Intersectoral Collaboration Research Articles

Integrating a Standardized Self-Report Tool into Geriatric Medicine Practice during the COVID-19 Pandemic: A Mixed-Methods Study.

Specialized geriatric services care for older adults (≥ 65 years of age) with dementia and other progressive neurological disorders, frailty, and mental health conditions were provided both virtually and in person during the pandemic. The objective of this study was to implement a software-enabled standardized self-report instrument - the interRAI Check-Up Self-Report - to remotely assess patients. A convergent, mixed-methods research design was employed. Staff found the instrument easy to use and the program-level metrics helpful for planning. Most patients urgently needed a geriatrician assessment (72%) and had moderate to severe cognitive (34%) and functional impairments (34%), depressive symptoms (53%), loneliness (57%), daily pain (32%), and distressed caregivers (46%). Implementation considerations include providing ongoing support and facilitating intersectoral collaboration. The Check Up enhanced the geriatric assessment process by creating a system to track all needs for immediate and future care at both the patient and program level.

Exploring intersectoral collaboration in diabetes care: A positioning theoretical perspective.

Intersectoral collaboration (IC) plays a significant role in the delivery of diabetes care and treatment of patients with type 2 diabetes (DM2), as the treatment and care of these patients take place in both primary care and specialist settings. The collaboration involves a large number of actors from primary and secondary healthcare sectors, who are expected to fulfil various roles when they engage in IC. We explored the actors' roles by applying the framework of positioning theory with the aim of revealing seemingly embedded understandings of such roles. The empirical data consisted of individual and focus group interviews. Our results indicate that naturalised understandings of the roles of actors interact with the way in which health professionals, patients, managers and relatives strive to develop IC that aims to help and guide patients who live with DM2.

Exploring Strategies to Strengthen the Integrated Inter-Sectoral Collaboration Among Early Childhood Care and Education Providers

Exploring Strategies to Strengthen the Integrated Inter-Sectoral Collaboration Among Early Childhood Care and Education Providers

Factors Associated with Modern Contraceptive Use Among Out of School Adolescent Girls in Majengo and Njoro Wards of Moshi Municipality, Tanzania.

Low uptake of modern contraceptives among adolescents remains a serious public health concern with over 20 million adolescents in need of modern contraceptives are not using any. In Tanzania where the adolescent fertility rate is 112 per 1000, only 15.2% of adolescents are using modern contraceptives. Contraceptive use stands out to be one of the key interventions to reduce the burden of adolescent pregnancy which is high in the country at 22%. There is little information on factors associated with modern contraceptive use among out of school adolescents, who are at an increased risk of adolescent pregnancies. To determine the prevalence and factors associated with modern contraceptive use among out of school adolescent girls in Moshi municipality, Kilimanjaro region. This was a population based cross-sectional study, conducted in Moshi municipality in Kilimanjaro region 2 wards; Majengo and Njoro. The wards were randomly selected out of the 21 wards in the region. Household survey was conducted in the wards and adolescents aged 10 to 19 years who were out of school and consented and or assented to participate in the study were recruited. Data was collected using Kobo Collect TM on an Android device. Data was analysed using SPSS version 20. To determine the factors associated with modern contraceptive use, crude and adjusted analysis using logistic regression analysis was done. A total of 298 out-of-school adolescents were enrolled, with a median age of 19 (IQR 17-19) years. The prevalence of ever use of modern contraceptives among 154 sexually active adolescents was 51%, and 35% were current users of the methods. Two of common methods ever used were; injectables (27.3%) and male condoms (3.2%) respectively. Factors independently associated with ever use of modern contraceptives were; being married or cohabiting (aOR: 5.7) and having 2 or more sexual partners in the past 12 months (aOR: 5.9). Ever and current use of modern contraceptives among out-of-school adolescents were reported at 51% and 35% respectively. Respondent's marital status and number of sexual partners was associated with ever use of modern methods. Strengthening of adolescent-friendly SRH services outside facility setting is needed given very few are currently using a modern method. Further, through inter-sectoral collaboration interventions to keep adolescent girls at school should be strengthened.

Promise and peril: how health system reforms impacted public health in three Canadian provinces

ObjectivesSeveral Canadian provinces and territories have reformed their health systems by centralizing power, resources, and responsibilities. Our study explored motivating factors and perceived impacts of centralization reforms on public health systems and essential operations.MethodsA multiple case study design was used to examine three Canadian provinces that have undergone, or are in the process of undergoing, health system reform. Semi-structured interviews were conducted with 58 participants within public health at strategic and operational levels, from Alberta, Ontario, and Québec. Data were analyzed using a thematic analytical approach to iteratively conceptualize and refine themes.ResultsThree major themes were developed to describe the context and impacts of health system centralization reforms on public health: (1) promising “value for money” and consolidating authority; (2) impacting intersectoral and community-level collaboration; and (3) deprioritizing public health operations and contributing to workforce precarity. Centralization highlighted concerns about the prioritization of healthcare sectors. Some core public health functions were reported to operate more efficiently, with less duplication of services, and improvements in program consistency and quality, particularly in Alberta. Reforms were also reported to have diverted funding and human resources away from core essential functions, and diminished the public health workforce.ConclusionOur study highlighted that stakeholder priorities and a limited understanding about public health systems influenced how reforms were implemented. Our findings support calls for modernized and inclusive governance, stable public health funding, and investment in the public health workforce, which may help inform future reforms.

Embedding anti-racism in Schools of Public Health: a pathway to accountability for progress towards equity.

The importance of seeing race as a socially constructed idea continues to produce unfair differences between humans and establishes power relations that lead to injustice and exposure to death. Since the racial justice movement in early 2020, therehas been a heightened awarenessof,and increased interest in,addressinghistoric racial disparities across Schools of Public Health (SPH) in Canada. Steps have been taken to recognize systemic racism and increase diversity through structural reforms to advance equity and inclusion; however, addressing racism demands collectively uprooting racist institutional designs still inherent in learning, teaching, research, service, and community engagement. This commentary highlights the need for sustained commitment to establishing longitudinal benchmarks for greater racial equity among students, staff, and faculty; revising curricula to include historic and contemporary narratives of colonialism and slavery; and providing community-engaged learning opportunities as instrumental to dismantle systemic drivers of racial health inequities locally and globally. We also advocate for intersectoral collaboration, mutual learning, and sharing of resources across SPH and partner agencies to accomplish a continual collective agenda for racial health equity and inclusion that is intersectional in Canada, while being held accountable to Indigenous and racialized communities.

Stakeholder views on work participation for workers with depression and intersectoral collaboration in depression care: a focus group study with a salutogenic perspective

Objective To explore how stakeholders in depression care view intersectoral collaboration and work participation for workers with depression. Design Focus group study applying reflexive thematic analysis using a salutogenic perspective. Setting and subjects We conducted seven focus group interviews in six different regions in Norway with 39 participants (28 women); three groups consisted of general practitioners (GPs), two of psychologists and psychiatrists and two of social welfare workers and employers (of which one group also included GPs). Results Stakeholders considered work participation salutary for most workers with depression, given the right conditions (e.g. manageable work accommodations and accepting and inclusive workplaces). They also highlighted work as an integral source of meaningfulness to many workers with depression. Early collaborative efforts and encouraging sick-listed workers to stay connected to the workplace were considered important to avoid long and passive sickness absences. Furthermore, stakeholders’ views illuminated why intersectoral collaboration matters in depression care; individual stakeholders have limited information about a worker’s situation, but through collaboration and shared insight, especially in in-person collaborative meetings, they (and the worker) can gain a shared understanding of the situation, thereby enabling more optimal support. Ensuring adequate information flow for optimal and timely follow-up of workers was also emphasized. Conclusions Stakeholders highlighted the salutary properties of work participation for workers with depression under the right conditions. Intersectoral collaboration could support these conditions by sharing insight and knowledge, building a shared understanding of the worker’s situation, assuring proper information flow, and ensuring early and timely follow-up of the worker.

COVID-19 pandemic has disrupted the continuity of care for chronic patients: evidence from a cross-sectional retrospective study in a developing country

BackgroundAny disruption in continuity of care for patients with chronic conditions can lead to poor outcomes for the patients as well as great damage for the community and the health system. This study aims to determine the continuity of care for patients with chronic conditions such as hypertension and diabetes during COVID-19 pandemic.MethodsThrough a cross-sectional retrospective study, data registered in six health centers in Yazd, Iran were analyzed. Data included the number of patients with chronic conditions (hypertension and diabetes) and average daily admission during a year before COVID-19 pandemic and the similar period after COVID-19 outbreak. The experience of continuity of care was assessed applying a validated questionnaire from a sample of 198 patients. Data analysis was done using SPSS version 25. Descriptive statistics, independent T-Test and Multivariable regression were used for analysis.FindingsResults indicate that both visit load of the patients with chronic conditions (hypertension and diabetes) and their average daily admission were decreased significantly during a year after COVID-19 pandemic compared to the similar period before COVID-19 outbreak. The moderate average score of the patients` experience towards continuity of care during the pandemic was also reported. Regression analysis showed that age for the diabetes patients and insurance status for the hypertension patients affect the COC mean scores.ConclusionCOVID-19 pandemic causes serious decline in the continuity of care for patients with chronic conditions. Such a deterioration not only can lead to make these patients` condition worse in a long-term period but also it can make irreparable damages to the whole community and the health system. To make the health systems resilient particularly in disasters, serious attention should be taken into consideration among them, developing the tele-health technologies, improving the primary health care capacity, designing the applied responsive models of continuity of care, making multilateral participations and inter-sectoral collaborations, allocating sustainable resources, and enabling the patients with selfcare skills are more highlighted.

Marburg virus disease: lesson learned from the first outbreak encounter in Tanzania

Marburg virus disease: lesson learned from the first outbreak encounter in Tanzania

Preface

2nd ASEAN International Conference on Energy and Environment (AICEE) Cambodia, Hybrid, 14-15 September 2022 Accelerating Clean Energy Transition to Enhance Energy Security and Environmental Sustainability in ASEANIntroductionASEAN Centre for Energy (ACE) is an intergovernmental organisation within ASEAN structure that represents the 10 ASEAN Member States’ (AMS) interests in the energy sector. With their growing population and economic growth, AMS are expected to be a new global epicentrum of energy market in the future. This trend pushes energy security as one of the highest priorities in energy development in the region.On the other hand, the ASEAN Plan of Action for Energy Cooperation (APAEC) Phase II: 2021-2025, a regional blueprint on energy cooperation, has a theme and sub-theme in which embracing energy transition is one of the key elements to achieve regional energy security and environmental sustainability.Therefore, the concerns on energy security and sustainability call for collaborative planning and action between energy and climate change policymakers, scholars, and businesses, to find common ground and ensure success in both areas. Energy and climate experts sometimes work in their own chambers and have limited interaction with each other. To bridge the chamber and pave the way forward, the short-run target of energy security and the long-run target of sustainability should be reconciled within the framework of the energy transition. During the energy transition, a mixture of fossil fuels and renewable energy that maximizes economic growth and minimizes emissions might be preferable. The optimal road map to decarbonization and shift to low carbon energy should also be developed.To help accelerating the energy transition, improve intersectoral collaboration and connect academia with policymakers and business sector, the ASEAN Centre for Energy (ACE) and the Institute of Technology of Cambodia (ITC) as the academe partner held the 2nd ASEAN International Conference on Energy and Environment (AICEE) in conjunction with the ASEAN Energy Business Forum (AEBF) 2022 and the 40th ASEAN Ministers on Energy Meeting (AMEM). The 2nd AICEE was in partnership with the Kyoto University, Japan, Japan-ASEAN Science, Technology, and Innovation Platform (JASTIP), and the International Society for Sustainable Future of Human Security (SustaiN Society), and support of the National Energy Technology Center (ENTEC), Thailand. This year, the 2nd AICEE was held in collaboration with the 8th International Conference on Sustainable Future for Human Security (The 8th SustaiN).List of Theme, Topic, Key Dates, Participants, Agenda, Steering Committee, Scientific Committee, Organizing Committee, Documentation, Conference Agenda are available in the pdf.

The Profound Implications of the Meaning of Health for Health Care and Health Equity.

Policy Points The meaning of health in health care remains poorly defined, defaulting to a narrow, biomedical disease model. A national dialogue could create a consensus regarding a holistic and humanized definition of health that promotes health care transformation and health equity. Key steps for operationalizing a holistic meaning of health in health care include national leadership by federal agencies, intersectoral collaborations that include diverse communities, organizational and cultural change in medical education, and implementation of high-quality primary care. The 2023 report by the National Academies of Sciences, Engineering, and Medicine on achieving whole health offers recommendations for action.

Individual and Community-Level Risk Factors for Giardiasis in Children under Five Years of Age in Pakistan: A Prospective Multi-Regional Study.

This study aimed to estimate the prevalence of Giardia lamblia infection and identify associated risk factors at both individual and community levels in a pediatric population in different agroecological zones of Khyber Pakhtunkhwa, Pakistan. A community-based cross-sectional study was conducted from March to December 2022. Using stratified sampling, 1026 households were recruited from nine agroecological zones. Stool samples were collected from 1026 children up to the age of five years and processed for detection of Giardia using a commercial ELISA kit. Data on potential risk factors were collected using a pre-structured questionnaire. A multivariable logistic regression model was used to identify risk factors associated with giardiasis. The study found that the prevalence of giardiasis in the study area was 3.31%. Children aged 13-24 months were found to be at higher risk for giardiasis. Illiterate mothers and fathers attending daycare institutions/kindergartens, mothers not practicing hand washing during critical times, households with companion animals, and homes where stray dogs/cats enter were identified as predictors of giardiasis at the individual level. Children living in sub-mountain valleys use un-piped water, inadequate domestic water storage vessels, drink un-boiled or unfiltered water, live near rubbish heaps or un-paved streets/pathways, and have unimproved latrine facilities were identified as risk factors of giardiasis at the community level. The study highlights the need for integrated intervention approaches at both individual and community levels to reduce the incidence of giardiasis in Khyber Pakhtunkhwa, Pakistan. Interventions aimed at promoting behavioral change and providing safe and adequate water sources, combined with individual-level interventions such as hand washing and awareness of giardiasis prevention methods, would be critical to addressing this health concern. Inter-sectoral collaboration between the health sector and other sectors would also be necessary to achieve meaningful progress in reducing the incidence of giardiasis in resource-limited areas.

Learning from intersectoral initiatives to respond to the needs of refugees, asylum seekers, and migrants without status in the context of COVID-19 in Quebec and Ontario: a qualitative multiple case study protocol

BackgroundRefugees, asylum seekers, and migrants without status experience precarious living and working conditions that disproportionately expose them to coronavirus disease 2019 (COVID-19). In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the public and community sectors engage in joint coordination efforts called intersectoral collaboration. This collaboration ensures holistic care provisioning, inclusive of psychosocial support, assistance to address food security, and educational and employment assistance. This research project explores how community and public sectors collaborated on intersectoral initiatives during the COVID-19 pandemic to support refugees, asylum seekers, and migrants without status in the cities of Montreal, Sherbrooke, and Toronto, and generates lessons for a sustainable response to the heterogeneous needs of these migrants.MethodsThis theory-informed participatory research is co-created with socioculturally diverse research partners (refugees, asylum seekers and migrants without status, employees of community organizations, and employees of public organizations). We will utilize Mirzoev and Kane’s framework on health systems’ responsiveness to guide the four phases of a qualitative multiple case study (a case being an intersectoral initiative). These phases will include (1) building an inventory of intersectoral initiatives developed during the pandemic, (2) organizing a deliberative workshop with representatives of the study population, community, and public sector respondents to select and validate the intersectoral initiatives, (3) interviews (n = 80) with community and public sector frontline workers and managers, municipal/regional/provincial policymakers, and employees of philanthropic foundations, and (4) focus groups (n = 80) with refugees, asylum seekers, and migrants without status. Qualitative data will be analyzed using thematic analysis. The findings will be used to develop discussion forums to spur cross-learning among service providers.DiscussionThis research will highlight the experiences of community and public organizations in their ability to offer responsive services for refugees, asylum seekers, and migrants without status in the context of a pandemic. We will draw lessons learnt from the promising practices developed in the context of COVID-19, to improve services beyond times of crisis. Lastly, we will reflect upon our participatory approach—particularly in relation to the engagement of refugees and asylum seekers in the governance of our research.

Setting the new European agenda for adult learning 2021-2030

Following the COVID-19 pandemic, international organisations and governments have issued mitigation policies, and (re)oriented broader policy strategies to respond to new problematisations about the future. In this context, the education ministers of the European Union (EU) adopted a Council Resolution on a new European agenda for adult learning 2021-2030. Drawing on the Advocacy Coalition Framework (ACF), this paper examines the political mobilisation and agenda setting behind this Resolution through network ethnography and the analysis of belief systems. The findings point at an increased social dialogue, favoured by an ‘uncommon’ way – as by our informants – through which the Slovenian Ministry of Education pursued the agreed priority at EU level, while holding the rotating Presidency of the Council of the EU. While visibility of adult learning rose under COVID-19, advocacy coalitions formed at national (Slovenian) and European level facilitated stronger alignment in agenda setting among different actors towards a holistic approach that calls for inter-sectorial and multi-stakeholder collaboration.

Versorgung von Menschen mit Seltenen Erkrankungen: Empfehlungen für eine gelungene intersektorale Zusammenarbeit

ZusammenfassungHintergrundSeltene Erkrankungen (SE) sind häufig durch komplexe Beschwerdebilder charakterisiert und erfordern in der Regel im Diagnose- und Versorgungsverlauf die Zusammenarbeit von spezialisierten Zentren und Primärversorgenden. Reibungslose Schnittstellen mit geringem Informationsverlust und Kooperation stellen daher eine essenzielle Grundlage in der Versorgung dar. Das Projekt „Evaluation von Schnittstellenmanagementkonzepten bei Seltenen Erkrankungen“ (ESE-Best) verfolgte mittels verschiedener Erhebungsinstrumente das Ziel, Empfehlungen für die Gestaltung und Umsetzung von Schnittstellen in der Versorgung von Menschen mit Seltenen Erkrankungen zu entwickeln.MethodenEs wurden mittels quantitativer und qualitativer Befragungen die Perspektiven der Zentren für Seltene Erkrankungen (ZSE), der Primärversorgung und der Betroffenen (Patient:innen, Eltern) erfragt sowie 2 Expert:innen-Workshops durchgeführt.ErgebnisseEs wurden insgesamt 28 Empfehlungen in den folgenden 5 Bereichen formuliert: 1) Vernetzung zwischen Primärversorgung und Zentren für Seltene Erkrankungen (ZSE), 2) Schnittstellen innerhalb der ZSE, 3) Bekanntheit von Seltenen Erkrankungen, ZSE-Strukturen und Zuständigkeiten, 4) Schnittstellen zwischen ZSE und Patient:innen sowie 5) weiterführende Empfehlungen.DiskussionDie Empfehlungen sollen zukünftig zu einem funktionierenden Schnittstellenmanagement bei der Versorgung von Menschen mit Seltenen Erkrankungen beitragen. Da die Erfahrungswerte von Primärversorgenden, ZSE und Betroffenen in die Entwicklung der Empfehlungen eingeflossen sind, können die externe Validität und damit die Umsetzbarkeit im Alltag angenommen werden. Es ist zu bedenken, dass zeitliche und personelle Ressourcen sowie organisationale Strukturen die Schnittstellenarbeit im Einzelfall beeinflussen können. Die Empfehlungen können an örtliche Gegebenheiten adaptiert werden.

Strengths and limitations of the Inclusive Society research model: an autoethnography

Purpose: The Inclusive Society partnership research model aims to promote change in society for people with disabilities by supporting research teams composed of researchers and partner organizations. The objective of this article is to identify the strengths and limitations of this research model. Material and methods: An autoethnography approach was used. Thematic analysis of four methods was undertaken: semi-directed interviews with members of the research teams funded by Inclusive Society (researchers, partners), a focus group with the Inclusive Society’s intersectoral collaboration agents, their logbooks, and Inclusive Society’s annual reports. Results: Strengths and limitations of the Inclusive Society model were identified through their networking activities, the role and support of the intersectoral collaboration agents and the partnership research program. Conclusions: Networking activities are an essential element of Inclusive Society. They are indispensable for composing intersectoral research teams that will work on answering needs of people with disabilities. Intersectoral collaboration agents are also a strength of the model, but their role could be clarified to better frame what tasks are in their scope of practice and what the research teams could ask from them. Finally, the research program eligibility criteria could be improved to support, among others, the projects’ appropriation phases.

How can we deliver on the promise of precision medicine in oncology and beyond? A practical roadmap for action.

Precision medicine (PM) is a form of personalized medicine that recognizes that individuals with the same condition may have different underlying factors and uses molecular information to provide tailored treatments. This approach can improve treatment outcomes and transform lives through favorable risk/benefit ratios, avoidance of ineffective interventions, and possible cost savings, as evidenced in the field of lung cancer and other oncology/therapeutic settings, including cardiac disease, diabetes, and rare diseases. However, the potential benefits of PM have yet to be fully realized. There are many barriers to the implementation of PM in clinical practice, including fragmentation of the PM landscape, siloed approaches to address shared challenges, unwarranted variation in availability and access to PM, lack of standardization, and limited understanding of patients'experience and needs throughout the PM pathway. We believe that a diverse, intersectoral multistakeholder collaboration, with three main pillars of activity: generation of data to demonstrate the benefit of PM, education to support informed decision-making, and addressing barriers across the patient pathway, is necessary to reach the shared goal of making PM an accessible and sustainable reality. Besides healthcare providers, researchers, policymakers/regulators/payers, and industry representatives, patients in particular must be equal partners and should be central to the PM approach-from early research through to clinical trials and approval of new treatments-to ensure it represents their entire experience and identifies barriers, solutions, and opportunities at the point of delivery. We propose a practical and iterative roadmap to advance PM and call for all stakeholders across the healthcare system to employ a collaborative, cocreated, patient-centered methodology to close gaps and fully realize the potential of PM.

Exploring intersections and integration of sexual reproductive health and mental health among adolescents and young adults: Areas of collaboration and lessons learned.

This special issue of the Bulletin of the Menninger Clinic addresses mental health issues in the field of sexual and reproductive health. The goal is to highlight important overlaps between reproductive and gender health concerns and mental health symptomatology. The issue includes topics around social determinants of health and their effects on reproductive health; the reproductive health sequelae of eating disorders; mental health challenges faced by gender diverse youth and strategies to mitigate these effects; integration of sexual health services and mental health care; and lessons for mental health advocates from the sex education realm. This special issue features areas of intersectoral collaboration among public health, medical, and mental health professionals to positively impact patients' holistic wellness.

The Migration Risk Environment: Challenges to Human Security for Venezuelan Migrant and Refugee Women and Girls Pre- and Post-Migration to Colombia

The Venezuelan crisis has unleashed multiple forms of sociopolitical violence against its population and created a context of unmet needs, insecurity, and human rights violations. Outward migration caused by this situation has been linked to health emergencies in neighboring countries. Venezuelan migrant and refugee women and girls (VMRWG) are among the most affected. We conducted a cross-sectional qualitative and Participatory Action Research (PAR) project to characterize the risk environments for VMRWG across migration phases, analyzing pre-departure, transit, border crossing, and resettlement risk factors for health and security through semi-structured interviews ( n = 30) and human cartographies ( n = 16). We found cross border risk and protective factors that inform cross-border health initiatives, migration policies, and human rights efforts for both the migrant and host communities. Findings and Recommendations Migratory trajectories of VMRWG from Venezuela to Colombia represent a risk environment for women and girls, connecting cross-border contexts through armed actors’ control, culturally reinforced gender roles and limited social and economic resources. Long-term sustainable migratory policies that are culturally sensitive and include a gender-approach to health should operationalize how gender roles are intimately connected to HIV risk and mental health disparities through reinforced structural factors. Such policies must address these structural factors. The public health system needs to incorporate and align with programmatic efforts implemented by international platforms (United Nations Population Fund (UNFPA), AID4AIDS, and Médecins Sans Frontières (MSF) also known as Doctors Without Borders) targeting screening for infectious diseases (including HIV and mental health disparities) in border crossings and borderlands. Sustainable policies to bridge gaps between services and populations and to decrease growing HIV cases depends on these strategies. Policies and programs of local governments (city and municipality level) addressing mental health disparities need to be expanded through peer leaders and civil society networks of care to guarantee wellbeing and quality of life after resettlement. International efforts and collaborations should capitalize on the re-opening of the border to establish inter-sectoral collaborations with Venezuelan NGOs and civil society organizations on both sides of the border to address gender-based violence, follow-up of cases, and access to services in sending and receiving communities. In order to broach gaps and tackle access barriers in resettlement communities in Colombia, services must be provided in peripheric territories and neighborhoods where some vulnerable migrants resettle. These services must rely on health sector-community collaborations. Public health sector efforts should be integrated and coordinated with family and child services on a local and national level Instituto Colombiano de Bienestar Familiar (ICBF), gender working groups, shelters, and citywide supported initiatives like the House of Women) to provide and promote access to social resources (education, jobs, and housing) for migrant women. Health promotion strategies are necessary to decrease infectious diseases and violence-related trauma among migrants across borders. These strategies can include outreach through peer leaders, civil society organization campaigns, and HIV mobile testing and counselling. These services should be delivered in a culturally sensitive manner, capitalizing on in-place cross-border networks of support. In Colombia, sustainable efforts in policy and programs have been made to provide Venezuelans with access to health care and social services with the help of inter-sectoral working groups, national laws, and border commissions. However, there is an urgent need to expand the humanitarian response and the health sector coverage to gender-based violence impacting infectious disease risk and mental health trauma in host communities. Connecting pre- and post-migration contexts in South-to-South migration is paramount. Tackling these issues can improve the protection of human rights and resettlement conditions in host communities.

Health professionals KAP study on rabies exposure assessment and NTV administration in Ethiopia

Background: Globally, it’s estimated 60,000 human deaths occur due to rabies with 95% of cases occurring in Africa and Asia. Annually, thousands of people are infected with rabies in Ethiopia and more than 2700 people die. In Ethiopia, the neural-based vaccine has been used since the 1950’s. Due to the old method of production, low immunogenicity and vaccine associated adverse events, WHO discourage the use of this vaccine and recommend replacing it with a safe and effective modern cell culture vaccine. There was no specific guidelines and training for this vaccine and health professional mismanage the nerve tissue vaccine (NTV) with cell culture vaccine resulting in vaccination failure. This study identifies professional knowledge, attitude and practice (KAP), vaccine related adverse events and the burden of rabies cases in humans. Methods: Data were collected from health professionals in selected health facilities using structured questionnaire to identify the level of KAP. Results: The study identified overall gaps in the professionals KAP as below standard which is not more than 25%. The majority of the respondents (97%) reported vaccine associated local adverse events followed by 20% systemic complications during vaccination. Only 2.4% of the respondents reported post-vaccine complications. Rabies cases in humans at those covered health facilities were reported to be 32 during the one-year study period with an average of two cases at each facility. Conclusions: Gaps identified in the professional KAP result indicate the need to provide specific training based on standard guidelines. Generally, the study indicates the need to strengthen rabies prevention and control efforts through inter-sectoral collaboration, and facilitating the establishment of facility-based rabies palliative care centers. In addition, it is recommended to work on technology transfer to replace old method of NTV production with safe and effective modern cell culture based anti-rabies vaccine production for effective rabies PEP.