NGOs), and clinicians providing HIV care were intentionally selected to represent diverse viewpoints. Using open- and closed-ended questions, interviewees were asked about their general support of task shifting, its potential advantages and disadvantages, and whether each of seven cadres of non-physician health workers should perform each of eight tasks related to ART provision. Responses were tallied overall and stratified by current job category. Interviews were conducted between November 2007 and June 2008.

Results: Of 62 stakeholders interviewed, 44% held leadership positions in the Ministry of Health, 44% were clinicians providing HIV care, and 13% were donors or employed by NGOs; 89% held a medical degree. Stakeholders were highly supportive of physician assistants performing simple ART-related tasks and unanimous in opposing community health workers providing any ART-related services. The most commonly cited motives to implement task shifting were to increase ART access, decrease physician workload, and decrease patient wait time, whereas chief concerns included reduced quality of care and poor training and supervision. Support for task shifting was higher among clinicians than policy and programme leaders for three specific task/cadre combinations: general mid-level nurses to initiate ART in adults (supported by 75% of clinicians vs. 41% of non-clinicians) and in pregnant women (75% vs. 34%, respectively) and physician assistants to change ART regimens in adults (43% vs. 24%, respectively).

Conclusions: Stakeholders agreed on some ART-related task delegation to lower health worker cadres. Clinicians were more likely to support task shifting than policy and programme leaders, perhaps motivated by their front-line experiences. Harmonizing policy and programme managers’ views with those of clinicians will be important to formulate and implement clear policy.

Best wishes,

Neil

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

Gauteng MEC for Health Qedani Mahlangu appoints 27 new health workers for the Natalspruit Hospital east of Johannesburg following OurHealth coverage of a man who died after waiting 12 hours for a bed. Mahlangu’s announcement follows OurHealth’s report that Katlehong resident Bheki Mabuya recently died after waiting 12 hours for the bed at the hospital. Mabuya had been diagnosed with bacterial meningitis, or a swelling of the tissue surrounding the brain and spinal cord caused by an infection. The condition is serious and can lead to brain damage and hearing loss….more

SOME well-meaning people hope we can end violence against immigrants by working to ensure that we are all the same. In reality, we can do it only if we respect the fact that we are different. A common response to the violence is to lament a lack of “social cohesion”. While those who suggest this mean well, their remedy would almost certainly make immigrants’ lives here even more difficult…..more

As of next month all schools in Gauteng will manage their own funds that amount to millions of rand. Panyaza Lesufi, MEC of education in Gauteng announced that all the province’s schools will become Section 21 schools from May 1……more

The 2015 World Health Assembly (from 18 May) will commit to strengthening member states’ capacity to deliver basic surgical and anaesthetic services in primary health care and at the district hospital level. The Assembly will have before it a report from the WHO Secretariat A68/31 [http://apps.who.int/gb/ebwha/pdf_files/WHA68/A68_31-en.pdf] and a draft resolution (EB136.R7) [http://apps.who.int/gb/ebwha/pdf_files/EB136/B136_R7-en.pdf] forwarded from the meeting in January of WHO’s Executive Board (EB).

Background

The Secretariat report, A68/31, reviews the global burden of surgical conditions, the importance and cost effectiveness of surgery and reviews some significant gaps in surgical and anaesthetic services globally. The report surveys a number of areas for action at the country level and current action at the Secretariat level.  

Highlighted in the section on country level action were: awareness raising, access to and quality and safety of emergency and essential surgical services, strengthening the surgical workforce, better data on surgery for policy making, monitoring and evaluation, and global collaboration and partnerships.

Actions by the Secretariat which are highlighted include: the Integrated Management for Emergency and Essential Surgical Care (IMEESC) toolkit; the WHO-CHOICE  project on cost-effectiveness of interventions; and the WHO Global Initiative for Emergency and Essential Surgical Care [http://who.int/surgery/globalinitiative/en/]. The Secretariat will work with MS to ensure that “surgical services at district and subdistrict levels of care are assessed and monitored”.

There was an extended discussion on this issue at the Executive Board meetings in May 2014 (EB135) and January 2015 (EB136) where there was widespread support for progressing this issue. The case for strengthening essential and emergency surgical and anaesthetic services was not contentious although many of the challenges were canvassed. See reports of discussion at EB135 [https://docs.google.com/document/d/1lKv0CXH5uh0HnzuS_lXvyaH0U3r-ntgC6yMSGS-21RI/edit#heading=h.nqpfzl541kt8] and EB136 [https://docs.google.com/document/d/1uva8FMfstqwhEyKJ-GMNU54bBFYqEgonOkZhm7KtHBY/edit#heading=h.cjdo4t746yqz].  

Developing a PHM commentary

PHM’s WHO Watch collective (more here [http://www.ghwatch.org/who-watch]) is keen to hear comments from activists in PHM’s country circles, regional networks and affiliates and other interested civil society and professional organisations on the priorities for strengthening surgical and anaesthetic services and the particular challenges to be overcome in different countries and localities.  Does the report in A68/31 correspond to your local realities? Does the proposed resolution, EB136.R7, address all of the key issues for you? What are the issues which need to be flagged at the WHA? Is there scope for building a broader people’s health movement through action around access to effective, safe and affordable surgical services?  

A draft PHM commentary on this item can be found here [https://docs.google.com/document/d/1sZ3-mfKl4FrCcNoUVDOqv3OBJS4Hoo7e37_HderR1O8/edit].  Comments and suggestions will be most welcome.  Please write to PHM Global Secretariat (globalsecretariat[AT]phmovement.org) with ‘WHO Watch / Surgery’ in the subject line.  

xxxxx

PHM Comment

This is an important area and it is good that WHO is moving to adopt a formal integrated strategy and plan of action.

The issues canvassed in the Secretariat paper (EB136/27) are important. The following issues are of particular importance to PHM: models of service organisation and service delivery, surgical and anaesthetic task distribution within the health workforce, efficacy and effectiveness: evidence, clinical guidelines, clinical audit, safety and quality, clinical governance and clinical accountability, professional accountability and public policy control over training, regulatory frameworks and financing, the role of informed public and community involvement in policy, planning, management and institutional accountability.

It will be important to explore and evaluate the options with respect to service organisation and service delivery in different settings as part of planning this initiative. This will involve surveying existing models and developing criteria for assessing options.  

Ensuring a high return on investment with respect to any expansion of surgical services will depend on: focusing surgery for conditions where surgical treatment has demonstrated efficacy; ensuring high quality and safety with respect to environments and practice; sustainable financing and payment arrangements; and appropriate workforce policies.

There are many lessons from the experience of surgery in rich countries including what to avoid: unreasonable reimbursement, exploitation of professional monopoly power, inappropriate and unsafe practices.  Likewise there are valuable models from resource poor settings (eg the Aravind Eye Care System).

One of the key issues for L&MICs is ensuring appropriate workforce profiles. Surgery in rich countries is highly specialised, relatively autonomous both in clinical decision making and entry control (associated with long training programs), and generously remunerated.  However, many surgical (and anaesthetic) procedures can be performed by personnel with more limited training and less generous remuneration.  The use of such practitioners in a supportive organisational context can ensure greater cost-effectiveness, reach and access. Carefully designed training programs for these practitioners, including rich continuing in-service training, is critical.

Developing models of service delivery will involve identifying in broad terms the types of surgery which might be carried out in local (often quite isolated) hospitals, those which might be restricted to the referral centres, and the more complex but less urgent surgery which can be scheduled for visiting teams.  In many L&MICs properly equipped mobile surgical teams play a critical role in facilitating access. Mobile teams can also play an important role in providing in-service training. Surgery should be integrated within existing PHC programs; it should not be constructed as a new vertical program. Provision should be made for adequate supplies, maintenance and technical support to ensure that surgical facilities in isolated areas and for mobile teams are safe for both patients and staff. It may be necessary to include security for mobile teams in some settings.

PHM urges a return to the district health system model. The roles assigned to the district hospital are critical.  These include both the provision of first level hospital services, including basic surgery and anaesthetics, but also a range of functions that would strengthen and support primary health care and other district-level services.  

Organisational policies and information systems to ensure that surgical services provided are efficacious and effective are critical.  This will require systems for reviewing and synthesising evidence and the availability and observance of clinical guidelines.  Safety and quality are critical. This will require clinical governance arrangements which ensure professional accountability – to peers, to management, to communities and to families and patients. Excessive professional autonomy of the surgical and anaesthetic professions is to be avoided. This requires that arrangements are in place for effective public policy control over training, regulatory frameworks and financing (including remuneration).

The process of expanding access to surgery in low resource settings will be fraught with risks and challenges.  One of the prerequisites for success will be to ensure that policy making, service planning and operational management are all embedded within an environment of public and community accountability.

There will be no ‘one size fits all’ model for expanding surgical services.  While general principles and strategies can be elaborated, institutional arrangements and operational details will need to respond to local and national context. Adapting general principles to local context will require developing local capacity for operations research before, during and after the roll out.

The development of any future strategy and action plan for WHO will need to break away from the prevailing culture of prolonged training, high specialisation, high clinical autonomy, private practice and high remuneration. We urge that whatever expert committees are assembled for this exercise they include people with experience in delivering surgery in low resource settings and that the process includes careful documentation and analysis of existing models of service delivery.  

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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  

Below is the citation and abstract of a new paper in the open-access journal Global Health: Science and Practice.

CITATION: Leveraging the Power of Knowledge Management to Transform Global Health and Development

Tara M Sullivan, Rupali J Limaye, Vanessa Mitchell, Margaret D’Adamo, Zachary Baquet#

First published online April 27, 2015, doi: 10.9745/GHSP-D-14-00228

Glob Health Sci Pract April 27, 2015

http://www.ghspjournal.org/content/early/2015/04/22/GHSP-D-14-00228.full.pdf

ABSTRACT: Good knowledge is essential to prevent disease and improve health. Knowledge management (KM) provides a systematic process and tools to promote access to and use of knowledge among health and development practitioners to improve health and development outcomes. KM tools range from publications and resources (briefs, articles, job aids) and products and services (websites, eLearning courses, mobile applications), to training and events (workshops, webinars, meetings) and approaches and techniques (peer assists, coaching, after-action reviews, knowledge cafés).

SELECTED EXTRACTS from full text (selected by Neil PW)

‘By its very nature, global health and development work involves a multitude of actors working toward common goals that transcend geographic, sectoral, organizational, and financial boundaries. These efforts require immediate access to the latest research and know-how and demand optimal use of limited resources to achieve maximum impact. Knowledge management (KM) can improve coordination, enhance learning and knowledge application, and improve capacity, thus heightening service quality, strengthening health systems, and, ultimately, improving health and development outcomes.’

‘KM approaches and techniques such as peer assists (bringing together a group of peers to elicit feedback on a problem, project, or activity and draw lessons from the participants’ knowledge and experience), coaching, mentorship, storytelling, and online orface-to-face forums such as communities of practice, are KM tools that can assist in enhancing coordination, learning, and adaptation.’

‘Because knowledge management has been informed by and used within disciplines outside public health, there is a crucial need to consider how to apply KM tools and processes from other fields to global health. Public health practitioners must recognize that one of the primary intangible assets we possess is knowledge and that we all require knowledge to solve the world’s pressing global health problems. The management of that knowledge is paramount but has yet to be viewed as such.’

Best wishes

Neil

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

Below is the citation and key messages of a paper on health policymaking, drawing from experience in Bangladesh, Gambia, India and Nigeria.

CITATION: Strengthening capacity to apply health research evidence in policy making: experience from four countries

Sarah Hawkes, Bhupinder K. Aulakh, Nidhee Jadeja, Michelle Jimenez, Kent Buse, Iqbal Anwar, Sandhya Barge, M. Oladoyin Odubanjo, Abhay Shukla, Abdul Ghaffar and Jimmy Whitworth

Health Policy Plan. (2015)

doi: 10.1093/heapol/czv032

First published online: April 21, 2015

KEY MESSAGES

• There is widespread acknowledgement of the need to strengthen capacity to increase the use of evidence in policy cycles and that capacity needs to be developed on both the supply and demand sides of evidence production. However, little experience of capacity strengthening in health sectors in low- and middle-income countries has been published to date.
• Strengthening the capacity of individuals and organizations is necessary but probably insufficient to ensure the sustainability of evidence-informed policy making. Institutional capacity needs to be strengthened too. This requires resources, legitimacy and regulatory support from policy makers.
• Evidence of what works to develop capacity to use evidence is needed — but rarely measured. We propose a new conceptual framework to evaluate the impact of capacity strengthening activities across a variety of levels and activities.
• For sustainable change, the politics of evidence-informed policy making needs to be understood and addressed—particularly the incentives facing policy makers to support the use of evidence in policy cycles.

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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  

Join USAID On May 11

Webinar: How to Get Published ? A Conversation with Journal Editors

The Health Communication Capacity Collaborative (HC3) will hold a webinar May 11 to help university faculty and students in Africa and Asia learn more about how to publish research manuscripts. The third webinar in HC3’s University Initiative series, How to Get Published?A Conversation with Jouurnal Editors will be a roundtable discussion among editors of communication journals.

May 11, 2015 11AM – 12 PM EDT

REGISTER NOW

http://www.eventbrite.com/e/how-to-get-published-a-conversation-with-journal-editors-tickets-16697527755?ref=ebtn

During a university needs assessment in 2013, HC3 identified some of the greatest challenges universities in sub-Saharan Africa and Asia face, including limited access to current literature and limited opportunities for scholarly publication. The webinar will provide advice on how to improve the ability of faculty and students in Africa and Asia to generate publishable research manuscripts. Participating editors will be asked to describe the mission of their journal and the types of manuscripts of interest to their readers, the nature of the review process, and guidelines or suggestions for authors that might encourage or facilitate more quality manuscript submissions. Doug Storey, PhD, director for Communication Science and Research at the Johns Hopkins Center for Communication Programs, will moderate.

Presenters include:

• Scott Ratzan, MD, editor-in-chief of the peer-reviewed Journal of Health Communication: International Perspectives
• Natalie Culbertson, managing editor, Global Health: Science and Practice (GHSP) Journal
• S. Shyam Sundar, PhD, editor-in-chief of the Journal of Computer-Mediated Communication
• Winston Mano, PhD, director of the Africa Media Centre and course leader of the MA in Media and Development at the University of Westminster
• Silvio Waisbord, PhD, professor and director of Graduate Studies in the School of Media and Public Affairs at George Washington University and editor-in-chief of the Journal of Communication

We hope that you will be able to join us!

For more information, contact Moremi Oladeinde. moladeinde@jhu.edu

__________

To send a message to the HIFA forum, simply send an email to: HIFA2015@dgroups.org

Below is the citation and abstract of a new paper in Maternal and Child Health Journal. Unfortunately the full text is restricted access and so I cannot read it, and the abstract does not really tell us anything. I have invited the lead author to join us to tell us more.

CITATION: Obasola OI, Mabawonku I, Lagunju I. A review of e-Health interventions for maternal and child health in Sub-Sahara Africa. Maternal and Child Health Journal. 2015. http://www.ncbi.nlm.nih.gov/pubmed/25652059

Corresponding author: Obasola OI, E. Latunde Odeku Medical Library, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria, Email address: olaseun@yahoo.com

ABSTRACT

To review e-health interventions for maternal and child health (MCH) and to explore their influence on MCH practices in sub-Sahara Africa (SSA). Keyword searches were used to retrieve articles from four databases and the websites of organisations involved in e-health projects for MCH in SSA. A total of 18relevant articles were retrieved using inclusion and exclusion criteria. The researchers reveal the prevalence of the application of mobile phones for MCH care and the influence of the use of information and communication technology (ICT) for delivering MCH information and services to target populations. There is a need to move the application of ICT for MCH care from pilot initiatives to interventions involving all stakeholders on a sub-regional scale. These interventions should also adopt an integrated approach that takes care of the information needs at every stage along the continuum of care. It is anticipated that the study would be useful in the evolution and implementation of future ICT-based programmes for MCH in the region.

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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  

Too many dying in Sierra Leone as result of Ebola response not virus itself – report

http://www.theguardian.com/world/2015/apr/28/too-many-dying-sierra-leone-response-ebola-report

Too many people are dying in Sierra Leone not from Ebola but as a result of the response to it, according to a report on the collapse of healthcare in the west African country.

Ebola has killed at least 3,900 people in Sierra Leone so far, but the epidemic has critically damaged the ability of the country’s limited healthcare system to cope with anything else, including soaring HIV and tuberculosis rates.

More people are believed to have died from malaria than from Ebola, while deaths of mothers and babies in childbirth are thought to have risen significantly.

Health and medical staff have been drawn away from their clinics into the Ebola response effort and the population has lost confidence in their health centres and hospitals. Attendance at clinics has plummeted by more than 70%….

Since Ebola there is a lack of trust between both doctors and patients; doctors are wary of who and what they are treating and patients are fearful of who’s treating them and what might happen if they are suspected of having Ebola…

“Everyone is rightly focusing hard on getting Ebola cases down to zero but a very real public health emergency happening around them is being ignored”

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CITATION: A modelling tool for policy analysis to support the design of efficient and effective policy responses for complex public health problems

Jo-An Atkinson, Andrew Page, Robert Wells, Andrew Milat, Andrew Wilson

Implementation Science 2015, 10:26  

doi:10.1186/s13012-015-0221-5

published online: 3 March 2015

ABSTRACT / Resumen:

Background: In the design of public health policy, a broader understanding of risk factors for disease across the life course, and an increasing awareness of the social determinants of health, has led to the development of more comprehensive, cross-sectoral strategies to tackle complex problems. However, comprehensive strategies may not represent the most efficient or effective approach to reducing disease burden at the population level. Rather, they may act to spread finite resources less intensively over a greater number of programs and initiatives, diluting the potential impact of the investment. While analytic tools are available that use research evidence to help identify and prioritise disease risk factors for public health action, they are inadequate to support more targeted and effective policy responses for complex public health problems.

Discussion: This paper discusses the limitations of analytic tools that are commonly used to support evidence-informed policy decisions for complex problems. It proposes an alternative policy analysis tool which can integrate diverse evidence sources and provide a platform for virtual testing of policy alternatives in order to design solutions that are efficient, effective, and equitable. The case of suicide prevention in Australia is presented to demonstrate the limitations of current tools to adequately inform prevention policy and discusses the utility of the new policy analysis tool.

Summary: In contrast to popular belief, a systems approach takes a step beyond comprehensive thinking and seeks to identify where best to target public health action and resources for optimal impact. It is concerned primarily with what can be reasonably left out of strategies for prevention and can be used to explore where disinvestment may occur without adversely affecting population health (or equity). Simulation modelling used for policy analysis offers promise in being able to better operationalise research evidence to support decision making for complex problems, improve targeting of public health policy, and offers a foundation for strengthening relationships between policy makers, stakeholders, and researchers.

Full text: http://www.implementationscience.com/content/10/1/26

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Below are the citation and extracts from a recent BMJ editorial. Health literacy is central to HIFA and I look forward to ideas from members on how we can contribute to this growing field. As a first step, I invite HIFA members in different countries to share how they ‘make health information and support available and accessible to people with different health literacy strengths and limitations’. As we have seen with the Ebola crtisis, the role of social science and, in particular, anthropology, is critical to how people obtain and interpret the healthcare information they need to protect their own health and the health of those for whom they are responsible.

CITATION: Health literacy: towards system level solutions

BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h1026 (Published 24 February 2015)

Cite this as: BMJ 2015;350:h1026

‘In a new resource aimed at low and middle income countries, the World Health Organization has redefined health literacy as “the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health.”’

[World Health Organization. Health literacy toolkit for low- and middle-income countries. A series of information sheets to empower communities and strengthen health systems. 2015. www.searo.who.int/entity/healthpromotion/documents/hl_tookit/en/ ]

‘Health literacy was traditionally conceptualised as an individual deficiency in verbal ability, numeracy, or both. It was measured as the equivalent school grade in classroom-style assessments of performance14 or as ability to read and interpret passages of health related text such as instructions on how to take medication… Two recent systematic reviews have added multiple dimensions to the construct of health literacy, including communication skills, motivation, confidence, trust, and the ability to access care…’

‘WHO is exhorting countries to assess and develop their own health literacy responsiveness — defined as “the way in which services, environments and products make health information and support available and accessible to people with different health literacy strengths and limitations.”’

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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  

Now, some examples of the MCH handbook are uploaded.

You can fined both local and English language versions of MCH handbooks from four countries:

Bangladesh, Thailand, Palestine and Kenya.

Some of them are simple and some are sophisticated.

Please check the following URL: http://www.hands.or.jp/activity/mch/hb/e-mchdata.html

Are you interested in the handbook?

Please join the international conference. http://www.jeso.or.jp/council/download/141117/MCHHBProfile.pdf

HIFA profile: Satoko Yanagisawa works at the School of Nursing & Health, Aichi Prefrctural University, Kamishidami, Togoku, Moriyama-ku, Nagoya, Japan. sayanagi AT nrs.aichi-pu.ac.jp