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Kosa SD, Coelho M, Friedman-Burley J, Lebel N, Kelly CE, Macdonald S, Du Mont J. Bridging Gaps in Collaboration Between Community Organizations and Hospital-Based Violence Treatment Centers Serving Transgender Sexual Assault Survivors. J Interpers Violence 2024; 39:1811-1829. [PMID: 37970834 DOI: 10.1177/08862605231211922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Community and healthcare organizations have not historically collaborated effectively, leaving gaps in the continuum of care for survivors of sexual assault. These gaps are particularly acutely felt by transgender (trans) survivors, who experience additional barriers to care and face higher rates of sexual assault. To bridge these gaps and enhance the provision of comprehensive support for trans people, we developed an intersectoral network of trans-positive community and hospital-based organizations in Ontario, Canada. As part of a baseline evaluation of the network, we conducted a social network analysis to determine the extent and nature of collaboration between members within and across these two sectors. Using a validated social network analysis tool (PARTNER survey), data were collected from June 22 to July 22, 2021. The extent of collaboration was examined by relationship type: intrasectoral (same sector) and intersectoral (different sectors). The nature of collaboration was examined using relational scores (value: power, level of involvement, potential resource contribution; trust: reliability, mission congruence, openness to discussion). Fifty-four community organizations (65.9% of 82 invited) and 24 hospital-based violence treatment centers (64.9% of 37 invited) responded. The majority of collaborations were within, rather than across, the two sectors: of all 378 collaborations described, 70.9% (n = 268) were intrasectoral collaborations and 29.1% (n = 110) were intersectoral collaborations. Intersectoral relationships were characterized by lower scores for level of involvement, trust, reliability, and mission congruence than intrasectoral relationships, but higher scores for power. These findings were shared in a virtual consultation session of key stakeholders, in which some participants expressed "surprise" and concern for the lack of collaboration and character of relationships across sectors. Recommendations to increase intersectoral collaboration, which included intersectoral program planning and service design and supporting increased opportunities for intersectoral training and knowledge exchange, are presented.
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Affiliation(s)
- Sarah Daisy Kosa
- Ontario Network of Sexual Assault/Domestic Violence Treatment Centres, Toronto, ON, Canada
| | - Madelaine Coelho
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Joseph Friedman-Burley
- Ontario Network of Sexual Assault/Domestic Violence Treatment Centres, Toronto, ON, Canada
| | - Nicholas Lebel
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Carolyn Emma Kelly
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Sheila Macdonald
- Ontario Network of Sexual Assault/Domestic Violence Treatment Centres, Toronto, ON, Canada
| | - Janice Du Mont
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, ON, Canada
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Strumann C, Pfau L, Wahle L, Schreiber R, Steinhäuser J. Designing and Implementation of a Digitalized Intersectoral Discharge Management System and Its Effect on Readmissions: Mixed Methods Approach. J Med Internet Res 2024; 26:e47133. [PMID: 38530343 PMCID: PMC11005442 DOI: 10.2196/47133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/13/2023] [Accepted: 01/31/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Digital transformation offers new opportunities to improve the exchange of information between different health care providers, including inpatient, outpatient and care facilities. As information is especially at risk of being lost when a patient is discharged from a hospital, digital transformation offers great opportunities to improve intersectoral discharge management. However, most strategies for improvement have focused on structures within the hospital. OBJECTIVE This study aims to evaluate the implementation of a digitalized discharge management system, the project "Optimizing instersectoral discharge management" (SEKMA, derived from the German Sektorübergreifende Optimierung des Entlassmanagements), and its impact on the readmission rate. METHODS A mixed methods design was used to evaluate the implementation of a digitalized discharge management system and its impact on the readmission rate. After the implementation, the congruence between the planned (logic model) and the actual intervention was evaluated using a fidelity analysis. Finally, bivariate and multivariate analyses were used to evaluate the effectiveness of the implementation on the readmission rate. For this purpose, a difference-in-difference approach was adopted based on routine data of hospital admissions between April 2019 and August 2019 and between April 2022 and August 2022. The department of vascular surgery served as the intervention group, in which the optimized discharge management was implemented in April 2022. The departments of internal medicine and cardiology formed the control group. RESULTS Overall, 26 interviews were conducted, and we explored 21 determinants, which can be categorized into 3 groups: "optimization potential," "barriers," and "enablers." On the basis of these results, 19 strategies were developed to address the determinants, including a lack of networking among health care providers, digital information transmission, and user-unfriendliness. On the basis of these strategies, which were prioritized by 11 hospital physicians, a logic model was formulated. Of the 19 strategies, 7 (37%; eg, electronic discharge letter, providing mobile devices to the hospital's social service, and generating individual medication plans in the format of the national medication plan) have been implemented in SEKMA. A survey on the fidelity of the application of the implemented strategies showed that 3 of these strategies were not yet widely applied. No significant effect of SEKMA on readmissions was observed in the routine data of 14,854 hospital admissions (P=.20). CONCLUSIONS This study demonstrates the potential of optimizing intersectoral collaboration for patient care. Although a significant effect of SEKMA on readmissions has not yet been observed, creating a digital ecosystem that connects different health care providers seems to be a promising approach to ensure secure and fast networking of the sectors. The described intersectoral optimization of discharge management provides a structured template for the implementation of a similar local digital care networking infrastructure in other care regions in Germany and other countries with a similarly fragmented health care system.
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Affiliation(s)
- Christoph Strumann
- Institute of Family Medicine, University Medical Centre Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Lisa Pfau
- Institute of Family Medicine, University Medical Centre Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Laila Wahle
- Lacanja GmbH Health Innovation Port, Hamburg, Germany
| | - Raphael Schreiber
- Institute of Family Medicine, University Medical Centre Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Jost Steinhäuser
- Institute of Family Medicine, University Medical Centre Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
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Leijon M, Algotson A, Bernhardsson S, Ekholm D, Ersberg L, Höök MJS, Klüft C, Müssener U, Garås ES, Nilsen P. Generation Pep - study protocol for an intersectoral community-wide physical activity and healthy eating habits initiative for children and young people in Sweden. Front Public Health 2024; 12:1299099. [PMID: 38435288 PMCID: PMC10904517 DOI: 10.3389/fpubh.2024.1299099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024] Open
Abstract
Background There is overwhelming evidence for the preventive effects of regular physical activity and healthy eating habits on the risk for developing a non-communicable disease (NCD). Increasing attention has been paid to community-wide approaches in the battle against NCDs. Communities can create supportive policies, modify physical environments, and foster local stakeholder engagement through intersectoral collaboration to encourage communities to support healthy lifestyles. The Pep initiative is based on intersectoral community-wide collaboration among Sweden's municipalities. Primary targets are municipality professionals who work with children and young people as well as parents of children <18 years. The goal is to spread knowledge and create commitment to children's and young people's health with a special focus on physical activity and healthy eating habits to facilitate and support a healthy lifestyle. The overarching aim of the research project described in this study protocol is to investigate factors that influence the implementation of the Pep initiative in Sweden, to inform tailored implementation strategies addressing the needs and local prerequisites of the different municipalities. Methods The project includes a qualitative and a quantitative study and is framed by a theoretical model involving four complementary forms of knowledge, explicitly recognized in the Pep initiative: knowledge about the issue; knowledge about interventions; knowledge about the context; and knowledge about implementation. Study 1 is a focus group study exploring barriers and facilitators for implementing the Pep initiative. The study will be carried out in six municipalities, selected purposively to provide wide variation in municipality characteristics, including population size and geographical location. Data will be analyzed using thematic analysis. Study 2 is a cross-sectional web-based survey investigating the implementability of the Pep initiative in Sweden's 290 municipalities. Conditions for implementing different areas of the Pep initiative will be examined in terms of the acceptability, appropriateness, and feasibility, three predictors of implementation success. Data will be analyzed using non-parametric statistics. Discussion The findings of the two studies will increase understanding of the prerequisites for implementing the Pep initiative in Swedish municipalities, which will provide valuable input into how implementation of the Pep initiative can best be facilitated in the different municipality settings.
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Affiliation(s)
- Matti Leijon
- Generation Pep, Stockholm, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Albin Algotson
- Department of Management and Engineering, Faculty of Science and Engineering, Linköping University, Linköping, Sweden
| | - Susanne Bernhardsson
- Region Västra Götaland, Research, Education, Development, and Innovation Primary Health Care, Gothenburg, Sweden
- Department of Health and Rehabilitation, Unit of Physiotherapy, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - David Ekholm
- Department of Culture and Society, Linköping University, Linköping, Sweden
| | | | | | - Carolina Klüft
- Generation Pep, Stockholm, Sweden
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ulrika Müssener
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | | | - Per Nilsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Ramponi F, Ssennyonjo A, Banda S, Aliti T, Nkhoma D, Kaonga O, Griffin S, Revill P, Kataika E, Nabyonga-Orem J. Demands for Intersectoral Actions to Meet Health Challenges in East and Southern Africa and Methods for Their Evaluation. Value Health Reg Issues 2024; 39:74-83. [PMID: 38007854 DOI: 10.1016/j.vhri.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 08/18/2023] [Accepted: 09/07/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES Focusing on the East, Central, and Southern African region, this study examines both regional and country-level initiatives aimed at promoting multisectoral collaboration to improve population health and the methods for their economic evaluation. METHODS We explored the interventions that necessitate cooperation among policymakers from diverse sectors and the mechanisms that facilitate effective collaboration and coordination across these sectors. To gain insights into the demand for multisectoral collaboration in the East, Central, and Southern African region, we presented 3 country briefs, highlighting policy areas and initiatives that have successfully incorporated health-promoting actions from outside the health sector in Zimbabwe, Uganda, and Malawi. Additionally, we showcased initiatives undertaken by the Ministry of Health in each country to foster coordination with national and international stakeholders, along with existing coordination mechanisms established for intersectoral collaboration. Drawing on these examples, we identified the primary challenges in the economic evaluation of multisectoral programs aimed at improving health in the region. RESULTS We illustrated how decision making in reality differs from the traditional single-sector and single-decision-maker perspective commonly used in cost-effectiveness analyses. To ensure economic evaluations can inform decision making in diverse settings and facilitate regional collaboration, we highlighted 3 fundamental principles: identifying policy objectives, defining the perspective of the analysis, and considering opportunity costs. We emphasized the importance of adopting a flexible and context-specific approach to economic evaluation. CONCLUSIONS Through this work, we contribute to bridging the gap between theory and practice in the context of intersectoral activities aimed at improving health outcomes.
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Affiliation(s)
- Francesco Ramponi
- Centre for Health Economics, University of York, York, England, UK; ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
| | - Aloysius Ssennyonjo
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | | | - Dominic Nkhoma
- Health Economics & Policy Unit (HEPU), Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Oliver Kaonga
- Centre for Health Economics, University of York, York, England, UK
| | - Susan Griffin
- Centre for Health Economics, University of York, York, England, UK
| | - Paul Revill
- Centre for Health Economics, University of York, York, England, UK
| | - Edward Kataika
- East, Central, and Southern Africa Health Community, Arusha, Tanzania
| | - Juliet Nabyonga-Orem
- WHO Regional Office for Africa, Inter Country Support team for Eastern and Southern Africa, Harare, Zimbabwe; Centre for Health Professions Education, Faculty of Health Sciences, North-West University, Potchefstroom Campus, Potchefstroom, South Africa
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Schiff M, Jha A, Walker D, Gonzalez-Pier E. Collectively achieving primary health care and educational goals through school-based platforms: financing solutions for intersectoral collaboration. Front Public Health 2023; 11:1241594. [PMID: 38089030 PMCID: PMC10713724 DOI: 10.3389/fpubh.2023.1241594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
Despite abundant evidence demonstrating that improvements to health and education are positively correlated, and the importance of school-based platforms to achieve shared impacts, collaboration between ministries of health and education remains limited across low- and middle-income countries. Enhancing this collaboration is essential to realize mutually beneficial results, especially following the COVID-19 pandemic, which severely impacted health and education outcomes globally and highlighted the importance of resilient, domestically funded systems for delivering key social services including primary health care and education. We argue that the lack of an effective joint financing mechanism has hindered adoption of collaborative multisectoral approaches such as the WHO/UNESCO's Health Promoting Schools (HPS) model. HPS is well-positioned to organize, finance, and deliver primary health care and education services through a school-based platform and strategy. Case studies from several low- and middle-income countries highlight the need to expand limited inter-ministerial collaborations to achieve cross-sectoral benefits and ensure sustainability of HPS beyond the lifecycle of external partners' support. It is important to identify ways to widen the resource envelope for sector-specific activities and create efficiencies through mutually beneficial outcomes. This paper offers two pragmatic solutions: an inter-ministerial joint financing mechanism that starts with alignment of budgets but matures into a formal system for pooling funds, or a fixed-term co-financing mechanism that uses donor contributions to catalyze inter-ministerial collaborations. Achieving sustainability in these initiatives would require engaging the ministries of health, education, and finance; developing a common administrative, financial, and monitoring mechanism; and securing long-term commitment from all concerned stakeholders.
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Petricone-Westwood D, Clow KA, Lebel S, Brunet J. An evaluation of the Interdisciplinary Psychosocial Oncology Research Group and Laboratory: An initiative to enable intersectoral and interdisciplinary collaboration. Can Oncol Nurs J 2023; 33:61-66. [PMID: 36789219 PMCID: PMC9894374 DOI: 10.5737/2368807633161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background Psychosocial oncology (PSO) is an interdisciplinary field that is often practised and researched in disciplinary silos. The Interdisciplinary PSO Research Group and Laboratory (IPSORGL) was developed in Ottawa (Ontario) to foster interdisciplinary collaboration and training amongst trainees, healthcare professionals (HCPs), and researchers. Methods The research team conducted an implementation and outcome evaluation of the IPSORGL. Data were collected using sequential mixed methods, including surveys and interviews. Results Eight trainees, six HCPs, and five researchers completed the survey. Six trainees and four HCPs participated in an interview. Benefits of the IPSORGL included establishing interdisciplinary connections and collaborations and obtaining unique training in a supportive environment. Challenges included members' differing preferences for meeting formats and content, and difficulties prioritizing the IPSORGL over other academic or clinical demands. Conclusions The IPSORGL fosters essential interdisciplinary training and collaboration, which bolsters psychosocial oncology research and practice. The sustainability of such initiatives, however, requires formal institutional support.
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Affiliation(s)
- Danielle Petricone-Westwood
- Corresponding author contact: Department of Supportive Care, Psychosocial Oncology Program, Juravinski Cancer Centre, Hamilton Health Sciences,
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Affiliation(s)
- Evelyne de Leeuw
- Centre for Health Equity Training, Research and Evaluation (CHETRE), University of New South Wales, Liverpool, NSW, Australia
- Population Health, South Western Sydney Local Health District, Liverpool, NSW, Australia
- Ingham Institute for Applied Medical Research, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
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Shung-King M, Weimann A, McCreedy N, Tatah L, Mapa-Tassou C, Muzenda T, Govia I, Were V, Oni T. Protocol for a Multi-Level Policy Analysis of Non-Communicable Disease Determinants of Diet and Physical Activity: Implications for Low- and Middle-Income Countries in Africa and the Caribbean. Int J Environ Res Public Health 2021; 18:13061. [PMID: 34948671 DOI: 10.3390/ijerph182413061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 12/01/2022]
Abstract
Non-communicable diseases (NCDs) are the leading cause of death globally. Despite significant global policy development for addressing NCDs, the extent to which global policies find expression in low-and-middle income countries’ (LMIC) policies, designed to mitigate against NCDs, is unclear. This protocol is part of a portfolio of projects within the Global Diet and Activity Research (GDAR) Network, which aims to support the prevention of NCDs in LMICs, with a specific focus on Kenya, Cameroon, South Africa and Jamaica. This paper outlines the protocol for a study that seeks to explore the current policy environment in relation to the reduction of key factors influencing the growing epidemic of NCDs. The study proposes to examine policies at the global, regional and country level, related to the reduction of sugar and salt intake, and the promotion of physical activity (as one dimension of healthy placemaking). The overall study will comprise several sub-studies conducted at a global, regional and country level in Cameroon, Kenya and South Africa. In combination with evidence generated from other GDAR workstreams, results from the policy analyses will contribute to identifying opportunities for action in the reduction of NCDs in LMICs.
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Abbas SS, Shorten T, Rushton J. Meanings and Mechanisms of One Health Partnerships: Insights from a Critical Review of Literature on Cross-Government Collaborations. Health Policy Plan 2021; 37:385-399. [PMID: 34791224 PMCID: PMC8896336 DOI: 10.1093/heapol/czab134] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/10/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022] Open
Abstract
Complex health policy challenges such as antimicrobial resistance and other emerging infections are driven by activities in multiple sectors. Therefore, addressing these also requires joint efforts from multiple sectors as exemplified in the One Health approach. We undertake a critical review to examine the different ways in which multisector partnerships have been conceptualized across multiple disciplines and thematic areas. We started with a set of six articles from the disciplines of health, nutrition and public administration that reviewed conceptual frameworks within their respective fields. We conducted backward citation tracing using the bibliography of the six articles to identify other articles in the same and related fields that conceptualized multisector partnerships. We identified 58 articles published from 1967 to 2018 from the fields of global health, infectious diseases, management, nutrition and sustainability sciences indicating that multisector partnerships have been a topic of study across different fields for several decades. A thematic analysis of the 58 articles revealed that multisector partnerships assume a variety of forms and have been described in different ways. Partnerships can be categorized by scope, scale, formality and strength. Multisector partnerships emerge in conditions of dynamic uncertainty and sector failure when the information and resources required are beyond the capacities of any individual sector. Such partnerships are inherently political in nature and subsume multiple competing agendas of collaborating actors. Sustaining collaborations over a long period of time will require collaborative approaches like One Health to accommodate competing political perspectives and include flexibility to allow multisector partnerships to respond to changing external dynamics.
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Affiliation(s)
- Syed Shahid Abbas
- Institute of Development Studies, Brighton, UK.,Public Health Foundation of India, New Delhi, India
| | | | - Jonathan Rushton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
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Weimann A, Shung-King M, McCreedy N, Tatah L, Mapa-Tassou C, Muzenda T, Govia I, Were V, Oni T. Intersectoral Action for Addressing NCDs through the Food Environment: An Analysis of NCD Framing in Global Policies and Its Relevance for the African Context. Int J Environ Res Public Health 2021; 18:ijerph182111246. [PMID: 34769763 PMCID: PMC8582825 DOI: 10.3390/ijerph182111246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/16/2022]
Abstract
Noncommunicable diseases contribute the greatest to global mortality. Unhealthy diet-a prominent risk factor-is intricately linked to urban built and food environments and requires intersectoral efforts to address. Framings of the noncommunicable disease problem and proposed solutions within global and African regional diet-related policy documents can reveal how amenable the policy landscape is for supporting intersectoral action for health in low-income to middle-income countries. This study applied a document analysis approach to undertake policy analysis on global and African regional policies related to noncommunicable disease and diet. A total of 62 global and 29 African regional policy documents were analysed. Three problem frames relating to noncommunicable disease and diet were identified at the global and regional level, namely evidence-based, development, and socioeconomic frames. Health promotion, intersectoral and multisectoral action, and evidence-based monitoring and assessment underpinned proposed interventions to improve education and awareness, support structural changes, and improve disease surveillance and monitoring. African policies insufficiently considered associations between food security and noncommunicable disease. In order to effectively address the noncommunicable disease burden, a paradigm shift from 'health for development' to 'development for health' is required across non-health sectors. Noncommunicable disease considerations should be included within African food security agendas, using malnutrition as a possible intermediary concept to motivate intersectoral action to improve access to nutritious food in African low-income to middle-income countries.
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Affiliation(s)
- Amy Weimann
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa; (T.M.); (T.O.)
- African Centre for Cities, University of Cape Town, Cape Town 7701, South Africa
- Correspondence:
| | - Maylene Shung-King
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa; (M.S.-K.); (N.M.)
| | - Nicole McCreedy
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa; (M.S.-K.); (N.M.)
| | - Lambed Tatah
- Health of Populations in Transition Research Group (HoPiT), University of Yaoundé I, Yaoundé 8046, Cameroon; (L.T.); (C.M.-T.)
- Global Diet and Physical Activity Research Group, Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Clarisse Mapa-Tassou
- Health of Populations in Transition Research Group (HoPiT), University of Yaoundé I, Yaoundé 8046, Cameroon; (L.T.); (C.M.-T.)
| | - Trish Muzenda
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa; (T.M.); (T.O.)
| | - Ishtar Govia
- Caribbean Institute for Health Research, The University of the West Indies, Mona Kingston 7, Jamaica;
| | - Vincent Were
- Center for Global Health Research, Kenya Medical Research Institute (KEMRI), P.O. Box 1578, Kisumu 40100, Kenya;
| | - Tolu Oni
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa; (T.M.); (T.O.)
- Global Diet and Physical Activity Research Group, Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
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Hien H, Semporé E, Kaboré A, Bazie H, Sié MAW, Sakana L, Meda C, Bakyono R, Neboua D, Somda D, Somda P, Ky R, Ouédraogo M, Meda N. [The challenge of intersectorality in the formulation of policies favourable to the health of older persons in west africa: the case of Burkina Faso]. Mali Med 2021; 36:49-55. [PMID: 37973589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
AIM The aim of this study was to contribute to a better development of health policies for the elderly in Burkina Faso. MATERIAL AND METHODS We have done a qualitative cross-sectional study from February to September 2018 in 4 ministerial departments of Burkina Faso (health, human rights, public service and national solidarity). The interviews included non-governmental organisations, associations, technical and financial partners. Inductive approach has used to produce results. RESULTS A total of 24 key informants were included in the study. Various interventions were implemented differently by the departmental departments. The study identified non-functional interdepartmental consultation frameworks as mechanisms for consultation. These frameworks have not been used in the formulation or implementation of policies for the elderly. CONCLUSION National coordination of public policies for the elderly in high level of decision-making is important. The activation of interdepartmental consultation frameworks is a necessity for formulating holistic and complementary interventions for the elderly and even beyond this target group.
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Affiliation(s)
- Hervé Hien
- Institut National de Santé Publique, Ouagadougou, Burkina Faso
- Institut de recherche en science de la santé (IRSS), Bobo-Dioulasso, Burkina Faso
| | | | - Ahmed Kaboré
- Unité de Formation et de Recherche en Sciences de la santé (UFR/SDS), Université de Ouaga1 Joseph KI-ZERBO, Burkina Faso
| | - Hermann Bazie
- Institut National de Santé Publique, Ouagadougou, Burkina Faso
| | - M Aziz W Sié
- Institut National de Santé Publique, Ouagadougou, Burkina Faso
| | - Leticia Sakana
- Institut National de Santé Publique, Ouagadougou, Burkina Faso
| | - Clement Meda
- Institut National de Santé Publique, Ouagadougou, Burkina Faso
- Institut supérieur des sciences de la santé (INSSA), université Nazi BONI, Bobo-Dioulasso, Burkina Faso
| | - Richard Bakyono
- Institut National de Santé Publique, Ouagadougou, Burkina Faso
| | - Désiré Neboua
- Institut National de Santé Publique, Ouagadougou, Burkina Faso
| | - Désiré Somda
- Institut National de Santé Publique, Ouagadougou, Burkina Faso
| | - Paulin Somda
- Direction Générale de la Santé Publique(DGSP), ministère de la santé, Burkina Faso
| | - Roland Ky
- Direction Générale de la Santé Publique(DGSP), ministère de la santé, Burkina Faso
| | - Macaire Ouédraogo
- Institut supérieur des sciences de la santé (INSSA), université Nazi BONI, Bobo-Dioulasso, Burkina Faso
| | - Nicolas Meda
- Institut National de Santé Publique, Ouagadougou, Burkina Faso
- Unité de Formation et de Recherche en Sciences de la santé (UFR/SDS), Université de Ouaga1 Joseph KI-ZERBO, Burkina Faso
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Mont JD, Kosa SD, Hemalal S, Cameron L, Macdonald S. Formation of an intersectoral network to support trans survivors of sexual assault: A survey of health and community organizations. Int J Transgend Health 2020; 22:243-252. [PMID: 34240068 PMCID: PMC8118235 DOI: 10.1080/26895269.2020.1787911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND To address the growing international recognition of the inequities faced by transgender (trans) persons and the lack of services that attend to the specific concerns of trans sexual assault survivors, we undertook the development of an intersectoral network of hospital-based violence treatment centers and trans-positive community organizations to enhance available supports. AIMS To examine anticipated involvement of organizations in the network and determine network activities, deliverables, and values. METHODS We developed a survey with guidance from an advisory group of trans community members and their allies. Items on the survey related to network activities, deliverables, and values, which were also informed by key insights from earlier network planning meetings, were rated on a 5-point Likert scale for their importance (1 = not important at all, 5 = very important). RESULTS Sixty-four out of 93 organizations invited responded to the survey, giving a response rate of 69%. The highest prioritized network activities were: improve access to support services for trans survivors, educate trans survivors on their rights/what to expect when seeking supports and information on organizations, provide ongoing education/training for service providers on trans-affirming care, and inform guidelines on appropriate and sensitive standards of care/better practices for trans survivors (means = 4.6). The highest prioritized deliverables were: provision of standardized sensitivity training on violence against trans persons for professionals and development of an online directory/resource list of trans-affirming service providers and organizations that is continuously updated (means = 4.5). Trauma- and violence-informed and trans-guided were the most highly rated values (means = 4.8). CONCLUSION These findings have implications for healthcare and community leaders seeking to collaborate across sectors to address the inequities faced by trans persons experiencing sexual assault.
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Affiliation(s)
- Janice Du Mont
- Women’s College Research Institute, Women’s College Hospital, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sarah Daisy Kosa
- Women’s College Research Institute, Women’s College Hospital, Toronto, Canada
- Ontario Network of Sexual Assault/Domestic Violence Treatments Centres, Toronto, Canada
| | - Shilini Hemalal
- Women’s College Research Institute, Women’s College Hospital, Toronto, Canada
| | | | - Sheila Macdonald
- Ontario Network of Sexual Assault/Domestic Violence Treatments Centres, Toronto, Canada
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Hansen VB, Aagaard S, Hygum A, Johansen JB, Pedersen SS, Nielsen VL, Neergaard MA, Salomonsen GR, Guldin MB, Gustafsson I, Eiskjær H, Gustafsson F, Roikjær SG, Nørager B, Larsen H, Zwisler AD. The First Steps Taken to Implement Palliative Care in Advanced Heart Disease: A Position Statement from Denmark. J Palliat Med 2020; 23:1159-1166. [PMID: 32380928 DOI: 10.1089/jpm.2019.0566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
According to the World Health Organization, palliative care must be available for everyone with life-threatening diseases. However, in daily practice the primary focus worldwide is on cancer patients. The aim of the article was to generate a national position statement as the first step in implementing palliative care in severe heart disease with focus on advanced heart failure, including tools to identify the need for and timing of palliative care and how palliative care could be organized in Denmark. A task force was formed in the Danish Society of Cardiology Heart Failure Working Group, and the position statement was prepared in collaboration with members from a broad group of specialties, including palliative medicine. Because of major gaps in evidence, the position statement was based on small and low-quality studies and clinical practice statements. This position statement was aligned with the European Society of Cardiology recommendation, focusing on relieving suffering from the early disease stages parallel to standard care and supplementing life-prolonging treatment. The statement delivers practical guidance on clinical aspects and managing symptoms during the three stages of advanced heart disease. Furthermore, the statement describes the importance of communication and topics to be broached, including deactivating implantable cardioverter defibrillators. The statement recommends a targeted effort on organizational strategies using high-quality assessment tools and emphasizes multidisciplinary and intersectoral collaboration. Danish cardiologists supported by allied professionals acknowledge the importance of palliative care in advanced heart disease. This national position statement intended to inform and influence policy and practice and can hopefully inspire other countries to take action toward implementing palliative care in advanced heart disease.
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Affiliation(s)
- Vibeke Brogaard Hansen
- Heart Failure, Department of Cardiology, Lillebaelt Hospital Vejle, Vejle, Denmark.,Danish Society of Cardiology, Copenhagen, Denmark
| | - Susanne Aagaard
- Danish Society of Cardiology, Copenhagen, Denmark.,Heart Failure, Department of Heart Disease, Aarhus University Hospital, Aarhus, Denmark
| | - Anette Hygum
- Palliative Care Team, Department of Oncology, Lillebaelt Hospital Vejle, Vejle, Denmark.,Danish Society of Palliative Medicine, Copenhagen, Denmark
| | - Jens Brock Johansen
- Danish Society of Cardiology, Copenhagen, Denmark.,Arrhythmias, Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Susanne S Pedersen
- Danish Society of Cardiology, Copenhagen, Denmark.,Palliative Care Team, Department of Oncology, Lillebaelt Hospital Vejle, Vejle, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Vivi Lindeborg Nielsen
- Danish Society of Cardiovascular and Thoracic Surgery Nursing, Copenhagen, Denmark.,Heart Failure, Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Mette Asbjørn Neergaard
- Danish Society of Palliative Medicine, Copenhagen, Denmark.,Palliative Care Team, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Gitte Ryom Salomonsen
- Heart Failure, Department of Heart Disease, Aarhus University Hospital, Aarhus, Denmark.,Danish Society of Cardiovascular and Thoracic Surgery Nursing, Copenhagen, Denmark
| | - Mai-Britt Guldin
- Institute of Public Health-Research Unit for General Practice, Aarhus University Hospital, Aarhus, Denmark
| | - Ida Gustafsson
- Danish Society of Cardiology, Copenhagen, Denmark.,Department of Cardiology, Bispebjerg Hospital, Copenhagen, Denmark
| | - Hans Eiskjær
- Danish Society of Cardiology, Copenhagen, Denmark.,Heart Failure, Department of Heart Disease, Aarhus University Hospital, Aarhus, Denmark
| | - Finn Gustafsson
- Danish Society of Cardiology, Copenhagen, Denmark.,Heart Failure, Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | - Stine Gundtoft Roikjær
- Danish Society of Cardiology, Copenhagen, Denmark.,Danish Knowledge Centre for Rehabilitation and Palliative Care (REHPA), Odense University Hospital and University of Southern Denmark, Nyborg, Denmark
| | - Betina Nørager
- Danish Society of Cardiology, Copenhagen, Denmark.,Congenital Heart Diseases, Department of Cardiology, Herlev & Gentofte Hospital, Herlev, Denmark
| | - Henrik Larsen
- Danish Society of Palliative Medicine, Copenhagen, Denmark.,Palliative Care Team, Department of Oncology, Rigshospitalet, Copenhagen, Denmark.,Danish Multidisciplinary Group for Cancer and Palliative Care, Copenhagen, Denmark
| | - Ann-Dorthe Zwisler
- Danish Society of Cardiology, Copenhagen, Denmark.,Danish Knowledge Centre for Rehabilitation and Palliative Care (REHPA), Odense University Hospital and University of Southern Denmark, Nyborg, Denmark.,Rehabilitation, Department of Cardiology, Odense University Hospital, Odense, Denmark
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Ho S, Javadi D, Causevic S, Langlois EV, Friberg P, Tomson G. Intersectoral and integrated approaches in achieving the right to health for refugees on resettlement: a scoping review. BMJ Open 2019; 9:e029407. [PMID: 31266840 PMCID: PMC6609038 DOI: 10.1136/bmjopen-2019-029407] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/17/2019] [Accepted: 05/21/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Better understanding, documentation and evaluation of different refugee health interventions and their means of health system integration and intersectoral collaboration are needed. OBJECTIVES Explore the barriers and facilitators to the integration of health services for refugees; the processes involved and the different stakeholders engaged in levaraging intersectoral approaches to protect refugees' right to health on resettlement. DESIGN Scoping review. METHODS A search of articles from 2000 onward was done in MEDLINE, Web of Science, Global Health and PsycINFO, Embase. Two frameworks were applied in our analysis, the 'framework for analysing integration of targeted health interventions in systems' and 'Health in All Policies' framework for country action. A comprehensive description of the methods is included in our published protocol. RESULTS 6117 papers were identified, only 18 studies met the inclusion criteria. Facilitators in implementation included: training for providers, colocation of services, transportation services to enhance access, clear role definitions and appropriate budget allocation and financing. Barriers included: lack of a participatory approach, insufficient resources for providers, absence of financing, unclear roles and insufficient coordination of interprofessional teams; low availability and use of data, and turf wars across governance stakeholders. Successful strategies to address refugee health included: networks of service delivery combining existing public and private services; system navigators; host community engagement to reduce stigma; translation services; legislative support and alternative models of care for women and children. CONCLUSION Limited evidence was found overall. Further research on intersectoral approaches is needed. Key policy insights gained from barriers and facilitators reported in available studies include: improving coordination between existing programmes; supporting colocation of services; establishing formal system navigator roles that connect relevant programmes; establishing formal translation services to improve access and establishing training and resources for providers.
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Affiliation(s)
- Shirley Ho
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Dena Javadi
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Sara Causevic
- Swedish Institute for Global Health Transformation, Royal Swedish Academy of Sciences, Stockholm, Sweden
- Global and Sexual Health, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Etienne V Langlois
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Peter Friberg
- Swedish Institute for Global Health Transformation, Royal Swedish Academy of Sciences, Stockholm, Sweden
- Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden
| | - Göran Tomson
- Swedish Institute for Global Health Transformation, Royal Swedish Academy of Sciences, Stockholm, Sweden
- Medical Management Centre, Department of Learning, Informatics, Management, Ethics, Karolinska Institute, Stockholm, Sweden
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Javadi D, Langlois EV, Ho S, Friberg P, Tomson G. Intersectoral approaches and integrated services in achieving the right to health for refugees upon resettlement: a scoping review protocol. BMJ Open 2017; 7:e016638. [PMID: 28855201 PMCID: PMC5629659 DOI: 10.1136/bmjopen-2017-016638] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Global insecurity and climate change are exacerbating the need for improved management of refugee resettlement services. International standards hold states responsible for the protection of the right of non-citizens to an adequate standard of physical and mental health while recognising the importance of social determinants of health. However, programmes to protect refugees' right to health often lack coordination and monitoring. This paper describes the protocol for a scoping review to explore barriers and facilitators to the integration of health services for refugees; the content, process and actors involved in protecting refugee health; and the extent to which intersectoral approaches are leveraged to protect refugees' right to health on resettlement, especially for vulnerable groups such as women and children. METHODS AND ANALYSIS Peer-reviewed (through four databases including MEDLINE, Web of Science, Global Health and PsycINFO) and grey literature were searched to identify programmes and interventions designed to promote refugee health in receiving countries. Two reviewers will screen articles and abstract data. Two frameworks for integration and intersectoral action will be applied to understand how and why certain approaches work while others do not and to identify the actors involved in achieving success at different levels of integration as defined by these frameworks. ETHICS AND DISSEMINATION Findings from the scoping review will be shared in relevant conferences and meetings. A brief will be created with lessons learnt from successful programmes to inform decision making in design of refugee programmes and services. Ethical approval is not required as human subjects are not involved. TRIAL REGISTRATION NUMBER Registered on Open Science Framework at https://osf.io/gt9ck/.
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Affiliation(s)
- Dena Javadi
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Etienne V Langlois
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Shirley Ho
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Peter Friberg
- Swedish Institute for Global Health Transformation (SIGHT), Royal Swedish Academy of Sciences, Geneva, Switzerland
- Department of Molecular and Clinical Medicine, Sahlgrens Academy and University Hospital, Gothenburg University, Gothenburg, Sweden
| | - Göran Tomson
- Swedish Institute for Global Health Transformation (SIGHT), Royal Swedish Academy of Sciences, Geneva, Switzerland
- Health System and Policy, Global Health, Karolinska Institutet, Stockholm, Sweden
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Abstract
Dentistry is facing many serious challenges and threats. Addressing them will require major changes in strategy. This work outlines the extent of dental disease in the Africa and Middle East Region (AMER) and suggests strategies to reduce inequalities in oral health. The main oral health challenges in the AMER relate to controlling the relentless increase in caries with age. A very conservative estimate of population caries levels suggests that a 5-fold increase in dental personnel would be required just to treat current levels of caries. Hence, we argue that current approaches to control caries in the AMER are both ineffective and unaffordable, and a new model to promote oral health is needed. Unless determinants of noncommunicable diseases are addressed and access to evidence-based minimal intervention dental care is improved, the burden of dental disease will persist. The new oral health promotion model calls for an integrated intersectoral common risk factor approach, namely, "oral health in all policies" (OHiAP). An OHiAP framework will initiate high-level policy initiatives and intersectoral partnerships. Oral health professionals have an important advocacy role in securing the fundamental changes in health strategy needed to control the growing, unjust, and unaffordable burden of oral disease.
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Affiliation(s)
- A Sheiham
- Department of Epidemiology & Public Health, University College London, London, UK
| | - D M Williams
- School of Dentistry, Bart's and The London School of Medicine and Dentistry, London, UK
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Abstract
Health is created largely outside the health sector. Engagement in health governance, policy, and intervention development and implementation by sectors other than health is therefore important. Recent calls for building and implementing Health in All Policies, and continued arguments for intersectoral action, may strengthen the potential that other sectors have for health. This review clarifies the conceptual foundations for integral health governance, policy, and action, delineates the different sectors and their possible engagement, and provides an overview of a continuum of methods of engagement with other sectors to secure integration. This continuum ranges from institutional (re)design to value-based narratives. Depending on the lens applied, different elements can be identified within the continuum. This review is built on insights from political science, leadership studies, public health, empirical Health in All Policy research, knowledge and evidence nexus approaches, and community perspectives. Successful integration of health governance, policy, and action depends on integration of the elements on the continuum.
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Affiliation(s)
- Evelyne de Leeuw
- Centre for Health Equity Training, Research and Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care & Equity, A Unit of Population Health, South Western Sydney Local Health District, NSW Health, A Member of the Ingham Institute, Liverpool Hospital, Liverpool, New South Wales 1871, Australia;
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Mehrmann L, Ollenschläger G. [Problem areas and examples of best practice in intersectoral medication treatment--a literature review]. Z Evid Fortbild Qual Gesundhwes 2013; 108:66-77. [PMID: 24602535 DOI: 10.1016/j.zefq.2013.08.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 08/23/2013] [Accepted: 08/29/2013] [Indexed: 11/26/2022]
Abstract
Transitions between the outpatient and inpatient sector are a critical phase in medication treatment. This article provides an overview of published problem areas and examples of best practice in the intersectoral medication treatment. Data with regard to related problem areas and examples of best practice was collected in August 2011 by a systematic literature research. The relevant literature was identified using the following databases and search engines: MEDLINE, The Cochrane Library, EMBASE, Google, and Google Scholar. Additionally, a hand search was done on the websites of SpringerLink and Thieme Connect. The initial search yielded a total of 4,409 records which were further selected in two screening steps and analysed according to their relevance. Of the remaining 63 records, 3 exclusively described problem areas, 11 of them examples of best practice, and 49 provided information on both problem areas and examples of best practice with regard to intersectoral medication treatment. Among other things, problem areas include varying legal regulations in inpatient and outpatient medication treatment, drug therapy interruptions after hospital discharge, or deficits in communication and continuity of care. Examples of best practice are projects, programmes, initiatives, recommendations, and points to consider with respect to medication reconciliation, pharmaceutical support, or transitions of care. Problem areas as well as examples of best practice are mainly focused on the transition from inpatient to outpatient care.
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Affiliation(s)
- Lena Mehrmann
- Ärztliches Zentrum für Qualität in der Medizin (ÄZQ), Berlin.
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Patil RR, Ghosh S, Tiwari S. Assessing perceptions about malaria among the elected representatives in rural India. Trop Parasitol 2011; 1:83-7. [PMID: 23508083 PMCID: PMC3593494 DOI: 10.4103/2229-5070.86938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 10/31/2011] [Indexed: 11/23/2022] Open
Abstract
Objective: The short-term objective of our endeavour was to understand the perception of Grama panchayat presidents and secretaries on the issues related to malaria and its control, being the key leaders of the Panchayat Raj Institutions (PRIs) at a Grama panchayat level. This was necessary to achieve the long-term objective of the role of PRIs in malaria control and their enhanced participation/partnership with the public health sector. Materials and Methods: Grama panchayat presidents and secretaries representing all the 28 Grama panchayats of Chikkanayakanahalli taluk Tumkur district in Karnataka were invited for a 1-day workshop. Deliberations with the participants (n = 32) shed light on their perceptions with respect to knowledge, attitude and practice vis-a-vis malaria and its control strategies. Results: Their knowledge of malaria as a disease was fairly good as they were well aware of it being a communicable disease and its transmission by mosquitoes. However, knowledge about the breeding sources of malaria mosquitoes (Anophelines) was very poor. Many practices in vogue to control mosquitoes at the community level were unscientific. There was a general negative attitude toward the government's handling of the malaria problem and the credibility of the health care system. Conclusion: Existence of health committees in every Grama panchayat coupled with their jurisdiction and responsibilities toward sanitation, water supply and health care resources makes PRIs a natural partner to the health sector. While health education and public health intervention strategies should be based on generic principles of science, the implementation and operational specifics should definitely be based on a sociological perspective of the stakeholders.
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Affiliation(s)
- Rajan R Patil
- Community Health Cell, Bangalore, India ; Division of Epidemiology, School of Public Health, SRM University, Chennai, India
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