International Health Projects Research Articles

Influence of Monitoring Systems on The Performance of Non-Governmental Organization Projects: A Case Study of Plan International Health Projects, Kenya

Influence of Monitoring Systems on The Performance of Non-Governmental Organization Projects: A Case Study of Plan International Health Projects, Kenya

Calculating war, calculating peace: the Rockefeller Foundation and science research in Britain

ABSTRACT The history of reconstruction and philanthropic aid efforts in Western Europe after the Second World War ended cannot be fully understood without examining the wartime networks, scientific projects and miscalculations of Allied planners. This case study of a Rockefeller Foundation project in Second World War Britain shows that the war gave scientists studying human nutrition an opportunity to conduct research on an unprecedented scale, with an unprecedented level of government support. The war thus paradoxically extended the vitality of certain international health projects at a time when support for many public health institutions and personnel was suspended. Nutrition research projects in Britain made considerable gains in refining the measurement and definition of malnutrition during the war, yet had little access to information about the fallout from food shortages operating across the Channel in occupied territory. Planning a rational, efficient system for dealing with hunger in liberated post-war territories proved to be an elusive goal. Only with the end of war in Europe could Allied scientists begin to witness the full force and extent of starvation policies imposed on civilians and prisoners by the Nazi regime and its allies. After assessing full-fledged starvation cases in the spring of 1945, a number of researchers who had worked in wartime Britain turned to assessing nutritional deficiencies in wider populations in Western Europe. The reconstruction period in Allied-occupied Germany provided a new set of opportunities for testing the effects of civilian rationing policies.

Disparities in Regional Publication Trends on the Topic of Artificial Intelligence in Biomedical Science Over the Last Five Years: A Bibliometric Analysis.

Bibliometric analysis is a scientific method that allows researchers to explore the current trend in a certain research area using citation information. This study aims to provide a meta-view of artificial intelligence studies focused on biomedicine in the last five years, which will provide an insight into current trends and future research directions. Besides the observation of increased publication rates in the area of AI in biomedicine, the results indicate a lower contribution from and a sparser network connectivity of countries with limited resources. Thus, working toward collaboration in terms of infrastructure and implementing alternative solutions such as FAIR (Findable, Accessible, Interoperable and Reproducible) and open access platforms could improve the collaborative nature of international health projects.

Assessing the Impact of a Global Health Fellowship on Pharmacists' Leadership Skills and Consideration of Benefits to the National Health Service (NHS) in the United Kingdom.

Antimicrobial resistance (AMR) poses a global, public health concern that affects humans, animals and the environment. The UK Fleming Fund’s Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) scheme aimed to support antimicrobial stewardship initiatives to tackle AMR through a health partnership model that utilises volunteers. There is evidence to indicate that NHS staff participating in international health projects develop leadership skills. Running in parallel with the CwPAMS scheme was the first Chief Pharmaceutical Officer’s Global Health (CPhOGH) Fellowship for pharmacists in the UK. In this manuscript, we evaluate the impact, if any, of participation in the CwPAMS scheme and the CPhOGH Fellowship, particularly in relation to leadership skills, and consider if there are demonstrable benefits for the NHS. The 16 CPhOGH Fellows were invited to complete anonymised baseline and post-Fellowship self-assessment. This considered the impact of the Fellowship on personal, professional and leadership development. Senior colleagues were invited to provide insights into how the Fellows had performed over the course of the Fellowship. All Fellows responded to both the pre- and post-Fellowship questionnaires with a return of 100% (16/16) response rate. There was a significant improvement in Fellows’ perception of their confidence, teaching abilities, understanding of behaviour change, management and communication skills. However, there was no change in the Fellows’ attitude to work. Feedback was received from 26 senior colleagues for 14 of the CPhOGH Fellows. Overall, senior colleagues considered CPhOGH Fellows to progress from proficient/established competencies to strong/excellent when using the national pharmacy Peer Assessment Tool and NHS Healthcare Leadership Model. The majority (88%) of senior colleagues would recommend the Fellowship to other pharmacists. The analysis of the data provided suggests that this CPhOGH Fellowship led to the upskilling of more confident, motivated pharmacist leaders with a passion for global health. This supports the NHS’s long-term plan “to strengthen and support good compassionate and diverse leadership at all levels”. Constructive feedback was received for improvements to the Fellowship. Job satisfaction and motivation improved, with seven CPhOGH Fellows reporting a change in job role and five receiving a promotion.

International Health Project for Improving the Level of Mother and Child Health in Developing Countries: Focusing on KOICA CTS Cases in Vietnam

우리는 전세계 최초로 무선 초음파 진단기를 개발하였다. 임산부의 원활한 출산을 위해 WHO에서는 4번의 사전 진찰을 받도록 하고 있으며, 이를 위해 초음파 진단기의 사용이 필수적이다. 하지만, 개발도상국의 소득수준과 의료시설은이에 미치지 못하고 있다. 우리는 자체개발한 무선 초음파 진단기를 이용해 KOICA의 CTS 프로그램을 베트남에서 진행하였다. 우리는 베트남 흥화현 내 보건소 및 병원에 휴대용 무선 초음파 진단기인 Sonon300C를 보급하였고, 사업성과를 더욱 높이기 위한 노력으로 진단 교육과 실습을 병행하고 아웃리치(Outreach) 프로그램을 실시하였다. 그 결과, 해당 지역의 초음파 진단기 보급률은 100%를 달성하였고, 교육 수료인원 비율은 59%까지 끌어올리는 성과를 얻었다.

Evaluation of a Community-based Child (Infants and Toddlers) Health Promotion Pilot Project in a Migrant Village in Kyrgyzstan

Children in migrant villages in Kyrgyzstan have a high incidence of anemia and need effective health promotion programs. The purpose of this study was to evaluate a pilot study of a health promotion project for infants and toddlers based on community participation. This was a retrospective study conducted to evaluate the effectiveness of the project. The project was carried out by nurses at a public health center, community health workers, and local residents in a migrant village. After the operational system of the project was established, health assessments, child-care education, provision of vouchers for iron supplements, and activities to improve residents' awareness were conducted during 6 months among 100 children, of whom 85 were finally analyzed. In international health projects, close cooperation of the project team with community residents and health workers is important. Access to the community-based program was feasible in the socially and economically poor migrant village, and improvements were shown in children's anemia and awareness of health care. By focusing on the effective aspects of this preliminary project, plans to utilize community health workers and promotion strategies can be added to the main project to improve health promotion among children in this area.

Maternal perceptions of breastfeeding and infant nutrition among a select group of Maasai women

BackgroundAdverse health outcomes are higher among Maasai children in the Ngorongoro Conservation Area compared to other co-located ethnic groups and regions of Tanzania. The Mama Kwanza Socioeconomic Health Initiative, a Canadian-Tanzanian partnership delivering healthcare at clinics in this region, gathered perceptions of mothers regarding breastfeeding and infant nutrition in order to inform culturally sensitive, realistic, and effective health promotion efforts.MethodsA qualitative description approach was used in interviewing 30 Maasai mothers of infants zero to six months of age to explore their infant feeding practices, beliefs, knowledge, and recommendations to support breastfeeding. A local research team was trained to conduct and transcribe the interviews and assist with data interpretation. Qualitative content analysis was used in analyzing the interview transcripts.ResultsLactation is universal in this culture with all the mothers planning to breastfeed for at least one year and most having initiated breastfeeding within one hour of birth. Lactation skills and knowledge are passed down intergenerationally from the elder women. None of the infants less than six months were exclusively breastfed, with a variety of liquid and semi-solid supplements given. Mothers perceived their milk alone was nutritionally insufficient with maternal dietary deficiencies cited as a factor.ConclusionsWhile there is a strong breastfeeding culture among the Maasai in Ngorongoro, intersectoral efforts are required to provide culturally respectful health education on the benefits of exclusive breastfeeding and to ensure the maternal dietary adequacy required to achieve this goal. The findings reinforce the importance of international health projects adapting health promotion initiatives to local realities and beliefs in efforts to improve maternal child health.

Resiliency in Medical Students and Residents Participating in the Global Health AMPATH Kenya Elective

Burnout has become a prominent issue among healthcare providers. The demands of working long shifts, prolonged periods of stress and increased time spent charting all contribute to this phenomenon. Current research suggests that an intrinsic sense of resilience may be key in combating this epidemic. Just as our sense of empathy and compassion can be cultivated through experience, so too can our level of resilience. We propose that engaging in an international health project during medical professional education may promote a greater sense of resiliency. To analyze this, we will use the Connor-Davidson Resilience Scale© to survey 4thyear medical students and residents at the Indiana University School of Medicine (IUSM) that have participated in the AMPATH rotation at Moi University in Kenya between June 2018 and May 2019. To determine the potential change in resilience we will ask our subjects to complete the survey prior to their trip, as well as 1-months and 1-year after their trip. This study may lead to the advocacy for such projects to be integrated into medical education curricula to combat the growing problem that is physician burnout.

Equity in international health research collaborations in Africa: Perceptions and expectations of African researchers.

Introduction and methodAfrica is currently host to a number of international genomics research and biobanking consortia, each with a mandate to advance genomics research and biobanking in Africa. Whilst most of these consortia promise to transform the way international health research is done in Africa, few have articulated exactly how they propose to go about this. In this paper, we report on a qualitative interviewing study in which we involved 17 genomics researchers in Africa. We describe their perceptions and expectations of international genomics research and biobanking initiatives in Africa.ResultsAll interviewees were of the view that externally funded genomics research and biobanking initiatives in Africa, have played a critical role in building capacity for genomics research and biobanking in Africa and in providing an opportunity for researchers in Africa to collaborate and network with other researchers. Whilst the opportunity to collaborate was seen as a benefit, some interviewees stressed the importance of recognizing that these collaborations carry mutual benefits for all partners, including their collaborators in HICs. They also voiced two major concerns of being part of these collaborative initiatives: the possibility of exploitation of African researchers and the non-sustainability of research capacity building efforts. As a way of minimising exploitation, researchers in Africa recommended that genuine efforts be made to create transparent and equitable international health research partnerships. They suggested that this could be achieved through,: having rules of engagement, enabling African researchers to contribute to the design and conduct of international health projects in Africa, and mutual and respectful exchange of experience and capacity between research collaborators. These were identified as hallmarks to equitable international health research collaborations in Africa.ConclusionGenomics research and biobanking initiatives in Africa such as H3Africa have gone some way in defining aspects of fair and equitable research collaborations in Africa. However, they will need to strive at achieving equitable health research collaborations if they truly aim at setting a gold standard for how international health research should be conducted in Africa.

Positive deviance: a different approach to achieving patient safety

Patient safety management within healthcare systems globally can feel like a relentlessly negative treadmill. Mortality reviews, incident reporting systems and audits all focus attention on what goes wrong and how...

A survey of the beliefs regarding international emergency medicine among fourth-year medical students planning on matching in emergency medicine

BackgroundWith the recent growth of fellowships in international emergency medicine, the authors sought to evaluate medical students’ attitudes toward international emergency medicine and to determine the effects these attitudes have on their residency selection.MethodsStudy design: Cross-sectional survey. Data collection: An anonymous, eight-question online survey was distributed to all members of the American Academy of Emergency Medicine Resident and Student section. This survey was also distributed to fourth-year medical students rotating through the Emergency Department at Los Angeles County and the University of Southern California.ResultsNinety-eight surveys were collected, 61 from rotating students and 37 from the AAEM mailing. There were no statistically significant differences in responses between the two groups. Of the respondents, 49.4% of have been exposed to IEM, and 46.9% have participated in international health projects. Ninety-four percent agree that IEM is an exciting career option. Seventy-nine percent said programs with IEM opportunities are more appealing than those without, and 45% said the presence of IEM opportunities would be an important factor in rank list; 53% believe that IEM requires formal public health training, and 63% believe it requires tropical medicine training; 68.3%of respondents speak a language in addition to English. This subset was more likely to have participated in IEM projects previously (p = 0.026) but not more likely to make match choices based on IEM.ConclusionsHalf of medical students surveyed had prior experience in international health, and most agree that international emergency medicine is an exciting career option. Over two thirds believe that the presence of IEM opportunities will be a factor in their match list decision.

The US President's Emergency Plan for AIDS Relief

This article analyses the US response under former President George W. Bush to the global HIV/AIDS epidemic at the intersection of neo-conservatism and neo-liberalism, highlighting the various ways their distinct gender logics collide to reproduce masculine privilege and gender inequalities on a global scale. The President's Emergency Plan for AIDS Relief (PEPFAR) is the United States global HIV/AIDS policy and is the largest commitment made by any single nation for an international health project. My analysis is based on PEPFAR's ‘formal’ policy texts, including its authorizing legislation, five-year strategic framework and specific policy directives for recipient organizations. In addition, I examine more ‘informal’ texts like Congressional reports and Presidential speeches delivered by George W. Bush on various occasions. Drawing on a rich body of feminist ethnographic work in the fields of global governance, international political economy, organizational theory and sexuality and masculinity studies, the following article examines the various ways market-based norms and practices can legitimate the moral imperatives of neo-conservatism to promote ‘traditional’ values and institutions in the global South as leading solutions to global problems and insecurities.

River Blindness Revisited*

My hypothesis on onchocerciasis, or river blindness, appeared in the Geographical Review of 1966. It led to an invitation from the World Health Organization in 1972 to revisit the problem area for two months to provide information to assist in the planning of a twenty‐year program of intervention. This article presents unpublished maps selected from my 1972 report. The issues discussed have relevance today regarding international health projects, air‐mass climatology, and human geography.

Rush Medical College

Rush Medical College

Development of a Community-based Participatory Global Health Project Model for Primary Health Care Capacity Development: A Case Study from a Rural Community in Ecuador

Purpose: The aims of this study were to identify successful strategies and propose a community-based parti- cipatoryglobalhealthprojectmodel forprimaryhealthcarecapacitydevelopment. Methods:The studyusedcase studymethodology. Aunit of analysiswasaninternational cooperationhealthproject entitled Community- based Primary Health Care Improvement in San Lorenzo, Ecuador using community-based participatory research conductedin2007~2008. Datawerecollected throughwindshield surveys, focus groupdiscussion, and provider surveys. Results:Identifiedsuccessful strategies for the international cooperation healthproject were reciprocal partnerships between researchersandcommunity, partners' capacitybuilding, south-to-southcooperation, and continuous monitoring and feedback. Community participation was found to be an essential tenet to guarantee the improvement of primary health care in the underserved rural community. Evidence from the activities of community health practitioners in Korea was applicable to the development of training programs for primary health care providers in Ecuador. Conclusion:Strategies for primary health care capacity development may be tailored depending on socio-cultural, political, and economical situations of each country. The model, however, would be applicable to the entire process of community-based global health projects in underserved rural communities of other countries.

Building global health through a center-without-walls: the Vanderbilt Institute for Global Health.

The Institute for Global Health at Vanderbilt enables the expansion and coordination of global health research, service, and training, reflecting the university's commitment to improve health services and outcomes in resource-limited settings. Global health encompasses both prevention via public health and treatment via medical care, all nested within a broader community-development context. This has fostered university-wide collaborations to address education, business/economics, engineering, nursing, and language training, among others. The institute is a natural facilitator for team building and has been especially helpful in organizing institutional responses to global health solicitations from the National Institutes of Health (NIH), Centers for Disease Control (CDC), and other funding agencies. This center-without-walls philosophy nurtures noncompetitive partnerships among and within departments and schools. With extramural support from the NIH and from endowment and developmental investments from the school of medicine, the institute funds new pilot projects to nurture global educational and research exchanges related to health and development. Vanderbilt's newest programs are a CDC-supported HIV/AIDS service initiative in Africa and an overseas research training program for health science graduate students and clinical fellows. New opportunities are available for Vanderbilt students, staff, and faculty to work abroad in partnership with international health projects through a number of Tennessee institutions now networked with the institute. A center-without-walls may be a model for institutions contemplating strategic investments to better organize service and teaching opportunities abroad, and to achieve greater successes in leveraging extramural support for overseas and domestic work focused on tropical medicine and global health.

INTERNATIONAL HEALTH EDUCATION: MOVING MEDICAL STUDENTS FROM PASSION TO SKILL.

Background University of British Columbia medical students interested in international health are able to attend inspirational talks and/or join international volunteer electives with nongovernmental organizations (NGOs). However, within the university, there is a shortage of training to provide students with the skills needed to participate in international health, in particular the skills for sustainable and community based international health work. Methods In 2005, a group of students formed The UBC Medical and Dental Students9 International Health Initiative. With guidance from faculty instructors and NGOs (including Doctors Without Borders [MSF]), students started four components: skill-building workshops and three international health projects in Uganda, India, and Honduras. Workshops were designed to teach medical students the skills needed to make them effective international health workers. Projects provided opportunities for students to practice those skills, in planning, development, or implementation of the projects. All the international health projects strove to address an unmet community need, partner with a local organization in the designated country, and emphasize principles of sustainability. Results Workshops: Two skill-building workshops were held, each led by an MSF field-worker and featuring a case study based on their real-life experiences. Presenters discussed an approach to international health challenges, such as project planning and ethical decision making. Approximately 40 students from diverse faculties, including medicine, nursing, and science, attended each workshop. Workshops were rated 8.2/10 by students. Projects: Ten medical students were involved in initiating international health projects in Honduras, Uganda, and India. Projects included conducting needs assessments, working with local organizations, and delivering public health workshops. Students expressed appreciation of the value and synergy from collaborating with students and health care providers in the local community. Conclusions Student health professionals interested in international health care were very receptive to learning skills directly from NGOs9 field-workers to apply to community-based projects overseas. Students participating in the international projects were inspired and learned from firsthand experience. It is anticipated that the blend of theoretical and practical international health training for students will create skilled future international health workers and develop beneficial partnerships in global communities.

Sustainability: The Elusive Dimension of International Health Projects

The Canada-China Yunnan Maternal and Child Health Project (1997-2003) sought to improve the quality of village life and promote development of productivity and social prosperity in Yunnan province, China. The project targeted grassroots maternal and child health workers: new and in-service village doctors; traditional village midwives; doctors at township health centres; doctors at county maternal and child health hospitals; and provincial health staff. Ten impoverished counties (population 2.2 million) in Yunnan province with high proportions of ethnic minority populations. There were three major innovations: training grassroots maternal and child health workers in participatory and community-based approaches and clinical skills; designing a model comprehensive referral system including provision of basic equipment; and introducing participatory monitoring and evaluation methods. Strategies to support sustainability were built into the project from the outset. Over 4,000 village, township, and county health workers received training. Maternal, infant, and under-five mortality rates declined over 30% in project counties. Project innovations were disseminated throughout the province, into other donor-funded initiatives, and integrated into national health projects by local partners. Maintaining the long-term benefits of international health interventions depends on sustaining innovations beyond short project timelines. Achieving sustainability poses a conundrum to implementing agencies. Three mechanisms influenced uptake in the Yunnan project: maintaining a good fit between core project elements and the existing health system; developing adequate organizational supports; and creating a handover plan from the outset. This project highlights some of the ways in which sustainability can be operationalized.

Rush Medical College.

Rush Medical College.

Negotiating relevance: belief, knowledge, and practice in international health projects.

his special issue of Medical Anthropology Quarterly was initiated to stimulate discussion of how medical anthropologists can best address the relationship between and practice in research related to health, disease, and illness in developing countries. Since public health and communication specialists often assume that changes in belief and precede behavioral changes, the issue is critical for all those who participate in primary health care interventions. Anthropologists working in such contexts face the challenge of negotiating with public health colleagues what information is considered as relevant to the health problems being studied. This volume discusses several ways that we may complicate our own efforts to negotiate relevance with our colleagues, which include the following: failing to provide a persuasive model of behavior change to replace the one drawn from social psychology; approaching research methodology in ways that regard theory as unimportant; and serving as experts in local knowledge in an uncritical fashion. After placing these issues within the context of anthropological involvements with primary health care, and pointing to principles that can guide alternative approaches, I introduce the articles in this special issue. My own interest in these questions stems mainly from research, fieldwork, and writing of evaluation reports completed during my seven years as a member of a team responsible for the evaluation of the health communication projects (HealthCom) administered by the Academy for Educational Development (AED) in a dozen sites in Africa, Asia, and Latin America. Financed by United States Agency for International Development funds, these projects used mass media and interpersonal communication to promote the use of oral rehydration for preventing dehydration from diarrhea, to improve vaccination coverage rates, to increase rates of breast-feeding, or to improve the use of antimalarial drugs. The model of health