Implementation Of Health Programs Research Articles

Analysis of the yearly transition function in measles disease modeling.

Globally, there were an estimated 9.8 million measles cases and 207 500 measles deaths in 2019. As the effort to eliminate measles around the world continues, modeling remains a valuable tool for public health decision-makers and program implementers. This study presents a novel approach to the use of a yearly transition function that formulates mathematically the vaccine schedules for different age groups while accounting for the effects of the age of vaccination, the timing of vaccination, and disease seasonality on the yearly number of measles cases in a country. The methodology presented adds to an existing modeling framework and expands its analysis, making its utilization more adjustable for the user and contributing to its conceptual clarity. This article also adjusts for the temporal interaction between vaccination and exposure to disease, applying adjustments to estimated yearly counts of cases and the number of vaccines administered that increase population immunity. These new model features provide the ability to forecast and compare the effects of different vaccination timing scenarios and seasonality of transmission on the expected disease incidence. Although the work presented is applied to the example of measles, it has potential relevance to modeling other vaccine-preventable diseases.

The Role of School Leaders in Developing Teams: Sources and Triggers in School Health Promotion

Although teams are the cornerstone of school health promotion, sources of team learning and the role of school leaders in developing such teams is unknown. It is important to understand the sources and triggers of team learning in order to establish the role of school leadership in the development of such teams. The investigation adopted a qualitative approach and a single case study design. Six members of the school management team and 12 teachers from one school participated. Eight of the 12 teachers were members of health committees responsible for the implementation of health policies in the school. Data were gathered by means of individual and focus group interviews. The findings revealed three sources of team learning that may be regarded as triggers: routine health promoting activities in the school, policies and guidelines for implementation of health programmes, and collaboration with other role players. School leaders were found to play an essential and multi-faceted role in team development, in that they were responsible for establishing developmental training programmes including creating opportunities for evaluation and reflection, managing interpersonal relationships and roles, articulating a vision, and facilitation of an open dialogue about the implementation of the health policy.

District-level differences in the distribution of mental and substance use disorders in Assam.

The lifetime prevalence of mental morbidity in Assam is estimated at 8% (NMHS 2015-16). Understanding the distribution patterns of different types of mental disorders among persons with mental morbidity in different districts would facilitate evidence-driven district mental health programming in Assam. Given the varied socio-geopolitical situation across districts in Assam, significant variations in the distribution of mental disorders are expected. To assess interdistrict differentials in common mental disorders (CMDs), severe mental disorders (SMDs), socioeconomic impact, healthcare utilization, and mental disability across three districts sampled in NMHS in Assam. This cross-sectional study used stratified random cluster sampling to identify and study eligible adult participants in Dibrugarh, Barpeta, and Cachar districts. Standardized scales and validated questionnaires were used to assess mental morbidity, disability, socioeconomic impact, and healthcare utilization. The distribution of different mental disorders among persons with mental disorders and their interdistrict differentials were tested using the Chi-square test of significance. Among persons with mental morbidity, the most common disorder was CMDs (79%). The proportional distribution of CMDs among persons with mental morbidity was significantly higher in the Dibrugarh district (79%), whereas the distribution of SMDs was higher in the Cachar district (55%). The distribution of alcohol use disorder was the highest in the Dibrugarh district (71.6%). Significant differences in disability and healthcare utilization were observed between the districts. NMHS 2015-16 Assam indicates significant differentials in the distribution of CMDs and SMDs, healthcare utilization, and associated disability between the three districts. The differentials necessitate further research to understand socio-ethnocultural, religious, geopolitical, and other factors influencing the distribution. These differences need to be accounted for during the implementation of mental health programs in the state.

School Health Services Utilisation Among Secondary School Students in Ibadan, Oyo State

This study assesses the utilisation of school health services in Ibadan North-West Local Government Area, Oyo State, Nigeria, with implications for primary healthcare among school children and the prevention of early-life preventable diseases. The research objectives include determining the level of school health service utilisation among secondary students in public and private schools, investigating barriers affecting utilisation, and examining the association between school type and service utilisation. A descriptive cross-sectional research design was employed, sampling 300 students aged 10-19 from a population of 37,396 in Ibadan North-West Local Government Area. The study utilized a multi-stage sampling procedure and a self-structured questionnaire with sections on socio-demographic characteristics, utilisation assessment, and barriers. The instrument's validity was established through content and face validity procedures. Results indicate a higher utilisation of school health services in private schools compared to public schools, highlighting a deficit in human and material resources for qualitative school health programs. Weak collaboration between the health and education sectors was detected, contributing to suboptimal standards and dissatisfaction among beneficiaries. Factors such as logistical challenges and changing living areas were identified as potential contributors to poor health program implementation. Recommendations include intensified efforts by school management boards to ensure service utilisation, the creation and maintenance of healthy school environments, and increased family involvement in school health service policies.

The Pentahelix Partnership Responses during Covid-19 Pandemic in Makassar

Background: A Partnership is one of the strategies for accelerating responses of Covid-19, especially in understanding the decisions made by the government and the various reactions of the community regarding the Covid-19 pandemic.
 Objective: This study aims to explore partnership efforts pentahelix involving the government, academia, community, business sectors, and the media in handling Covid-19.
 Methods: The qualitative study was carried out through in-depth interviews with 18 participants consisting of government, media, academics, and community elements. The participants were members of the Covid-19 Handling Task Force (Covid-19 Task Force) and people who were directly involved in handling Covid-19 in Makassar. The content analysis was performed using the collected data. The themes that emerge from the data are the pentahelix partnership with the government, community groups, academics, business sectors, and mass media. The data were collected from December 2022 to March 2023.
 Results: The pentahelix partnership involves 5 parties: government, community, academics, business sectors, and the media. The partnership is accomplished through coordination, collaboration, participation, and mutual assistance. This partnership is established in the implementation of government policies in handling Covid-19 with the formation of Task Forces where the community participates in its implementation. Coordination between the government and academics regarding ways to resolve the Covid-19 case; collaboration with business sectors in providing facilities and infrastructure for handling Covid-19 activities as well as with the media that assist in disseminating information, public education, and news related to the incident of Covid-19 was adopted to implement the health policies during this pandemic.
 Conclusion: handling covid-19 with pentahelix partnerships was carried out through coordination, collaboration, participation, and mutual assistance of all parties. The partnership process is a strategy for implementing health programs related to the handling of Covid-19 which are regulated by the government.

Utilization Patterns of Maternal and Child Health (MCH) Care Services: A Cross-Sectional Study in Rawalpindi, Pakistan

Background: Despite the implementation of various maternal health programs and schemes at both regional and national levels in Pakistan, maternal mortalities and morbidity remain significantly high. This suggests that maternal health services are being underutilized. Aim: This current study focuses on assessing the utilization patterns of maternal health services and the factors associated with their utilization in Rawalpindi, Pakistan. Methods: The cross-sectional study was conducted over one year (2021-2022) among mothers aged 15 to 49 years in the field practice area of DHQ Rawalpindi. The minimum required sample size was determined as 645. Participants were selected using a simple random sampling technique from a randomized list of villages. Data was collected through home visits, utilizing a pretested, standardized questionnaire. In the analysis, the significance of associations between variables was established at P<0.05. Results: Among the 645 potential participants, 632 provided consent for inclusion in the study. Only 58.3% of participants received any Antenatal Care (ANC), and a mere 11.7% received full ANC services. More than half of the participants (52.7%) had experienced pregnancy-related complications. Variables such as younger age and limited decision-making capacity were significantly associated with the lack of full ANC services (P<0.05). Conclusion: This study highlights that a woman’s age, literacy status, parity, socioeconomic status, and occupation are major determinants influencing the utilization of maternal health care services. These determinants should be taken into account when planning future interventions aimed at promoting attitudinal changes and, consequently, enhancing the utilization of maternal health care services.

Barriers to implementing health programs based on community participation: the Q method derived perspectives of healthcare professional

BackgroundCommunity participation in implementing health programs leads to positive organizational, social and individual consequences. This study aimed to investigate the prospects of a sample of Iranian healthcare professionals about their perceived barriers to implementing health programs based on community participation.MethodsThis was a cross-sectional study that employed a Q-methodology approach. Twenty health professional sorted the 47 statements into a 9-column Q-sort diagram ranging from − 4 as not important to + 4 as very important. The data were analyzed with PQMethod 2.35 software. The centroid factor analysis and varimax rotation were used for data analysis. Factors identified were interpreted and described in terms of the participants perspectives on the phenomenon.ResultsAnalysis of the study participants’ viewpoints (the Q-sorts) resulted in a five factor solution (accounted for 57% of the total variance) to endorse the main barriers to the implementation of health programs based on community participation in Iran. Barriers related to government, health programs, lack of necessary skills amongst health professionals and weak coordination between departments, barriers related to community, lack of understanding of goals, benefits and transparency of roles and responsibilities were among the important emanated factors to implementing health programs based community participation.ConclusionHealth policymakers and managers should consider the five mentioned identified barriers based on the community when planning and implementing the health program participation and try to empower the community to implement the programs in Iran.

Student’s Knowledge and Practices on Basic School Health Services in Relation to School Health Nurse Program

IntroductionBasic school health services (BSHS) provided by the school nurse have the potential to significantly reduce the prevalent preventable health issues at school community. The objective of this study was to assess the of students on basic school health services in relation to school health nurse program. To assess the Students Knowledge and Practices on basic school health services in relation to school health nurse programMethodsAn analytical cross-sectional study conducted among 313 students on basic school health services in schools with and without implementation of school health nurse program using a non-probability purposive sampling technique. Data were collected using a self-administered questionnaire and an observation check list, and analyzed using descriptive and inferential statistics.ResultsThere is statistically significant difference in mean score of knowledge among students with School Health Nurse Program (SHNP) and not having school health nurse program. The practice of basic school health was significant association on how at comfort students felt when dealing with health issues (p<0.001), providing first aid and emergency care (p<0.001), conducting screening programs (p<0.001), distribution of free iron and deworming tablets (p<0.001), and engaging in physical activity (p<0.001).ConclusionsImplementation of school health nurse program has positive impact on basic school health program in schools. Students' knowledge and practice regarding school health services found higher in SHNP-implemented schools than in SHNP-non-implemented schools. Thus, study suggest that the basic school health program's implementation in schools is influenced by the school health nurse program.

Research on Consumption of Sugar-Sweetened Drinks and 100% Fruit Juice

Measurement of consumption of sugar-sweetened and 100% fruit juice drinks is typically patchy and often nutritionally focused, particularly in developing countries such as Turkey, with limited public perception and awareness of the health risks associated with excessive SSB consumption, and a low stimulus level of 100% fruit juice intake. In the study, the effects of socio-demographic, economic, and lifestyle characteristics of individuals and households on their different consumption probabilities of pure fruit juice (100% FJ) and sugar-sweetened beverages (SSB) were determined using the random-effects bivariate probit model in the context of family heterogeneity in Turkey. A richer source of information was elicited by deriving different probabilities from the bivariate random effects probit model. The applied model was found to be more compatible with the data and all the correlation coefficients examined were statistically significant. While most of the variables were statistically significant, according to the regressor effect, the probability of consuming 100% fruit juice among sugar-sweetened intakers was found to be greater or less than the probability of consuming 100% fruit juice of a randomly selected individual from the population (e.g., marginal probability). In this context, we can expect that the implementation of distinct intervention health programs that will involve different population segments will contribute greatly to the development of ideal outcomes. In addition, policy recommendations were presented considering the effects of very important variables.

Assessment of utilisation of government programmes and services by pregnant women in India.

Since the implementation of various maternal health programs, Maternal Mortality Ratio (MMR) has significantly declined in India through improvements in maternal health services. However, inequality persists at the regional and socio-economic levels. In light of this, the present study aims to assess the existing regional disparities in utilising various government initiatives for safe motherhood in India. National-level datasets such as National Family and Health Surveys (NFHS-3 (2005-06); NFHS-4 (2015-16) and NFHS-5(2019-21); Health Management Information System (HMIS), 2019-20; Sample Registrar System (SRS), 2001-2018) were used in the study. In addition, composite Index and inequality measures (Range, Ratio, and Gini) were calculated to examine inequality. At the same time, the Pearson correlation was used to investigate the correlation between various components of maternal health services and Maternal Mortality Rate (MMR). The composite index score (0.65) reflects that India is still far behind the targets of the utilisation of maternal health care services. Within the utilisation of services, the Gini coefficient reveals that the least inequality was recorded in skilled birth assistance deliveries (0.03) and institutional deliveries (0.04). In contrast, the highest inequality was recorded in receiving Iron and Folic Acid (IFA) Tablets for 100 days (0.19) and four Antenatal Care (ANC) visits (0.13) among selected states. Based on the composite score for maternal health utilisation, Kerala, Tamil Nadu, Andhra Pradesh, Odisha, and Delhi were amongst the best performers, whereas Bihar, Jharkhand, Uttar Pradesh, and Assam were amongst the worst performers. This indicates that the government's single-minded focus on enhancing institutional deliveries and skilled health-assisted deliveries has detracted from other essential interventions related to maternal health. Therefore, the states with the utilisation of maternal services need to initiate immediate action to increase the ANC and Post-natal Care (PNC utilisation with more attention towards better implementation of existing ANC programmes by the government.

Perspectives of School Nurses on Implementation of Asnani School Oral Health Program

Oral health of children has consistently been a key area of focus in public health. School oral health programs are effective and economical approaches to improve oral health of children. This research explores the School Nurses’(SN) perspectives on Asnani School Oral Health Program (ASOHP).

Digital financial services for health in support of universal health coverage: qualitative programmatic case studies from Kenya and Rwanda

BackgroundThis document describes two qualitative programmatic case studies documenting experiences implementing digital financial services (DFS) for health with a focus on expanding access to universal health coverage (UHC). The CBHI 3MS system in Rwanda and the i-PUSH and Medical Credit Fund programs in Kenya were selected because they represent innovative use of digital financing technologies to support UHC programs at scale.MethodsThese studies were conducted from April-August 2021 as part of a broader digital financial services landscape assessment that used a mixed methods process evaluation to answer three questions: 1) what was the experience implementing the program, 2) how was it perceived to influence health systems performance, and 3) what was the client/beneficiary experience? Qualitative interviews involved a range of engaged stakeholders, including implementers, developers, and clients/users from the examined programs in both countries. Secondary data were used to describe key program trends.ResultsRespondents agreed that DFS contributed to health system performance by making systems more responsive, enabling programs to implement changes to digital services based on new laws or client-proposed features, and improving access to quality data for better management and improved quality of services. Key informants and secondary data confirmed that both implementations likely contributed to increasing health insurance coverage; however, other changes in market dynamics were also likely to influence these changes. Program managers and some beneficiaries praised the utility of digital functions, compared to paper-based systems, and noted their effect on individual savings behavior to contribute to household resilience.Discussion/ConclusionsSeveral implementation considerations emerged as facilitators or barriers to successful implementation of DFS for health, including the importance of multisectoral investments in general ICT infrastructure, the value of leveraging existing community resources (CHWs and mobile money agents) to boost enrollment and help overcome the digital divide, and the significance of developing trust across government and private sector organizations.The studies led to the development of five main recommendations for the design and implementation of health programs incorporating DFS.

Values and preferences related to workplace mental health programs and interventions: An international survey.

This study explores the perspectives of workers and managers on workplace programs and interventions that seek to promote mental wellbeing, and prevent and treat mental health conditions The results contributed supporting evidence for the development of the WHO's first global guidelines for mental health and work, which provide evidence-based recommendations to support the implementation of workplace mental health programs and supports, to improve their acceptability, appropriateness, and uptake. An international online survey was used to examine the values and preferences among workers and managers related to workplace mental health prevention, protection, promotion, and support programs and services. The survey was made available in English, French, and Spanish and recruitment consisted of convenience sampling. Descriptive statistics were used to analyse the survey data. Rapid thematic qualitative analysis was used to analyse the results of open-ended questions. N = 451 responses representing all WHO regions were included in the analysis. These results provide a unique international perspective on programs and supports for mental health at work, from the standpoint of workers and managers. Results suggest that workers value interventions developed in consultation with workers (including indicated, selective and universal interventions), increased training and capacity building among managers, and targeted interventions to address the pervasive impact of stigma on perceptions about mental health at work and help-seeking. The findings of this study seek to reflect the perspectives of workers and their managers, and therein to promote improved access, availability and uptake of mental health programs and supports at work and-ultimately- to support the potential of workplaces as environments that promote and support mental health.

School Health Services in India: Status, Challenges and the Way Forward.

Schools provide a crucial platform for health and well-being interventions targeting children and adolescents. Early promotive and preventive initiatives are vital for enabling children and adolescents to reach their optimal potential, thereby adding to the country's social return-on-investment, creating a favourable demographic dividend. This review analyses the evolution of school health initiatives in India, including the current curriculum proposed under the Ayushman Bharat program. The manuscript highlights the challenges, and gaps in implementation of the current school health programs and proposes potential pathways for bridging these gaps for promotion of adolescent well-being. The review also discusses the concept of Health Promoting Schools and suggests adaptations and key recommendations to Indian context regarding 'how' to translate it into on-field reality based on the appraisal of successful case studies from other countries. Though India started school health services more than 100 y ago, the school health programmes in most Indian states are weak and fragmented, with piecemeal health screening with minimal focus on health promotion and well-being. The recently launched School Health and Wellness initiative under the Ayushman Bharat program has lots of promise. However, it needs to be translated into effective implementation to prevent it from meeting the fate of its forerunner programs. The school health program needs to move beyond the screening centric approach and be aspirational and holistic in nature focusing upon the overall well-being of the adolescents. Concerted efforts through intersectoral convergence are needed to optimally utilise the platforms of schools for promotion of adolescent well-being.

Implementation of health and wellbeing policies and programs for students: Views of Australian universities.

Universities are a crucial setting to address and promote optimal mental health of young Australians. However, there is a lack of knowledge of universities' views of current implementation of health and wellbeing initiatives. Therefore, we examined the views of Australian universities on the implementation of health and wellbeing policies and programs within Australian universities. An online survey of Australian universities asked respondents to rate their level of agreement with five statements pertaining to the implementation of health and wellbeing policies and programsfor students within Australian universities using a 5-point Likert scale (strongly agree to strongly disagree). Eleven universities completed the survey (28.2% response rate). All respondents (n = 11) agreed that universities play a crucial role in supporting the health and wellbeing of their students and report access to sufficient expertise to do this. Approximately three-quarters (8/11) agreed that universities know what policies and programs to implement to support their students' health and wellbeing. There was less agreement that universities have sufficient resources (2/11 agree) or access to sufficient information about the health and wellbeing of their student population (3/11 agree) to support the implementation of health and wellbeing policies and programs. Australian universities demonstrated strong organisational commitment to supporting the health and wellbeing of their students but highlighted some key barriers to implementation. SO WHAT?: Findings from this preliminary research highlight potential barriers and facilitators to the implementation of health and wellbeing policies and programs in Australian universities, and potential foci for future research.

O.2.3-2 How to effectively develop and modify workplace health programs: case studies in UK contact centers

Abstract Purpose Workplace health programs are often implemented to improve employee health, and subsequently business outcomes (e.g., reducing absence). However, they rarely consider the full range of complexity and variability of organizational factors. This can lead to poor implementation, effectiveness and sustainability. As such, innovative methods which facilitate the development or modification of health programs while considering an organization’s unique organizational culture barriers are needed. Contact center-based organizations in particular have several organizational barriers, which create highly sedentary environments with limited opportunities for physical activity engagement. This study aims to improve the development, implementation and effectiveness of workplace health programs in contact centers by identifying and addressing these barriers. Methods This study is underpinned by the Six Steps in Quality Intervention Development framework (6SQuID). 6SQuID emphasizes co-production with stakeholders which is important in ensuring interventions are acceptable and sustainable. Four workshops were conducted in two contact center-based UK organizations over seven months. The workshops, with management, aimed to accomplish the following in each organization: 1) define the problem (with wellbeing programs) and its causal factors (organizational culture barriers), and 2) co-produce theories of change, theories of action and an action plan to address the causal factors and solve the problem. Results Organization 1 (private sector, nursing services) defined their problem as: low focus on engagement and participation in wellbeing activities. Organization 2 (public sector, emergency services) defined their problem as: wellbeing programs lack proactivity, engagement and sustainability. Each organization developed an action plan to address the causal factors of their problem and initiate their theory of change pathways (desired short, medium and long-term outcomes). Activity examples included: sanctioning time for well-being program/behaviour participation (e.g., break-taking to reduce sitting) and improving program promotion. Conclusions This study provides learnings on how to facilitate more effective development (or modification) and implementation of workplace health programs (especially those related to sedentary behaviour, physical activity and mental health) by including management in identifying and addressing organizational culture barriers. Results have the potential for application to other organizations with desk-based workers. This study is part of a University of Edinburgh-funded PhD studentship.

Assessment of knowledge, attitude, and practice of public primary school teachers on school health programme in Bende Local Government Area of Abia State, Nigeria

Background: The National School Health Policy recommends School Based Committee for schools which is responsible for the implementation of school health programmes (SHP). There are not enough medical doctors to deliver healthcare services in the primary schools hence teachers are looked upon to assist in healthcare delivery in schools. Teachers are in a vantage position to facilitate health among school-aged children. Children spend greater part of their time in school and have opportunity to regularly receive instructions in healthy living from their teachers. Methodology: This was a descriptive cross-sectional study conducted in 34 public primary schools in Bende Local Government Area (LGA), Abia State. All the primary school teachers (320) in the LGA were studied. Data were collected using pre-tested self-administered questionnaire. Data were analysed using SPPSS version 26 and presented in frequency tables. Chi-square was used to test association between categorical variables. P<0.05 was taken as statistically significant. Results: Ages of the participants were positively skewed with a mean value of 39.5±6.793 and a skewness of 0.136. From the findings, 204(63.7%) had good knowledge, 124 (38.7%) had positive attitude and 150 (46.9%) had good practice to school health services. There were statistically significant differences between socio-demographic characteristics and good knowledge and positive attitudes. There was statistically significant difference between socio-demographic characteristics and practice of school health services except marital status with a p-value of 0.108. Conclusion: The participants had good knowledge but negative attitude and poor practice of school health services. There may be need for training intervention studies in school health services to upgrade teachers’ knowledge, attitude and practice. There should be a legislation in the state and country requiring prospective teachers to obtain a diploma in school health services before engaging in teaching profession.

Infectious diseases in migrant pregnant women from an area of the Colombian Caribbean

Human migration is an activity that affects society in economic and political aspects and as a social determinant because of its differential impact on individual's health. To describe the situation of health and infectious diseases of vertical transmission risk in migrant pregnant women from an area of the Colombian Caribbean from 2019 to 2021. A descriptive cross-sectional study was carried out on pregnant irregular migrants in the Riohacha and Santa Marta municipalities in Colombia. Hemogram, uranalysis, toxoplasma, FTA-ABS, VDRL, rubella, hepatitis B, HIV (TORCHs), vaginal swab, basal glycemia, and transaminases, among other paraclinical tests, were done on pregnant women. Data was arranged, tabulated, and analyzed in SPSS v.23.0. A descriptive statistical analysis with measures of central tendency and dispersion for quantitative variables, and proportions analysis was done for qualitative variables. A total of 555 clinical records were analyzed. Of the infectious agents with a risk of vertical transmission, syphilis was the most frequent with 3.6%. Regarding toxoplasmosis, 2.5% were IgM-positive. 4.2% of the pregnant women had IgG antibodies against Rubella and 2 women showed antibodies against HIV. Our results reflect the need for the implementation of educational, prevention, and detection health programs with the aim to decrease the number of prenatal infections in the pregnant migrant population for preventing fatal complications both in mothers and newborns.

Applying design thinking for collaborative strategic planning in global health partnerships: the Operation Smile experience

Background Power asymmetries between global health actors based in low and middle-income countries (LMICs) and those based in High-Income Countries persist. Often actors in low-resource settings are seen solely as implementers of projects designed in High-Income Countries and are often not involved in the decision-making. To tackle the problem of power imbalances, a human-centered framework of design thinking was used for inclusive strategy development. This paper discusses how design thinking was used as a framework for the co-creation of Operation Smile Malawi’s (OSM) long-term strategy in a collaborative environment with in-country and international partners. Methods The strategic planning process included a situation analysis, priority setting workshop and participant feedback. A four-question design thinking framework was used to frame the three-day priority setting sessions; ‘what is’, ‘what if’, ‘what wows’, and ‘what works’. Design thinking tools that were used during the priority setting workshop included; visualization, journey mapping, mind mapping, brainstorming and concept development. At the end of the priority-setting sessions, an e-survey was used to assess the participants’ understanding and perception of the use of design thinking for strategic planning. Results The product of the process was a long-term strategy with goals, activities and strategies that were understood and agreed upon by all stakeholders. The post-workshop e-survey revealed that all participants responded that the design thinking process fostered team spirit during the entire process. The design thinking process also made the strategic planning workshop more productive and enabled participants to incorporate their own ideas into the five-year strategy. Furthermore, participants reported learning something outside their area of expertise. Conclusions As global health organizations increasingly recognize the need for equitable partnerships in the design and implementation of global health programs, the human-centred approach of design thinking can be used to create open and collaborative program design.

People with mental illness stigmatize mental illness less: A comparison study between a hospital-based sample of people with mental illness and a non-clinical general population sample in urban India.

Evidence shows that stigma negatively influences the quality of life of persons with severe mental illness. Nonetheless, stigma towards mental illness is lower among persons with a lived experience of mental illness compared to the rest of the population. Understanding the association between stigma of mental illness and the mental status of individuals living in urban India and whether this association is moderated by demographic factors opens a new avenue for prevention of social exclusion. Persons diagnosed with schizophrenia, bipolar disorder, or severe unipolar depression (cases, n = 647) were recruited from among hospital patients in New Delhi between November 2011 and June 2012 and matched with non-psychiatric urban dwellers by age, sex, and location of residence (controls, n = 649). Propensity score matching with multivariable linear regression was used to test whether stigma towards mental illness, measured by a 13-item Stigma Questionnaire, differed between cases and controls. Cases reported significantly lower stigma scores than controls (b = -0.50, p < 0.0001). The strength of the association between mental illness and stigma was not affected after controlling for age, caste, sex, education, and employment status, while wealth marginally reduced the strength of the association. These findings suggest individuals with a lived experience of mental illness, in New Delhi, India, may be more tolerant towards mental illness and support the need to involve persons with lived experience in the development and implementation of health promotional campaigns and programs aimed at reducing stigma towards mental illness.