Address Health Challenges Research Articles

An Ecological Perspective on Rural, Low-Income Mothers' Health

Using structural equation modeling, this study examined interactions among factors traditionally associated with health outcomes within a sample of rural low-income mothers. Prior research has established that education, employment, income, marital status, and health insurance coverage independently predict health outcomes. However, no studies have examined the simultaneous influence of these factors as conceptualized from an ecological systems perspective. Results indicate that when the multiple factors are considered simultaneously, different effects emerge. Implications are that the context in which these women live and the interactions between and among key influencing factors must be considered when addressing health challenges in rural areas.

Addressing health challenges in the five regional priority areas: progress in one year

Addressing health challenges in the five regional priority areas: progress in one year

A consortium approach to competency-based undergraduate medical education in Uganda: process, opportunities and challenges.

Uganda, like the rest of Africa, is faced with serious health challenges including human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS), other infectious diseases and increasing non-communicable diseases, yet it has a significant shortage of health workers. Even the few health workers available may lack desired competencies required to address current and future health challenges. Reducing Uganda's disease burden and addressing health challenges requires Ugandan medical schools to produce health workers with the necessary competencies. This study describes the process which a consortium of Ugandan medical schools and the Medical Education Partnership for Equitable Services to all Ugandans (MESAU) undertook to define the required competencies of graduating doctors in Uganda and implement competency-based medical education (CBME). A retrospective qualitative study was conducted in which document analysis was used to collect data employing pre-defined checklists, in a desktop or secondary review of various documents. These included reports of MESAU meetings and workshops, reports from individual institutions as well as medical undergraduate curricula of the different institutions. Thematic analysis was used to extract patterns from the collected data. MESAU initiated the process of developing competencies for medical graduates in 2011 using a participatory approach of all stakeholders. The process involved consultative deliberations to identify priority health needs of Uganda and develop competencies to address these needs. Nine competence domain areas were collaboratively identified and agreed upon, and competencies developed in these domains. Key successes from the process include institutional collaboration, faculty development in CBME and initiating the implementation of CBME. The consortium approach strengthened institutional collaboration that led to the development of common competencies desired of all medical graduates to address priority health challenges in Uganda. It is important that the MESAU consortium continues engaging all stakeholders in medical education to support the implementation and sustainability of CBME in Uganda.

The CompHP Core Competencies Framework for Health Promotion in Europe

The CompHP Project on Developing Competencies and Professional Standards for Health Promotion in Europe was developed in response to the need for new and changing health promotion competencies to address health challenges. This article presents the process of developing the CompHP Core Competencies Framework for Health Promotion across the European Union Member States and Candidate Countries. A phased, multiple-method approach was employed to facilitate a consensus-building process on the development of the core competencies. Key stakeholders in European health promotion were engaged in a layered consultation process using the Delphi technique, online consultations, workshops, and focus groups. Based on an extensive literature review, a mapping process was used to identify the core domains, which informed the first draft of the Framework. A consultation process involving two rounds of a Delphi survey with national experts in health promotion from 30 countries was carried out. In addition, feedback was received from 25 health promotion leaders who participated in two focus groups at a pan-European level and 116 health promotion practitioners who engaged in four country-specific consultations. A further 54 respondents replied to online consultations, and there were a number of followers on various social media platforms. Based on four rounds of redrafting, the final Framework document was produced, consisting of 11 core domains and 68 core competency statements. The CompHP Core Competencies Framework for Health Promotion provides a resource for workforce development in Europe, by articulating the necessary knowledge, skills, and abilities that are required for effective practice. The core domains are based on the multidisciplinary concepts, theories, and research that make health promotion distinctive. It is the combined application of all the domains, the knowledge base, and the ethical values that constitute the CompHP Core Competencies Framework for Health Promotion.

Addressing health challenges in a resource‐poor setting

Addressing health challenges in a resource‐poor setting

A conversation with Tadataka Yamada

Dr. Tadataka “Tachi” Yamada (Figure ​(Figure1)1) joins us for our next Conversation with Giants in Medicine. Born in Japan and trained in the United States as a gastroenterologist, he quickly rose to be the chairman of the Department of Internal Medicine at University of Michigan. He moved to industry and eventually became the Chairman of Research and Development for GlaxoSmithKline. In the next step in his interesting career, he took on the presidency of the Bill and Melinda Gates Foundation Global Health Program. In this capacity, he oversaw over $9,000,000,000 in programs directed at addressing health challenges of the developing world. In 2011, Dr. Yamada moved on to become the Chief Medical and Scientific Officer (CMSO) and Executive Vice President of Takeda Pharmaceuticals. The full interview can be seen on the JCI website, http://www.jci.org/kiosk/cgm.

Advancing primary care to promote equitable health: implications for China

China is a country with vast regional differences and uneven economic development, which have led to widening gaps between the rich and poor in terms of access to healthcare, quality of care, and health outcomes. China's healthcare reform efforts must be tailored to the needs and resources of each region and community. Building and strengthening primary care within the Chinese health care system is one way to effectively address health challenges. This paper begins by outlining the concept of primary care, including key definitions and measurements. Next, results from a number of studies will demonstrate that primary care characteristics are associated with savings in medical costs, improvements in health outcomes and reductions in health disparities. This paper concludes with recommendations for China on successfully incorporating a primary care model into its national health policy, including bolstering the primary care workforce, addressing medical financing structures, recognizing the importance of evidence-based medicine, and looking to case studies from countries that have successfully implemented health reform.

A Public Health Framework for Rare Blood Disorders

f S The public health system encompasses governments, healthcare providers, and others working to improve population health. The IOM in 1988 dentified three core functions of public health: assessent, policy development, and assurance. In 1994, the Core Public Health Functions Steering Committee, which included representatives from U.S. Public Health Service agencies and other major public health organizations, developed the framework for the ten essential services for public health. This framework of generic goals nd strategies is used by public health programs and ystems to address health challenges facing the populaion or community as a whole, notably environmental azards, injuries, infections, and common chronic disases, but has also been applied to blood disorders. The papers in this supplement to theAmerican Journal of PreventiveMedicine address various facets of blood isorders and public health. Specifically, the majority of he papers focus on blood disorders that are considered are in North America or Western Europe. Because of heir rarity, rare disorders often are not considered to fall nder the purview of the public health system even hough, collectively, rare disorders do affect large numers of people. However, a public health framework is eeded to address public health services and functions for ll rare disorders, including blood disorders, regardless of he incidence or prevalence of a given disorder. The lack of a public health framework for many blood isorders, both rare and common, is a particular concern. or example, even a relatively common blood disorder uch as venous thromboembolism (VTE), with a U.S. revalence of at least 1 million people, lacks an established mechanism for surveillance. Little is definitively known about the magnitude of the public health burden of VTE. AlthoughVTE is an important cause ofmortality

SP3-48 Routine mortality and cause of death reporting and analysis systems in seven Pacific Island countries

IntroductionStatistics on mortality levels and causes of death are essential for health planning. However, at the end of 2003, only 7 of 27 countries in the Western Pacific Region had...

Integrating cultural humility into health care professional education and training

As US populations become increasing diverse, healthcare professionals are facing a heightened challenge to provide cross-cultural care. To date, medical education around the world has developed specific curricula on cultural competence training in acknowledgement of the importance of culturally sensitive and grounded services. This article proposes to move forward by integrating the concept of cultural humility into current trainings, in which we believe, is vital in complementing the current model, and better prepare future professionals to address health challenges with culturally appropriate care. Based on the works of Chinese philosophers, cultural values and the contemporary Chinese immigrants' experience, we hereby present the QIAN (Humbleness) curriculum: the importance of self-Questioning and critique, bi-directional cultural Immersion, mutually Active-listening, and the flexibility of Negotiation. The principles of the QIAN curriculum reside not only between the patient and the healthcare professional dyad, but also elicit the necessary support of family, health care system as well as the community at large. The QIAN curriculum could improve practice and enhance the exploration, comprehension and appreciation of the cultural orientations between healthcare professionals and patients which ultimately could improve patient satisfaction, patient-healthcare professional relationship, medical adherence and the reduction of health disparities. QIAN model is highly adaptable to other cultural and ethnic groups in multicultural societies around the globe. Incorporating its framework into the current medical education may enhance cross-cultural clinical encounters.

Science-based health innovation in sub-Saharan Africa

In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation.This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive on-the-ground research in the form of four country case studies of health and biotechnology innovation, six studies of institutions within Africa involved in health product development, and one study of health venture funds in Africa. To the best of our knowledge it is the first extensive collection of empirical work on African science-based health innovation.The four country cases are Ghana, Rwanda, Tanzania and Uganda. The six case studies of institutions are A to Z Textiles (Tanzania), Acorn Technologies (South Africa), Bioventures venture capital fund (South Africa), the Malagasy Institute of Applied Research (IMRA; Madagascar), the Kenyan Medical Research Institute (KEMRI; Kenya), and Niprisan’s development by Nigeria’s National Institute for Pharmaceutical Research and Development and Xechem (Nigeria).All of the examples highlight pioneering attempts to build technological capacity, create economic opportunities, and retain talent on a continent significantly affected by brain drain. They point to the practical challenges for innovators on the ground, and suggest potentially helpful policies, funding streams, and other support systems.For African nations, health innovation represents an opportunity to increase domestic capacity to solve health challenges; for international funders, it is an opportunity to move beyond foreign aid and dependency. The shared goal is creating self-sustaining innovation that has both health and development impacts. While this is a long-term strategy, this series shows the potential of African-led innovation, and indicates how it might balance realism against opportunity. There is ample scope to learn lessons more systematically from cases like those we discuss; to link entrepreneurs, scientists, funders, and policy-makers into a network to share opportunities and challenges; and ultimately to better support and stimulate African-led health innovation.

An experience of virtual leadership development for human resource managers

ProblemStrong leadership and management skills are crucial to finding solutions to the human resource crisis in health. Health professionals and human resource (HR) managers worldwide who are in charge of addressing HR challenges in health systems often lack formal education in leadership and management.ApproachManagement Sciences for Health (MSH) developed the Virtual Leadership Development Program (VLDP) with support from the United States Agency for International Development (USAID). The VLDP is a Web-based leadership development programme that combines face-to-face and distance-learning methodologies to strengthen the capacity of teams to identify and address health challenges and produce results.Relevant changesThe USAID-funded Leadership, Management and Sustainability (LMS) Program, implemented by MSH, and the USAID-funded Capacity Project, implemented by IntraHealth, adapted the VLDP for HR managers to help them identify and address HR challenges that ministries of health, other public-sector organizations and nongovernmental organizations are facing.Local settingsThree examples illustrate the results of the VLDP for teams of HR managers:1. the Uganda Protestant and Catholic Medical Bureaus2. the Christian Health Association of Malawi3. the Developing Human Resources for Health Project in Uganda.Lessons learntThe VLDP is an effective programme for developing the management and leadership capacity of HR managers in health.

Arctic Peoples and Beyond: research opportunities in neuroscience and behaviour

Objectives. Arctic and northern peoples are spread across Alaska, Canada, Russia and the Scandinavian countries. Inhabiting a variety of ecosystems, these 4 million residents include Indigenous populations who total about 10% of the population. Although Arctic peoples have very diverse cultural and social systems, they have health issues related to environmental impacts and knowledge/treatment disparities that are common to other minority and Indigenous peoples around the world. Research that explores the neuroscience and behavioural aspects of these health disparities offers challenges and significant opportunities. As the next generation of neuroscientists enter the field, it is imperative that they view their contributions in terms of translational medicine to address health disparities.Study Design. A workshop was designed to bring neuroscientists together to report on the current directions of neuroscience research and how it could impact health disparities in the North. This workshop produced research recommendations for the growth of neuroscience in the North.Methods. On May 31, 2006 the National Institute of Neurological Disorders and Stroke, the Burroughs Wellcome Foundation, the Arctic Division of AAAS and the University of Alaska co-sponsored a workshop entitled “Arctic Peoples and Beyond: Decreasing Health Disparities through Basic and Clinical Research.” Also, the role and goals of the International Union for Circumpolar Health (IUCH) were presented at the meeting.Results. A set of recommendations related to research opportunities in neuroscience and behaviour research and ways to facilitate national and international partnerships were developed.Conclusions. These recommendations should help guide the development of future health research in circumpolar neuroscience and behaviour. They provide ideas about research support and informational exchange that will address health challenges.

Reinventing global health: the role of science, technology, and innovation

The Millennium Development Goals have become an international standard against which to assess trends in development and human well being. Their adoption in 2000 coincided with two important factors: the growing recognition of the role of science and technology in solving human problems, and the emergence of new infectious diseases. These developments have helped to define biomedical research as one of the most critical public policy issues facing the global community. The state of human health in much of the developing world continues to decline at a time when the world's fund of biomedical knowledge continues to expand. This challenge offers new opportunities for promoting international cooperation in biomedical research of relevance to developing countries as outlined in the report of the Millennium Project Task Force on Science, Technology and Innovation. 1 UN Millennium Project, Task Force on Science, Technology and InnovationInnovation: applying knowledge in development. Earthscan, London, Sterling, VA2005 Google Scholar Addressing health challenges of the developing world will require new forms of international partnerships that take into account emerging opportunities in the globalisation of scientific knowledge.

Primary health care: a framework for policy development.

Primary health care has utility for policy development at all levels of organization in any nation, including policies influencing the health of persons living with severe and persistent mental illnesses. Using the primary health care framework, policies to improve health and housing for this population evolve from intersectoral collaboration. Active participation by those persons whose essential health is compromised by housing that is not acceptable, adequate, suitable, and affordable is required. Appropriate and affordable methods that address health challenges are identified. Access to services meeting essential health care needs of citizens has potential for healthy outcomes.