MEDBOX is an innovative online library aimed at improving the quality of healthcare in humanitarian action, worldwide. An independent internet platform supported by international agencies and scientific institutions active in humanitarian assistance and development, MEDBOX collates the increasing number of professional guidelines, textbooks and practical documents on health action available online today and brings these into the hands of humanitarian aid workers: when they need it, where they need it. MEDBOX is still under development! We are keen to receiving more documents, training materials and presentations relevant to improve the quality of health action! Your feedback is valuable to us, so do get in touch if you have something you’d like to share with us to improve on, and maximise, our collaborative space. Do send your comments to: info@medbox.org MEDBOX. Capacity building and quality assurance through innovation.

 USAID-funded Health Policy Project has just published ‘Scaling up Evidence-Informed HIV Prevention for Adolescent Girls and Young Women’. Below is a description from the website and selected abstracts that highlight the importance of health education and information. I look forward to learn from HIFA members about current policy and practice regarding sex and HIV education for adolescent girls (and boys) in different countries. Is sex education banned in some countries and, if so, what are the consequences? Is sex and HIV education widely available in your country?

It is interesting that the report specifically calls for ‘clear policies and legislation supporting access to information and services are needed to reduce the risk of HIV transmission among young people.’ I would welcome any examples of positive and negative policies/actions by governments in relation to sex and HIV education. We shall then add these examples to the growing HIFA-Watch world map of access-to-health-information: www.hifa2015.org/hifa-watch

‘Adolescents are a critical priority in HIV prevention programming. Today’s adolescents have never known a world without AIDS. People born with HIV and those becoming sexually active in an era of HIV and AIDS face complicated risks and challenges that were unknown to previous generations.

‘Today, 1.8 billion young people ages 10-24 comprise 44 percent of the world’s population. Many of the countries with the highest HIV prevalence are experiencing a massive “youth bulge” in population, so even with decreasing HIV prevalence, the absolute number of young people living with HIV or at risk of acquiring HIV will grow in the next five years. There is also growing evidence that many high-risk behaviors among key populations begin during adolescence.

‘Young women are especially vulnerable, with HIV infection rates nearly twice as high as those for young men. At the end of 2012, approximately two-thirds of new HIV infections in adolescents aged 15 to 19 years were among girls. An AIDS-free generation is not possible without addressing the specific needs of adolescents-especially girls-that put them at risk for HIV acquisition.

‘Scaling up evidence-informed interventions for adolescents is essential. This brief offers priority interventions for programmers based on evidence from successful programming for women and girls; though a number of the interventions listed also benefit men and boys. The brief is divided into three parts: evidence-informed priority areas for programming; implementation and research gaps that must be addressed; and considerations for scaling up successful programming for girls and young women. To download this brief, please visit www.healthpolicyproject.com or www.whatworksforwomen.org ‘

SELECTED EXTRACTS

‘Evidence among adults has shown that community-based interventions (including media) that provide accurate information about HIV transmission can significantly reduce HIV stigma and discrimination (works among adults)

‘Promising interventions such as encouraging communication between adults and young people about reproductive health information, can increase protective behaviors among adolescents, and providing HIV prevention education by people living with HIV (who wish to sero-disclose) to youth can reinforce messages about protective behavior.’

‘Studies have consistently shown that increasing women’s access to information, skills, technologies, services, social support, and income increased their ability to protect themselves from HIV’

‘Adolescents are often overlooked in government bureaucracy and the information needs of young people are a low priority.’

‘Substantial evidence exists that sex and HIV education with certain characteristics (e.g., a clear focus on HIV prevention; addressing situations that might lead to unwanted or unprotected intercourse, how to avoid these, and how to get out of them; a focus on knowledge, values, norms, attitudes, and skills; employment of participatory teaching methods, etc.) prior to the onset of sexual activity may be effective in reducing stigma and preventing transmission of HIV by increasing age at first sex and, for those who are sexually active, increasing condom use and HIV testing, and reducing the number of sexual partners.’

‘The quality of sex education is as important as its provision; fidelity to the successful components of pilot programs must be maintained. Training for teachers to conduct age-appropriate, participatory sex education that can improve students’ knowledge and skills, is essential.’

Best wishes, Neil

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

CITATION: Has the WHO Global Code of Practice on the International Recruitment of Health Personnel been effective?

Akhenaten B S Tankwanchi, Sten H Vermund, Douglas D Perkins

http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(14)70240-2/fulltext

The Lancet Global Health, Volume 2, Issue 7, Pages e390 – e391, July 2014 <Previous Article|Next Article> doi:10.1016/S2214-109X(14)70240-2

‘The adoption of the WHO Global Code of Practice on the International Recruitment of Health Personnel in May, 2010, ostensibly heralded a new era of accountability in the migration of health-care workers. […] However, the only study to evaluate the comprehensive implementation of the Code by all WHO member states has found disappointing results…

‘The 2013 data reveal that the number of physicians from sub-Saharan Africa recruited into the US physician workforce continues to increase substantially despite the WHO Code adoption…’]

The WHO Integrated Management for Emergency & Essential Surgical  Care (IMEESC) Toolkit contains a short 3 page poster on Waste Disposal for Clinical Procedures which is part of the Best Practice Safety Protocols, at the following link below:  http://www.who.int/surgery/publications/immesc_best_practice/en/

Please do not hesitate to contact us if you require more information.

Best wishes

Dr Meena Nathan Cherian MD

Emergency & Essential Surgical Care (EESC) program

Service Delivery and Safety Department (SDS)

Health Systems & Innovation

World Health Organization- HQ

Avenue Appia 20, CH-1211 Geneva 27, Switzerland

tel:0041 22 791 4011; fax: 0041 22 791 4153

cherianm@who.int; www.who.int/surgery

Hesperian has always worked with partners around the world to make our resources available in many languages, and recently we have been especially focusing on expanding the availability of our resources in French and in local languages for West Africa by strengthening our partnerships with grassroots organizations in the region and increasing the number of translations of our materials available in those languages.

I’m happy to share that 6 chapters in French from the New Where There Is No Doctor are newly available in our free HealthWiki (http://en.hesperian.org/hhg/Healthwiki ). Each chapter provides information that community health workers and educators in West Africa and other French speaking countries can use to build lasting good health in their communities

Chapters include:

1. Belly Pain, Diarrhea, and Worms: http://fr.hesperian.org/hhg/New_Where_There_Is_No_Doctor:Chapitre_15_:_Les_douleurs_au_ventre,_les_diarrh%C3%A9es,_et_les_vers

2. Pregnancy and Birth: http://fr.hesperian.org/hhg/New_Where_There_Is_No_Doctor:Chapitre_26_:_La_grossesse_et_l%E2%80%99accouchement

3. Newborn Babies and Breastfeeding: http://fr.hesperian.org/hhg/New_Where_There_Is_No_Doctor:Chapitre_27_:_Les_nouveau-n%C3%A9s_et_l%27allaitement

4. Caring for Children: http://fr.hesperian.org/hhg/New_Where_There_Is_No_Doctor:Chapitre_28_:_Prendre_soin_des_enfants

5. Good Food Makes Good Health: http://fr.hesperian.org/hhg/New_Where_There_Is_No_Doctor:Chapitre_28_:_Prendre_soin_des_enfants

6. Water and Sanitation: Keys to Staying Healthy: http://fr.hesperian.org/hhg/New_Where_There_Is_No_Doctor:Chapitre_32_:_L%E2%80%99eau_et_assainissement_:_Les_cl%C3%A9s_pour_rester_en_bonne_sant%C3%A9

Other French language resources are on the way, as are translations into Bambara, Fon, Malinke, Pular, and Wolof.

Please use these resources in your work, share them with your friends and colleagues.

Warm Regards,

Libby Engles

Media and Communications Associate

Hesperian Health Guides

libby@hesperian.org

Last week (June 19th) I attended, on behalf of HIFA, a seminar in London entitled: “Apps, maps and cyber chats: how technology can be harnessed for global health“, organised by the Royal College of Physicians and the Alma Mata Global Health Network. This seminar, which was attended by about 40 people and chaired by Dr Caroline Free from the London School of Hygiene and Tropical Medicine, was to explore how technological innovations can be employed in low-resource settings to address global health issues.

Discussion was led by a panel comprising:

– Chris Phillips, MapAction (specialist in provision of geographical information systems in emergency situations)

– Dr Tariq Sadiq, St. George’s University/eSTI2 Consortium ( director of eSTI2 – electronic self-testing instruments for sexually transmitted infections) ;

– Alan Hardiman, T-Systems (manager, telemedicine and tele-health solutions)

– Dr Susie Whitwell, Medicine Africa (mental health lead for the King’s-THET-Somaliland Partnership )

Key points from the discussion included: 

Access

– Mobile phones were becoming widespread even in remote areas and already being used in imaginative ways (e.g. banking) and mobile health apps were beginning to spread

– For financial sustainability in the developing world mHealth applications will need to be “at cost”  – similar to essential drugs

– Need to guard against risk of widening health inequalities– technology is not always the answer – keep things simple!

Efficacy

– The technology needed to be tailored to the situation e.g. a maternal health application had originally intended to use text messaging but switched to voice messaging when participant literacy levels were checked

– “Gameification” has proved useful in getting messages across

Developments

– There were exciting developments in the pipeline e.g. on use of mobile phones as part of a “lab on a chip” package for rapid diagnosis of TB, malaria etc.

– Distance learning in health care was a potential growth area – useful interaction  between mLearning and mHealth

– In recent years some applications, like disaster mapping using mobiles, have moved from “nice to have”  to “must have”

– Offline applications had lots of potential, especially now storage capacity was rapidly increasing, although issues of updating and data security would need addressing

Scaling up 

– Some mHealth applications, e.g. smoking cessation, started in high income countries but are now being used in middle and low income ones

– Difficulties in scaling up pilots were sometimes owing to technical issues such as lack of access to smartphones but often because funding is available only for short pilots

– Another problem with scaling up is that people do not pay sufficient regard to getting key people on side – attention has to be paid to local and national politics

Privacy and other legal issues 

– Security of private health-related information was an issue, although many users e.g. younger people were less concerned about this than is often assumed; danger of seeking to impose western views on this

– Some development was being slowed by fears of legal action if an application leads to a wrong diagnosis

– Corporate ownership of software was a problem in developing countries – although open source software was becoming more used

Evaluation

– There was a potential problem with indiscriminate use of unevaluated information – there was a case for regulation or at least for giving health workers help in critical appraisal

– Similarly there was a potential problem in using software applications that had not been properly evaluated.

– Funding was often not available for longer evaluation studies

– However, evaluations often needed to be rapid to avoid being left behind by rapidly advancing technology, although functions (like text messaging) changed more slowly than devices

HIFA colleagues will be pleased hear that seminar participants showed lively interest in our work, including of course the mHIFA challenge, and many took away with them further information about the HIFA network.

Regards, Geoff Royston

HIFA profile: Geoff Royston is former Head of Strategic Analysis and Operational Research in the Department of Health for England and is currently President-Elect of the UK Operational Research Society. He has had a range of activities and responsibilities involving analysis and research to inform the design, implementation and evaluation of evidence-based policies and programmes in health and social care. These include modelling for understanding the performance of complex systems, analysis and communication of risk, and horizon scanning and futures thinking. He has also worked on information and communication technology in the health sector, notably in leading the design and national launch of NHS Direct.  He has served on both scientific and medical UK Research Council panels and is a member of the editorial board for the journal Health Care Management Science, for which he was Guest Editor for the Special Issue on Global Health published in 2012.  He has been a consultant for the World Health Organisation on the use of information and analysis to improve the management of healthcare and population health.

You might be interested in a new and well-received report by C3 Collaborating for Health and the European Association for the Study of Obesity, ‘Obesity: perception and policy – multi-country review and survey of policymakers’. Rates of obesity have been rapidly rising, first across the developed world and, more recently, in developing countries. The health impacts can be myriad and serious, and the implications for individuals and for governments – including increasing health-care costs and falling economic output – are clear. Policymakers will be faced with the financial consequences of obesity – and they are well placed to take action to control the epidemic and its health repercussions. However, are their perceptions of obesity and obesity policy accurate? Do they appreciate the extent of the epidemic, the drivers of obesity, and the tools and actions that need to be taken to make a difference? To find out, C3 and EASO commissioned surveys of policymakers’ attitudes towards and knowledge of obesity issues in 11 countries: Brazil, Bulgaria, Canada, Denmark, England, France, Germany, Italy, Mexico, Spain and the United States. It found that policymakers would benefit from greater awareness of the extent of obesity and overweight (and particularly the latter) in their countries, with a better appreciation of ‘what works’ and the impact of obesity-prevention and -management programmes. If policymakers have solid knowledge of the extent of the problem and the existing evidence on successful interventions, national policies are more likely to be put in place that adequately address the reality of tackling obesity in the population.

The report, which was launched at the European Congress on Obesity in Bulgaria in May, is available to download from this page: http://www.c3health.org/c3activities/documents/obesity-policymaker-survey-2014/

Patricia Hughes

Associate: Nursing, Health & Development

C3 Collaborating for Health

The G77 met in Bolivia last week to commemorate the formation of the Group of 77 on 15 June 1964. ‘The Group of 77 is the largest intergovernmental organization of developing countries in the United Nations, which provides the means for the countries of the South to articulate and promote their collective economic interests and enhance their joint negotiating capacity on all major international economic issues within the United Nations system, and promote South-South cooperation for development.’ http://www.g77.org/doc/

The Group issued the Santa Cruz Declaration ‘For a New World Order for Living Well’, which starts as below: http://www.g77bolivia.com/en/declaration-santa-cruz

‘1. We, the Heads of State and Government of the member States of the Group of 77 and China, have gathered in the city of Santa Cruz de la Sierra, Plurinational State of Bolivia, for the commemoration of the fiftieth anniversary of the establishment of the Group.’

The Declaration has this to say about public health and access to medicines:

’62.     We recognize that universal health coverage means that everyone has access, without discrimination, to a set of basic medical services of promotion, prevention, cure and rehabilitation that meet the needs and are determined nationally, as well as to essential quality, safe, affordable and effective medicines while ensuring that the use of these services does not entail serious economic difficulties for users, especially people in vulnerable situations.

’63.     We also recognize that many developing countries do not have the financial or human resources or the infrastructure to implement the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Therefore, we call upon developed countries and relevant international organizations to provide the adequate financial resources and technology to developing countries that will complement their efforts to have policies and measures that provide universal health coverage and basic health services for all.

’64.     We note with great concern that non-communicable diseases have become an epidemic of significant proportions, undermining the sustainable development of member States. In that sense, we acknowledge the effectiveness of tobacco control measures for the improvement of health. We reaffirm the right of member States to protect public health and, in particular, to ensure universal access to medicines and medical diagnostic technologies, if necessary, including through the full use of the flexibilities in the Doha Declaration on the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement) and Public Health.

’65.     We recall paragraph 142 of the outcome document of the United Nations Conference on Sustainable Development, in which Heads of State and Government reaffirmed the right to use, to the fullest extent, the provisions contained in the TRIPS Agreement, the Doha Declaration on the TRIPS Agreement and Public Health, the decision of the General Council of the World Trade Organization (WTO) of 30 August 2003 on the implementation of paragraph 6 of the Doha Declaration and, when formal acceptance procedures are completed, the amendment to article 31 of the TRIPS Agreement, which provide flexibilities for the protection of public health, and in particular to promote access to medicines for all and encourage the provision of assistance to developing countries in this regard. We affirm the importance of taking advantage of the use of TRIPS flexibilities in order to promote the people’s health and access to medicines. We call upon developed countries to fully respect the right of developing countries to make full use of TRIPS flexibilities and to refrain from taking actions, including trade measures, to prevent or dissuade developing countries from exercising this right.

’66.     We are concerned about the increasing problem of antimicrobial resistance to existing drugs, including those against tuberculosis and malaria. As a result, increasing numbers of patients, especially in developing countries, face the prospect of dying from preventable and/or treatable diseases. We urge the international health authorities and organizations, especially the World Health Organization (WHO), to take urgent action and to work together upon request with developing countries that do not have adequate resources to address this problem.’

Best wishes, Neil

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

New health domains are coming, but unfortunately they will likely be awarded to a set of private companies that have no experience or interest in public health.  ICANN’s recent decision to ignore multiple calls from the public health community, World Health Organizations, World Medical Association, countries like France and Mali, and other stakeholders means that a new .health top level domain will soon be on the Internet, along with other health-related domains (such as .med, .healthcare, .doctor, etc.).  However, these domains will be operated with virtually no restrictions and by companies in the business of generating profit, not quality and reliable health information.  See our previous work on the .health and other health-related domains in work in the Lancet (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62215-1/fulltext ) and the Journal of Medical Internet Research (http://www.jmir.org/2014/3/e62/ )

Specifically, on 6 June 2014, ICANN’s New gTLD Program Committee, who is empowered to make board-level decisions regarding new ‘generic-top level domain names’ (think existing .com and .biz, but now being expanded to .health, .doctor, .clinic, .healthcare) announced that it would take no action to protect or provide additional safeguards for health domains despite multiple warnings and a call for a halt to their award process.  In their decision they noted objections from the World Health Organization and others, but stated that there were ‘no noted objections to move forward’ (see:  https://www.icann.org/resources/board-material/prelim-report-new-gtld-2014-06-06-en ).

This decision means that the .health will be auctioned away to the highest bidder of 3 private companies in September, a move that could have disastrous impacts on the right to quality and reliable health information.  We’ve called for action in our prior research, and now are calling for it again.  Unless drastic action is taken, ICANN will continue to ignore public health in favor of profits and unregulated Internet expansion.

Timothy Ken Mackey, MAS, PhD

Assistant Professor, UC San Diego, School of Medicine

Associate Director, MAS Program in Health Policy and Law

Director, Global Health Policy Institute

Website:  www.ghpolicy.org  

Linkedin Profile

MyMobileUniversity is an initiative by LTT Global a global pioneer in mobile learning to impact lives globally through education. It is a FREE learning platform for all ages, making available content from ages 2 upwards covering academic, lifestyle and lifelong learning. Everyone gets an opportunity to learn something new, up-skill or re-skill themselves at their own time and money and time is no longer an issue. MyMobileUni.com’s platform makes it a one-stop centre to access FREE and quality learning content. We have links to the world’s leading Massive Open Online Courses (MOOC) providers like Coursera, edX and Udacity. We also have access to other universities, organizations and subject matter experts from all over the world who have content that they like to share with the world.’ http://mymobileuni.com/ 

The Global Health Workforce Alliance has published the official report of the Third Global Forum on Human Resources for Health. Below are extracts from the executive summary, I have also added the report’s 10 point agenda, together with (for comparison) the 7-point agenda from our pre-Recife discussion on HRH here on the HIFA forum (HIFA was the official platform for global discussions in the weeks leading up to Recife).

Human Resources for Health: foundation for Universal Health Coverage and the post-2015 development agenda http://www.who.int/workforcealliance/knowledge/resources/report3rdgf/en/

‘This report describes the proceedings and main outcomes of the Third Global Forum on Human Resources for Health, which was jointly convened by the Government of Brazil, WHO, the Pan American Health Organization (PAHO) and the Global Health Workforce Alliance in Recife, Brazil, from 10 to 13 November 2013. The event, organized around the theme of Human Resources for Health: Foundation for Universal Health Coverage and the Post-2015 Development Agenda, provided an opportunity to bolster political commitment and to update the human resources for health agenda, to make it more relevant to the current global health policy discourse, including the push towards the health Millennium Development Goals, the universal health coverage objective and the post-2015 agenda.’

‘In addition, countries and human resources for health stakeholders were invited to make explicit commitments related to human resources for health to accelerate efforts on their national health development agendas as the basis for an inclusive mutual accountability framework.’

‘With 1800 participants and attendees from 93 Member States, including more than 40 ministers and/or deputy ministers, the Third Global Forum was the largest ever human resources for health event. The conference had a dual nature: a technical event to share new evidence, best practices and lessons learned among experts and planners in human resources for health; and a political one to galvanize the support of policy-makers.’ […]

‘The Third Global Forum showed that the global community must significantly and ambitiously raise the bar in its efforts: aiming much higher in terms of the political will, good governance and financial and other resources committed to address challenges related to human resources for health. A holistic agenda on human resources for health instrumental to attaining universal health coverage will require interconnected efforts at the national and global levels in support of four main areas of action:

• anticipate and adapt to new challenges;

• articulate ambitious targets with a long time horizon (10–15 years), including producing larger number of health workers and establishing benchmarks for the performance of higher education and employment;

• broaden participation in policy development and response beyond the public health sector by engaging other key constituencies and sectors and create accountability mechanisms to support and oversee implementation; and

• innovate through more efficient and rational planning and use of financial and human resources in the health sector and towards more results-focused implementation. […]

‘The Recife Political Declaration on Human Resources for Health, adopted by representatives of Member States attending the Third Global Forum, was the ultimate outcome of the event and enshrined these principles, marking the beginning of a new era in human resources for health. The Recife Declaration recognized the centrality of human resources for health in the drive towards achieving universal health coverage. It reaffirmed the vision that all people everywhere must have access to a skilled, motivated and facilitated health worker within a robust health system; it committed governments to creating the conditions for the inclusive development of a shared vision with other stakeholders; and it reaffirmed the role of the WHO Global Code of Practice on the International Recruitment of Health Personnel as a guide for action to strengthen the health workforce and health systems. Further, it identified a range of actions, including improving planning, education, management, governance, information systems and the adoption of innovative approaches, to be implemented in accordance with countries’ contexts and needs. The political statements made in the Recife Declaration, matched by the more than 80 commitments by WHO Member States and Global Health Workforce Alliance member organizations, are the best measure of the success of the Third Global Forum on Human Resources for Health in bolstering political commitment for the health workforce agenda and represent a shared platform and common startingpoint for further policy dialogue and action on developing human resources for health in the years ahead.’ […]

‘The report presents a 10-point agenda [for action]:

1. Recognize the centrality of the health workforce in translating the universal health coverage vision into improved health care on the ground.

2. Assess the gap between the need for a health workforce, actual supply and the population’s demand for health services.

3. Formulate human resources for health policy objectives that encapsulate the vision for the health system and services.

4. Build the data, evidence base and strategic intelligence required to implement and monitor the policy objectives and to sustain effective management.

5. Build and sustain the technical capacity to design, advocate for and implement policies.

6. Build political support at the highest level to ensure continuity in the pursuit of universal health coverage.

7. Reform the governance and institutional human resources for health environment.

8. Assess the cost of the various scenarios of health workforce reforms.

9. Encourage international partners to focus their support and to report on their official development assistance for building the capacity of health systems.

10. Encourage international partners to address transnational issues and strengthen global human resources for health governance, collaborative platforms and mechanisms.’

It is interesting to compare the 10-point agenda from Recife (above) with the 7-point agenda below that emerged from HIFA discussions before Recife (HIFA was the official platform for multi-stakeholder discussion in the run-up to Recife).

‘1. Funders should think more long-term

2. Support expansion and improvement of community health worker programmes

3. Governments should assume responsibility for HRH planning

4. Strengthen professional associations

5. Strengthen education and training

6. Address needs of laboratory professionals

7. Strengthen management and leadership.’

A 2-page summary of our discussions on HIFA is available here:

http://www.hifa2015.org/wp-content/uploads/GHWA-HIFA-Discussion-on-HRH.pdf 

Best wishes, Neil

HIFA profile: Neil Pakenham-Walsh is the coordinator of the HIFA campaign (Healthcare Information For All) and co-director of the Global Healthcare Information Network. He is also currently chair of the Dgroups Foundation (www.dgroups.info), a partnership of 18 international development organisations promoting dialogue for international health and development. He started his career as a hospital doctor in the UK, and has clinical experience as an isolated health worker in rural Ecuador and Peru.  For the last 20 years he has been committed to the global challenge of improving the availability and use of relevant, reliable healthcare information for health workers and citizens in low- and middle-income countries. He is also interested in the wider potential of inclusive, interdisciplinary communication platforms to help address global health and international development challenges. He has worked with the World Health Organization, the Wellcome Trust, Medicine Digest and INASP (International Network for the Availability of Scientific Publications). He is based near Oxford, UK. www.hifa2015.org  neil.pakenham-walsh AT ghi-net.org

On behalf of the Centers for Disease Control and Prevention (CDC), I am pleased to announce the release of a new CDC Blast Injury mobile application to assist in the response and clinical management of injuries resulting from terrorist bombings and other mass casualty explosive events. The application provides clear, concise, up-to-date medical and healthcare systems information to assist healthcare providers and public health professionals in the preparation, response, and management of injuries resulting from terrorist bombing events. We invite you and your organization to join us for a Google+ Hangout on June 30th at 11:30 EDT as we discuss this new tool. You can RSVP and join the Hangout here: https://plus.google.com/+CDC

Download the mobile application for free today from the iTunes store: https://itunes.apple.com/au/app/cdc-blast-injury/id890434999?mt=8&ign-mpt=uo%3D2

We hope that you can join us on June 30th as we launch the CDC Blast Injury mobile application.

Forwarded by Nand Wadhwani

The Mother and Child Health and Education Trust

http://motherchildtrust.org  |  http://healthphone.org

A new paper in the WHO Bulletin (free access) suggests that SMS text messages are more effective (and probably much less expensive) than a 1-day workshop to promote rational prescribing of antibiotics. Below is the citation and selected extracts.

CITATION:

Yaolong Chen et al. Use of text messages to communicate clinical recommendations to health workers in rural China: a cluster-randomized trial. Bull World Health Organ 2014;92:474–481 | doi: http://dx.doi.org/10.2471/BLT.13.127076

http://www.who.int/bulletin/volumes/92/7/13-127076.pdf

ABSTRACT

Objective: To compare the effectiveness of mobile phone text messaging and that of traditional health worker training in communicating clinical recommendations to health workers in China.

Methods: A cluster-randomized controlled trial (Chinese Clinical Trial Register: ChiCTR-TRC-09000488) was conducted in 100 township health centres in north-western China between 17 October and 25 December 2011. Health workers were allocated either to receive 16 text messages with recommendations on the management of viral infections affecting the upper respiratory tract and otitis media (intervention

group, n = 490) or to receive the same recommendations through the existing continuing medical education programme – a one-day training workshop (control group, n = 487). Health workers’ knowledge of the recommendations was assessed before and after messaging and traditional training through a multiple choice questionnaire. The percentage change in score in the control group was compared with that in the intervention group. Changes in prescribing practices were also compared.

Findings: Health workers’ knowledge of the recommendations increased significantly in the intervention group, both individually (0.17 points; 95% confidence interval, CI: 0.168–0.172) and at the cluster level (0.16 points; 95% CI: 0.157–0.163), but not in the control group. In the intervention group steroid prescriptions decreased by 5 percentage points but antibiotic prescriptions remained unchanged. In the control group, however, antibiotic and steroid prescriptions increased by 17 and 11 percentage points, respectively.

Conclusion: Text messages can be effective for transmitting medical information and changing health workers’ behaviour, particularly in resource-limited settings

SELECTED EXTRACTS (selected by Neil PW)

‘Health workers in rural China do not receive systematic, qualified medical education and training1,2 because, unlike their urban counterparts, they face constraints such as inadequacies in transport and funding and they are largely unaware of the need for education.’

‘This study shows that compared with traditional methods of medical education, text messages are more effective in leading to a greater understanding of recommendations, especially for family physicians, a result that was shown by changes in prescribing practices.’

Best wishes, Neil

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

HealthPhone™ is a personal video reference library and guide to better health and nutrition practices, for families and communities, including the illiterate, in their language, distributed on mobile phones…..more

Establishing and Using Data Standards in Health Workforce Information Systems

Over the last nine years, the USAID-funded CapacityPlus global project and its predecessor, the Capacity Project, have worked with countries to adapt and implement human resources information systems (HRIS) to better track and support their health workforces. HRIS are only valuable, however, to the extent that stakeholders use them for policy and management decisions, and can only be deemed successful if the decisions in turn lead to better health care. Both criteria wholly depend on the quality of data in the system.

In the context of HRIS, data quality is best defined as how well the data represent the real world (Brown 2011). Poor data quality can adversely affect support for—and even the livelihoods of—the very health workers we want the systems to benefit. Low-quality data can also influence organizational, project, or donor indicators. A national HRIS typically involves numerous data collection and entry steps and many users countrywide, all of which pose challenges to ensuring data quality (Wakibi 2008). As countries move ahead with HRIS scale-up efforts, it is important to establish and use standards (organizational, national, and international) to align and and harmonize the collection, aggregation, and analysis of human resources for health (HRH) data…..more