A New Era in Cancer Care: How a Five-Minute Jab is Revolutionizing Treatment.

Lung Cancer in South Africa.

Health Systems Need to Transform Data Collection to Advance Health Equity.

Talent Management is an essential component in transforming health systems if carefully implemented for the public sector especially in low income countries. In Zimbabwe public health sector, talent retention and engagement are viewed as amongst the challenges affecting the realisation of effective performance and productivity from the existing Health workforce. Largely, modern health care systems lack robust strategies to identify and utilize employee talent essential to help attain organisational citizenship. The study reviewed the relevancy and effectiveness of talent management practices in the public health sector using a case study of Parirenyatwa Group of Hospitals, one of the major referral hospitals in Zimbabwe. The study aimed at closing the talent pipe-line gaps as part of the Health Systems Strengthening initiative towards bringing about talent retention and engagement amongst the health workforce in public sector settings. The study assessed the impact of the existing talent management initiatives focusing on variables; recruitment and attraction perspective, compensation and rewarding component, health workforce succession management and implemented performance management system. The study obtained cross sectional data collected through a designed tool following a purposive (non-probability) sampling technique from a sample of n=200 existing health management team to assess the perception of implemented talent management approaches. The study further used responses from n=450 randomly selected health professionals recruited in the last 3 years prior to the survey to analyse the association between the variables on talent management practices namely (recruitment and selection, compensation and rewarding, succession management and performance management system) and the age of health workforce to employee engagement. The data on recruited cadres was obtained from the existing Hospital Human Resources for Health Recruitment Database. The research revealed that talent management in public health sector currently suffers from theoretical problems since the existing Human Resources for Health literature concentrates on anecdotal information. The human resource practitioners need to come up with more involving workplace activities to demystify the theory that millennials are generally finding it difficult to engage. In addition, the public sector succession planning strategies would need to be in place for the millennials well in time to adequately replace the considerable number of those at retiring stages. The Logistic regression analysis revealed recruitment and attraction perspective, and succession management positively influence health workforce engagement while adherence to implementing performance management system negatively affected employee engagement. Compensation and rewarding practices in a public health set up proved an insignificant variable to health workforce engagement hence study concluded further analysis on the impact on wider target group. The study revealed as the age increases, the health workforce become more engaged and self-motivated to develop their personal talent, thus theory suggests such are ‘Baby Boomers’ age group that do not need much push and are prepared to perfect their work talent for the benefit of the health system. The role of performance management system must be equally elevated within health system initiatives in order to achieve ultimate health workforce engagement. The study recommended the public health sector to incorporate in its human resources policy, a strategy for managing and utilisation of talent from the different health workforce generations within the health system. In improving the performance of public health systems, talent management need to be put forward in the health systems strengthening agenda in order to build highly engaged health teams. Talent management practices become essential and if carefully implemented, are likely to help public health systems retain rare skills especially in highly specialised functions. Furthermore, the organisations need to synchronise its strategic plan with the talent management strategy. There must be continuous capacity building of human resources departments to firstly own policies that influence talent management so as to ensure ultimate health workforce engagement.

Surveillance of human and animal health is often carried out separately worldwide, which leads to the under-reporting of zoonotic and emerging diseases. Early cross-information between wildlife, domestic animal and public health sectors may reduce both exposure and cost of outbreaks. We have assessed the feasibility of a One Health Surveillance and Response System (OHSRS) in the Adadle district of Ethiopia in the Somali Region (SRS), with regard to integration into the existing regional surveillance-response system in the Somali Region of Ethiopia (SRS). To meet the objectives of a surveillance-response system, we established a One Health Surveillance and Response Unit (OHSRU) at the district level. Community Animal Health Workers, Community Health Workers (CHWs), and both human and animal health district staff and regional experts were trained together on the OHSRS. An inception workshop was held with all relevant stakeholders. To ensure the active engagement of communities in the surveillance response system, a Community-Based Emergency Fund (CBEF) and CAHW cost recovery mechanisms were established. All public and animal health staff of different administration levels were linked together. Human and animal health information was collected and shared effectively among sectors. This approach helped bridging the physical separation between the public and animal health sectors in disease surveillance in the Adadle district. Joint interventions, such as disease outbreak investigations and community awareness were initiated by the OHSRU. We demonstrated that the OHSR was successfully operationalized in Adadle districts and contributed to improving the early detection and response of zoonotic diseases. However, technical barriers, cost-effectiveness, legality of data and ethical safeguarding, along with political commitment should be addressed to effectively operationalize the OHSR in the whole region. Designing the OHSR through the existing surveillance system, engaging communities and other relevant sectors using a participatory process is an important contribution to a sustainable OHSR. One Health Impact Statement In this research work, the public and animal health sectors collaborated in data collection and initiated joint interventions. By integrating the surveillance operational costs for disease outbreak investigation and cost of public health associated with zoonotic diseases can be reduced as One Health surveillance and response lead to early detection and response to zoonotic diseases. As one health is collaborative efforts multispectral, multidisciplinary and transdisciplinary, i.e. involvement of all relevant sectors including community members and different disciplines in the launching workshop of surveillance system helped to define and agree the role of each sectors or partner’s in the One Health approach. This played a curtail role in the success of the approach. Lessons learned from this work can be used for further improvement in One Health approach in different settings.

Healthcare is one of India's largest sectors, in terms of revenue and employment, and the sector is expanding rapidly. The private sector accounts for more than 80% of total healthcare spending in India. When it comes to healthcare, there are two Indias: the country with that provides high-quality medical care to middle-class Indians and medical tourists, and the India in which the majority of the population lives—a country whose residents have limited or no access to quality care. A widespread lack of health insurance compounds the healthcare challenges that India faces. Although some form of health protection is provided by government and major private employers, the health insurance schemes available to the Indian public are generally basic and inaccessible to most people. For the small percentage of Indians who do have some insurance, the main provider is the government-run General Insurance Company (GIC), along with its four subsidiaries. While public sector health insurance has not fared well, the market for private health plans is expanding in India. With this background in mind, the main objective of this study is to compare the customer satisfaction between public and private sector medical insurance companies in India. The study is descriptive in nature as it seeks to describe in detail the state of customer satisfaction between public and private sector health insurance companies thus giving an in-dept understanding of the reality of customer satisfaction among medical insurance companies. The target population for the study comprises all individual customers having health insurance from all insurance companies that operate in India. The non probability sampling technique used in this study is convenience. A sample size of two hundred and fifty (250) customers has been used. To check the consistency of the questionnaire, item to total correlation has been used. Independent Sample T-test is used to compare the customer satisfaction between the public sector and private sector health insurance companies. The questionnaire is found consistent and it has been found that there is no significant difference in customer satisfaction between the public sector and private sector health insurance providers.

This article reviews the forms that psychotherapeutic leadership can take for psychiatrists attempting to optimise outcomes for individuals receiving treatment in the public mental health sector. It explores a range of roles and functions that psychiatrists can take on as psychotherapy leaders, and how these can be applied in clinical, administrative and research contexts. Psychiatrists need to play an increasing role in clinical, administrative and academic settings to advance service provision, resource allocation, training and research directed at psychotherapies in the public health sector.

The study aimed to examine the influence of contract administration activity on employee performance among doctors in the public health sector in Nairobi County, Kenya moderated by employee engagement. Drawing on the theory of industrial jurisprudence, the research targeted a population of 789 public service medical doctors. Probability’s stratified sampling technique was employed to categorize the population into specialization based strata and 327 doctors selected through simple random sampling. Non-probability’s purposive sampling technique was used to pick 21 top managers. The study was based pragmatism research philosophy and convergent parallel mixed methods design. Quantitative data was gathered from doctors using a selfstructured questionnaire while qualitative data was collected from top managers using an openended interview guide. Reliability of the questionnaire was assessed using Cronbach's alpha coefficient and validity was established through face, criterion, content and construct validities. Hypotheses were tested using regression analysis at a 0.05 level of significance. The study found that though contract administration activity had a positive and significant influence on employee performance, the performance of the doctors in public service health sector in Nairobi County was affected by the non-full implementation of their 2017 contract. Further, results showed that relationship between contract administration activity and employee performance was significantly moderated by employee engagement. The study also found that there was no employee engagement policy in the public service. Therefore, study recommended that labour relations stakeholders should formulate more innovative and practical mechanisms that guarantee timely contract administration. Also, formulation of employee engagement policyasa pillar of enhanced employee performance, especially among the public service health sector, should be encouraged.

Can Cyprus overcome its health-care challenges?

BackgroundClimate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials.MethodsFifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention.ResultsResults indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%), severe weather (68%) and poor air-quality (57%). Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies.ConclusionsThis study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into policies and programs, while higher levels of government must improve efforts to support local adaptation and provide the capacity through which local adaptation can succeed.

Background: The process of improving the quality of health care delivery requires that health systems function efficiently and effectively. A key component of health care systems’ efficiency is the administration of records that are often poorly managed. Any improvement in the management of records has to be done in full cognisance that records are generated in an organisational setting and based on a national legislative and regulatory framework.Objectives: The purpose of this article is to assess the contextual legislative and regulatory framework of South Africa’s health care system and its impact on the effectiveness of records management in public health care institutions.Method: Data for the study were obtained from two sources. On the one hand, the study conducted a review of literature that not only provided background information but also informed the research process. On the other hand, a varied number of respondents were identified through purposive sampling, and their expert knowledge solicited through semi-structured interviews.Results: The literature review, as well as the interviews, revealed that findings on the legislative and regulatory environment are multi-layered. For instance, respondents echoed observations made from the literature review that, whilst South Africa had a complex array of legal instruments, compliance levels at public health institutions were very rudimentary and contrary to the levels of sophistication expected by the legal instruments. A number of respondents noted the lack of specific guidelines for health records and that in most government departments there was ‘a very low key focus on the regulatory issues’. Several respondents stated that even when there were general guidelines for managing records, very few public institutions were compliant. A majority of the respondents noted a lack of an integrated approach in the different legislative and regulatory instruments, for instance, on the issue of records retention.Conclusion: The study revealed three related observations: firstly, that there is substantial legislative and regulatory dissonance in the management of health records in the country’s public health sector; secondly, understanding the complex interplay of different legal and regulatory instruments in the country’s public health sector is a critical first step, but it remains the beginning of the process; thirdly, there are lessons to be drawn from the extensive experiences of other countries such as the United Kingdom in addressing the legislative and regulatory challenges.

Background: Attrition of health professionals from public health sectors is found to be a barrier to effectiveness of health systems and to provide essential health service to population. In Ethiopia, the public health system is the major provider of health care service to the people. In particular, the poor segment of community uses public hospital, health centers and clinic, since the private health facilities are inaccessible and unaffordable to them. The aim of this study was to determine the magnitude and factors associated with health professionals’ attrition from public health sectors in Bahir Dar city. Methods: A Facility based cross-sectional study was conducted in September-October 2012. All inclusive sampling techniques of five years document reviews were used to select 727 health professional documents. Quantitative and qualitative data were collected using structured questionnaires and indepth-interview guides respectively, by trained data collectors. Descriptive statistics (frequencies, proportion and chi square test) were used to describe the study population in relation to relevant variables. To identify independent predictors of attrition, only variables that were statistically significant during bivariate analysis were entered into multiple logistic regression models to control the effects of confounders. Pvalues sex, marital status, educational status, workplace, current salary, professional category and work experience were the main factors associated with health professionals’ attrition from public health sectors. Conclusion: The findings showed that the level of health professionals’ attrition is high in the study area. Policy makers and health mangers should design appropriate retention strategies for health professionals at public health sectors in terms of most associated factors with attritions of health professionals to reduce the prevalence of health professionals’ attrition from public health sectors in collaboration with development partners and concerned body.

Introduction. Collecting data about the structure and function of private health care sector in Serbia and its inclusion in joint health care system is one of the most important issues for making decisions in health care and getting more accurate picture about the possibilities of health care system in Serbia. The aim of this analysis was to compare health institutions, personnel, visits, number of hospital days and morbidity by ICD-10 classification of diseases in public and private health sector in South Backa, Nisava, Toplica and Belgrade district in 2009. Material and Methods. A retrospective comparative analysis was performed using data about private providers of health services obtained from the Institute of Public Health Novi Sad, the Institute of Public Health Nis and the City Institute of Public Health Belgrade. Data about personnel and morbidity in public health sector in Serbia for 2009 was obtained from the Center for Information Technology of the Institute for Public Health of Serbia. Data about public health facilities in South Backa, Nisava, Toplica and Belgrade district in 2009 was obtained from Serbian Chamber of medical institutions. Results. The results showed that health care was provided in Belgrade district in 2009 by total of 1,051 employees in private sector and 31,404 in public sector. We found that public sector had a far wider range of health facilities than private sector, which was mainly due to the number of clinics. In South Backa district private sector had 323 practices, the district of Belgrade 655 and Nisava and Toplica district 173. Seventeen times more visits to households (4,650,423 vs. 267,356) and 111 times greater number of hospital days was provided in public health sector as compared to private health sector (781,083 vs. 7,023) in South Backa district. Conclusion. The conclusion of this analysis was that public health sector has remained the foundation of health care system in Serbia. Private health sector is expanding, but its structure and scope of services is still undervalued as compared to public sector.

Impacts of climate change on public health in Australia

Orientation: There is a misalignment between the strategic goals of the public health sector, which include strengthening health systems to produce desired health outcomes, and the human resource management of the human resources for health.Research purpose: This study aimed to describe the extent and identify the factors influencing the human resource management in achieving the strategic objectives of the public health sector.Motivation for the study: Managers in the public health sector can develop interventions and effective procedures to improve alignment in the human resource management of the human resources for health to improve health outcomes.Research approach/design and method: A qualitative descriptive study design with an interpretivist approach was utlised to conduct the study. A document review and sixteen face-to-face interviews were conducted, eight human resource (HR) practitioners and eight line managers purposively selected from an urban and rural district.Main findings: The public health sector provides a unique context that requires different considerations for human resource management. Human resource managers and line managers do not only have different backgrounds and orientations but they also function in different contexts (administrative vs. clinical) in the public health sector. The factors influencing effective human resource management are as follows: the lack of capacity to implement key HR strategies in the public health sector, competing priorities and the absence of clear roles in performing human resource practices.Practical/managerial implications: There is a need to foster a partnership approach between the HR manager and line manager to provide effective human resources management as it is complex and fractured, particularly during change and decentralisation.Contribution/value-add: This article addresses the research gap on human resource management in the public health sector shifting focus from individual practices to a systems thinking approach in strengthening human resource management. It also makes a theoretical contribution by adding context to human resource management as a key requirement for implementation decision making.

In this edition of Healthcare Papers, Miller et al. make the case for greater engagement of the public health sector in healthcare system reform. Although I agree with many of the points made, I challenge the premise that public health is unwilling and/or unprepared to lead or participate in system change. Ontario's public health sector is not only ready to participate in transformation of the healthcare system, provincial and local involvement is well under way. Public health has been actively engaging colleagues in both the healthcare and non-health sectors to discuss health system evolution and transformation. Make No Little Plans - Ontario's Public Health Sector Strategic Plan sets out the vision, strategic goals and collective areas of focus for the next three to five years, and includes an immediate emphasis on establishing collaborative mechanisms within the sector and with others in the health sector and non-health sectors. As an initial step, public health is identifying and analyzing key intersection points between public health and primary care to enable better alignment and integration. In Ontario, public health is not only participating in health reform, we are in a position to help drive it.