Public Health Collaboration Research Articles

Ten years onwards: Comparison of the South Eastern European regional public health strategy 2004 and the South Eastern European 2020 strategy

Aim: Regional collaboration has continuously contributed to the development of public health in the South Eastern Europe (SEE) region since 2000 when the Public Health Collaboration in SEE (PH-SEE) was initiated. This article looks into two frameworks for regional collaboration in the area of public health: a framework developed in 2004 by a network of public health professionals and academics, and another one developed by the SEE Health Network as integral part of the SEE 2020 strategy on Jobs and Prosperity in a European Perspective, adopted in 2013. It compares the commonalities and differences of the two frameworks; considers what is still valid and relevant after ten years and which new features have emerged in the new strategy. Methods: A literature review was carried out and a qualitative analysis was applied for the comparison of the two frameworks. Results: Notwithstanding the time gap of nearly ten years, the commonalities between the two regional health strategies are significant. Major consistent goals include: improving equity in health; strengthening human resources for health; improving intersectoral cooperation and governance. The differences between the two regional strategies, including issues around social participation and regional health information systems, are partially due to their different development context. Cross-border policies and quality management have emerged as new or more pronounced topics in the SEE 2020 strategy’s health dimension. Conclusions: Many aspects addressed in the 2004 framework are pertinent with regard to the SEE 2020 health dimension and remain relevant in the current context. The integration of health as part of the economic SEE 2020 strategy reflects a significant paradigm shift and important step forward for public health

Global Infectious Diseases in February 2023: Monthly Analysis

Public health security in human societies is placed under enormous strain by infectious disease epidemics. According to the WHO, COVID-19 and Mpox remain on the list of PHEICs, whereas cholera, dengue, and other contagious diseases remain endemic in several countries and regions. Data on prevalent infectious diseases have been collected worldwide in recent weeks, and may provide new ideas for international collaboration in public health.

Bibliometric analysis of medical and health research collaboration between China and ASEAN countries.

To reveal the characteristics, development trend and potential opportunities of China-ASEAN collaboration in the medical and health field based on bibliometrics. Scopus and International Center for the Study of Research Lab (ICSR Lab) was used to analyze the scale, collaboration network and distribution, impact of cooperative papers, collaboration dominance and evolution of the literature on China-ASEAN medical and health collaboration in the Scopus database from 1992 to 2022. From 1992 to 2022, 19,764 articles on medical and health collaboration between China and ASEAN were filtered for analysis. The number of China-ASEAN collaborations has shown a clear upward trend over the years, indicating a gradually closer and improved collaboration relationship overall. The institutional collaboration network between China and ASEAN countries was obviously clustered, and the network connectivity was limited. The substantial differences between the median and mean values of citation impact of China-ASEAN medical and health research collaboration reflected that the collaboration was 'less' but 'better'. The dominance share of collaboration between China and the main ASEAN countries was fluctuating upward and has become more and more stable after 2004. Most of the China-ASEAN collaboration focused on their own characteristic research topics. In recent years, collaboration in infectious diseases and public health had expanded significantly, while other research topics had maintained in a complementary development trend. Collaboration between China and ASEAN in the medical and health field has exhibited a progressively closer relationship, and the trend of complementary research has remained stable. However, there are still areas of concern, including the limited scale of collaboration, narrow scope of participation and weak dominance.

Cardiac Adverse Events Following COVID-19 Vaccination in Patients With Prior Vaccine-Associated Myocarditis.

Limited information exists to guide shared clinical decision making on COVID-19 vaccination in persons with a prior history of vaccine-associated myocarditis, pericarditis, or myopericarditis (VAMP). The objective of this retrospective observational case series was to characterize cardiac outcomes within 30 days following receipt of 1 or more COVID-19 vaccinations during 2021 in US service members diagnosed with prior non-COVID-19 VAMP between 1998 and 2019. As part of the collaborative public health mission with the Centers for Disease Control and Prevention for enhanced vaccine adverse events surveillance, the Defense Health Agency Immunization Healthcare Division maintains a clinical database of service members and beneficiaries referred for suspected adverse events following immunizations. Cases in this database recorded between January 1, 2003, and February 28, 2022, were reviewed to identify individuals with prior VAMP who received a COVID-19 vaccine in 2021 and developed signs or symptoms suggestive of VAMP within 30 days following COVID-19 vaccination. Before the COVID-19 pandemic, 431 service members had verified VAMP. Among these 431 patients, 179 had records that confirmed receipt of a COVID-19 vaccine in 2021. Of these 179 patients, 171 (95.5%) were male. Their median age was 39 years (range, 21-67) at the time of COVID-19 vaccination. Most (n = 172; 96.1%) experienced their original VAMP episode after receipt of the live replicating smallpox vaccine. Eleven patients experienced cardiac-suggestive symptoms (chest pain, palpitations, or dyspnea) within 30 days of COVID-19 vaccination. Four patients met the criteria for recurrent VAMP. Three men aged 49, 50, and 55 years developed myocarditis within 3 days of an mRNA COVID-19 vaccine. One 25-year-old man developed pericarditis within 4 days of receiving an mRNA vaccine. All 4 COVID-19 recurrent VAMP cases fully recovered with minimal supportive care within weeks (myocarditis) to months (pericarditis). As demonstrated by this case series, albeit rare, VAMP may reoccur after COVID-19 vaccination among patients who experienced cardiac injury after smallpox vaccination. The clinical characteristics and course of the 4 recurring cases were mild, appearing similar to the post-COVID-19 VAMP described in individuals without a history of VAMP. More research is warranted on factors that may predispose patients to vaccine-associated cardiac injury and which vaccine platforms or schedules may reduce the risk of recurrence among patients who have experienced these events.

The current state of public health education in India: A scoping review.

With the creation of public health management cadre in the state, district, and block levels of India, there is a need for a comprehensive, synergistic education system to ensure efficient public health across the country. This scoping review, therefore, aims to examine the characteristics of public health education programs available in India's varied geographical and regional contexts. It examines 16 program-related descriptors across public health Doctoral, Masters, Bachelors, Post-graduate Diploma, and Diploma education programs offered. Data was retrieved through institutional websites. Results of our analysis showed 84 unique institutions in 20 states and 3 UTs currently offering 116 public health programs across India's 28 states and 8 UTs. Private and public institutes were 65% (n = 75) and 35% (n = 41) respectfully. The majority of universities mainly provided Masters of Public Health (n = 73, 63%) programs followed by Postgraduate Diploma (PGD) and Diploma (n = 17, 15%), BPHSc (n = 14, 12%), and Ph.D. (n = 12, 10%). The majority of Ph.D. programs in public health are offered in Maharashtra, Karnataka, and Haryana, while Masters in Public Health programs are offered highest in Karnataka, Bachelors in Public Health programs in Rajasthan, Post Graduate Diploma in Public Health program in Delhi, and Tamil Nadu had the most number of Diploma in Public Health programs. Thirty-one percent (n = 36) of the public health programs are offered across the south, 28% (n = 32) across the north, and 22% (n = 26) across the west Analyzed descriptors provide comprehensive information on program characteristics, mainly admission, format, and tuition fee. The review offers five suggestions to improve collaborative public health education and prepare a workforce with the skills, knowledge, and expertise to respond to the twentyfirst century's public health threats and challenges in India.

Assessment of Knowledge, Attitude and Practices About Rabies Prevention and Associated Factors in Wolaita Sodo City, Southern Ethiopia

Background: Rabies is a fatal viral zoonotic disease which causes encephalitis in many warm-blooded animals and humans. It is an incurable disease once the clinical signs appear. However, it can be prevented via vaccination and community awareness. This study was therefore designed to assess knowledge, attitude and practices about rabies prevention and associated factors in Wolaita Sodo city, Southern Ethiopia. Methods: A community based cross-sectional study was conducted from May to June 2022. Multi-stage sampling technique was employed for selection of sample unit and data were collected from 423 households by face-to-face interview using structured questionnaire. Data were entered to Microsoft Excel and coded, cleaned and analyzed using SPSS version 20 software. The frequency distribution of both dependent and independent variables were worked out by using descriptive statistics technique (frequency, mean, SD and percentage). Association between independent variables and KAP scores on rabies was calculated using Pearson’s Chi square. Variables having p<0.05 was considered as statistically significant. Results: Out of 423 respondents interviewed, 256(60.5%) were males and 167(39.5%) females. The majority of the respondents 145(34.3%) were diploma and above on educational status. Almost all of the respondents indicated that they had previously heard about rabies. Out of 423 interviewed respondants 228(53.9%) had good level of KAP on rabies. There was strong association between KAP scores and sex (χ2=40.811, p<0.05); age (χ2=82.917, p<0.05); educational level (χ2=241.782, p<0.05); occupation (χ2=276.558, p<0.05); household size (χ2=49.176, p<0.05) and dog ownership (χ2=143.619, p<0.05). Conclusion: Generally, these findings indicate that the Wolaita Sodo city community has good KAP score about rabies. However, raising the community awareness through continuous education, increase knowledge regarding wound washing, seeking post exposure prophylaxis and the need to vaccinate dogs, provision of pre and post exposure vaccines and creating rapid means of communications are suggested. Thus, close collaboration of public health, veterinary sector and local authorities is a key element for preventing this fatal incurable disease. Keywords : Attitude, Knowledge, Practice, Prevention Rabies and sodo city. DOI: 10.7176/JHMN/104-01 Publication date: November 30 th 2022

9.N. Workshop: It Takes Two To Improve European Child Health (Care)

Abstract Many societal developments have an impact on health care in general and on child health care, in particular. Internationally challenges include an aging population, more cultural diversity and a rising prevalence of chronic diseases among children and adolescents, revealing potential risks for child health care. A strong focus must be placed on prevention strategies that are effective, sustainable and equitable. Planning and implementing prevention strategies may require shifts in the organization of care, such as the forging and strengthening of interdisciplinary and intersectoral partnerships within a country. A promising example of such partnerships is the collaboration of public health with paediatrics. Both professional groups acknowledge the call for greater integration since prevention strategies can only be achieved and sustained by working together. The objectives of this workshop are to: • Provide a selective overview of three partnerships and plans for cooperation between public health and paediatrics. • To exchange experiences and possibilities with the audience to pave the way for further successful partnerships. In this workshop, we outline the partnership and plans for cooperation between public health and paediatrics in three European countries: Netherlands, Finland and Switzerland. In the first presentation, Danielle Jansen and Károly Illy will share the new vision towards the year 2030 of the Dutch Paediatric Society in which building blocks are presented to guarantee accessible, high-quality, timely and effective care for every child. One of the building blocks to be highlighted is the interprofessional collaboration between paediatricians and public health professionals. In the second presentation, Julia Dratva and Susanne Stronski from Switzerland will present a shared paediatric and public health vision of a digital child health booklet. The digital booklet will empower parents and adolescents, provide access to personal health irrespective of place or time, improve sharing health information among care professionals, thus ensuring continuity of care and limiting redundancy of investigations and in addition, and provide data for public health research and monitoring. Challenges and solutions will be shared with the audience. In the third presentation, Silja Kosola from Finland will present a Finnish vision for school health care where professionals trained in public health and medicine collaborate with each other as well as with teachers for the benefit of children and adolescents. This multidisciplinary collaboration across governing bodies is especially important as Finland undergoes a national reform of social and health care services. After the three presentations, we engage the audience by asking for their experiences and sharing the examples of collaborations between public health and paediatrics, as well as barriers and facilitators. At the end of the workshop, we would like to summarize the results of the workshop in an overview of preliminary best practices. Key messages • Global climatic, societal and politic developments reveal potential risks for child health cand health care, which must be countered effectively, sustainably and equitably. • Greater integration of prevention across sectors is elemental and can be achieved through interprofessional partnerships.

Comparing Practices Used in Overdose Fatality Review Teams to Recommended Implementation Guidelines.

Objectives:Overdose fatality review teams are a public health and public safety collaboration that reviews fatality cases using a multidisciplinary team to provide recommendations for overdose prevention. No research exists on the case review practices currently being used in these programs.Design:We administered a cross-sectional survey measuring case review practices and perceptions to a convenience sample of overdose fatality review teams.Setting:We administered the online survey to participants at a national virtual forum on overdose fatality review.Participants:In this study, we examined 30 county-level overdose fatality review teams from 6 states who completed the survey.Main Outcome Measures:We developed measures of case review practices from an overdose fatality review implementation guide. We provided descriptive statistics on the survey items used to measure these practices and examined how practice uptake varied by overdose fatality review team characteristics.Results:Most overdose fatality review teams had adequate representation and membership, but none adhered to all of the practices measured from the implementation guide. The largest gap was in perceived effectiveness and implementation of case review recommendations. In addition, teams that had been reviewing cases for longer reported more adherence to recommended practices.Conclusions:Overdose fatality case review is a collaboration between local public health and public safety agencies that holds great promise. However, these teams will require additional training and technical assistance with local community support to ensure that recommendations are actionable.

The Overdose Response Strategy: Reducing Drug Overdose Deaths Through Strategic Partnership Between Public Health and Public Safety.

Context:Public health and public safety collaborations can strengthen and improve efforts to address the worsening drug overdose crisis.Program:The Overdose Response Strategy is addressing this need through a national public health and public safety program designed to foster the cross-sector sharing of timely data, pertinent intelligence, and evidence-based and innovative strategies to prevent and respond to drug overdose.Implementation:Since 2015, the Overdose Response Strategy has been implemented by state-based public health and public safety teams who work together to prevent and respond to drug overdoses within and across sectors, states, and territories. The public health and public safety teams share data systems to inform rapid and effective community overdose prevention efforts; support immediate, evidence-based response efforts that can directly reduce overdose deaths; design and use promising strategies at the intersection of public health and public safety; and use effective and efficient primary prevention strategies that can reduce substance use and overdose long term. Implementation of the Overdose Response Strategy aligns with the US Centers for Disease Control and Prevention's Strategic Partnering Framework.Evaluation:The evaluation of the Overdose Response Strategy, which is currently underway, is based on 2 evaluation approaches: Collective Impact and Organizational Network Analysis. These approaches provide a way to look at the strength of the relationship between public health and public safety and the way the relationship is leveraged to advance program goals and objectives.Discussion:The Overdose Response Strategy serves as a strategic partnership model that can potentially be applied to other issues, such as gun violence, that may benefit from public health and public safety collaboration.

Cost-effectiveness and cost-utility of hypertension and hyperlipidemia collaborative management between pharmacies and primary care in portugal alongside a trial compared with usual care (USFarmácia®).

Background: There is little experience in the economic evaluation of pharmacy/primary care collaborative health interventions using interprofessional technology-driven communication under real-world conditions. This study aimed to conduct cost-effectiveness and cost-utility analyses of a collaborative care intervention in hypertension and hyperlipidemia management between pharmacies and primary care versus usual (fragmented) care alongside a trial. Methods: An economic evaluation was conducted alongside a 6-month pragmatic quasi-experimental controlled trial. Data sources included primary care clinical software; pharmacy dispensing software; patient telephone surveys; and published literature. The target population was adult patients on hypertension and/or lipid-lowering medication. The perspective was societal. We collected patient-level data on resource use to estimate trial costs. Effect outcomes included blood pressure (BP) and quality-adjusted life years (QALYs). Bootstrapping was used to estimate uncertainty around the incremental cost-effectiveness and cost-utility ratios. Cost-effectiveness planes and acceptability curves were estimated. Results: The intervention was not shown to have reasonable levels of cost-effectiveness or cost-utility when compared to usual care as denoted by the levels of uncertainty expressed in wide confidence intervals. The probability of the intervention being cost-effective is 28% at the threshold of €20,000 per QALY gained and 57% at the threshold of €500 per mmHg systolic BP decrease. Conclusion: Considering the limitations of the trial which affected effectiveness and economic outcomes, our results are not generalizable for community pharmacy and primary care in Portugal. This research offers, however, valuable lessons on methods and strategies that can be used in future economic evaluations of collaborative public health interventions with the potential for reimbursement. Clinical trial registration: https://www.isrctn.com/ISRCTN13410498, identifier ISRCTN13410498

Progressing dementia risk reduction initiatives for culturally and linguistically diverse older adults in Australia.

Dementia is a global public health concern, with approximately 487,500 Australians living with this condition. As an incurable disease, collaborative public health approaches are at the forefront for risk reduction of dementia. In Australia, nearly one in three individuals older than 65 years belong to culturally and linguistically diverse populations (CALD), yet dementia prevention approaches within CALD communities remain limited. Current health services and education require a targeted multidimensional and multicultural approach for dementia prevention interventions. Recent recognition of gaps in CALD dementia awareness and accessibility has instigated a range of initiatives that address language disparities and dementia literacy within Australia's older population. While these have created pockets of dementia awareness and health promotion, a 'whole of community' and government approach is needed to decrease the recognised modifiable risk factors of dementia. This work serves to identify effective methods to promote dementia risk factor reduction using behaviour change techniques through five key recommendations specific for CALD communities. These suggestions are covered by the need for federal funds to be allocated to specific culturally inclusive initiatives highlighted under primary care, public health, research and community sectors. Key recommendations are created to address language disparities and dementia literacy in Australia's older population to aid healthy brain ageing for CALD older adults.

Law enforcement and public health collaborations and partnerships in Africa

Though not high profile, collaborations and partnerships between law enforcement agencies (LEAs) and public health organizations do exist across Africa. Law enforcement and public health (LEPH) partnerships have been common, but not necessarily optimum, in responses to epidemics such as sexually transmissible infections, tuberculosis, and malaria, and pandemics such as HIV/AIDS and COVID-19. There are some such collaborations in responses to gender-based violence (GBV), particular socio-economic problems and challenges, counter-insurgency and terrorism (when it happens within civilian spaces), to address issues of rape, disease and death. Leadership in development of such approaches comes from a wide range: local and national governments, law enforcement agents, CSOs, regional economic bodies and United Nations agencies. They have also a wide range of success and sustainability. There are examples of excellent collaboration in partnerships with long histories and experience of working together, especially among those that have established common goals aimed at local, national and global health outcomes. However, antagonisms also exist between civil society organizations (CSOs) and LEAs, with CSOs placing blame on law enforcement agents for harms caused, and with LEAs perceiving CSOs as enemies of the state because of their work with and advocacy for the rights of culturally or politically taboo or sensitive matters, such as sex work or homosexuality. Not uncommonly, partnerships have not been formed; or where they have formed but have failed to achieve consensus and joint results, have collapsed. Much more needs to be done at all levels to achieve effective, humane and sustained joined-up responses to difficult public health issues in the African context. 

The Development of a Collaborative Binational Strategy to Support the San Diego-Tijuana Transborder Community During the COVID-19 Pandemic.

The COVID-19 pandemic illustrates the need for and importance of cross-border public health collaboration. San Diego, California and Tijuana, Baja California are an interconnected region with one of the busiest international borders in the world and hundreds of thousands bi-directional crossings each day. As the sister cities witnessed the rising case numbers early in the pandemic, it became essential and urgent to implement a formal structure to facilitate cross-border COVID-19 communication, coordination, and collaboration. The present article describes how the development of a Collaborative Binational Strategy led to coordinated outreach and initiatives that addressed access and equity in the transborder region. Through examples, the article illustrates how regional leaders in San Diego and Tijuana harnessed existing transborder partnerships to collaboratively build infrastructure and communication pathways to exchange data, guidance, troubleshoot shared challenges, build capacity, and establish cross-border testing and vaccine opportunities. The challenges, lessons learned, and best practices may inform other multi-level, interdisciplinary, and cross-border jurisdictions on how to support a transborder community during a pandemic or other health emergency.

Use of a national trauma registry to target violence reduction initiatives

BackgroundThe incidence of interpersonal violence resulting in penetrating traumatic injury has increased in the UK. Violence reduction initiatives vary across the world, from reactive diversionary schemes to proactive educational intervention. To be successful a collaborative public health approach to violence reduction is vital. We examined regional data collected in a trauma network area as part of mandatory national trauma data submission to establish whether useful data could be extracted from this type of registry to inform regional violence reduction initiatives. Key information required to accurately target initiatives includes: who are the victims? where do incidents occur? and when do incidents occur? MethodsData were obtained from the national Trauma Audit and Research Network (TARN). This study utilised TARN inclusion criteria. Data for penetrating trauma patients from hospital sites in the Severn Major Trauma Network over an eight-year period were included in the analysis (1 June 2012 to 5 April 2020). The data were analysed using SPSS Statistics V27 and TARN analytics software. Existing ethical approval for anonymised registry data (PIAG section 60) was used. ResultsOver the eight-year study period, 299 cases of penetrating trauma were registered in the Major Trauma Network. Overall, the incidence of penetrating trauma is increasing (R value +0.470, and +0.900 when 2020 excluded). Male victims account for 87.3% of cases (n=261). Younger individuals are more likely to be victims of penetrating trauma. The proportion of victims aged 13-18 years increased from 0% in 2012 to 21.6% in 2019. There were 43 (14.3%) incidents of victims presenting more than once during the study period. The early evening and hour after midnight had the highest numbers of penetrating trauma incidents. Most incidents occurred in a small proportion of postcodes. All the postcodes identified as having high incidence of penetrating injuries were also areas with high deprivation. ConclusionThis study demonstrated that national trauma registry data can be used to establish valuable information about serious penetrating trauma in a region. This data provides key information with which to target a proactive approach to violence reduction in our region with implications for public health, police, and clinical policymakers.

Trade, intellectual property, and the public health bearing

ABSTRACT The objective of this article is to describe the current fracture between global trade and public health priorities, as well as examine opportunities for harmonisation. A literature review of public health, global trade, and intellectual property articles describes several issues with recommendations. Currently, there is mixed quality of research and a lack of health impact assessments to accompany the global trade agenda. Human rights concepts continue in debate as flexibilities to trade laws remain without organised surveillance or evaluation. There are specific, relevant recommendations to implement a trade agenda inclusive of public health leadership. Recent trade and intellctual property advances in public health collaborations should be supported and continued. Trade groups should produce impact assessments before decisions on policies are made, with quality to the research. Lastly, a global research and development treaty should be an open, accessed path.

Beyond HIV outbreaks: protocol, rationale and implementation of a prospective study quantifying the benefit of incorporating viral sequence clustering analysis into routine public health interventions

IntroductionHIV continues to have great impact on millions of lives. Novel methods are needed to disrupt HIV transmission networks. In the USA, public health departments routinely conduct contact tracing and...

Localising vaccination services: Qualitative insights on public health and minority group collaborations to co-deliver coronavirus vaccines

Ethnic and religious minorities have been disproportionately affected by the SARS-CoV-2 pandemic and are less likely to accept coronavirus vaccinations. Orthodox (Haredi) Jewish neighbourhoods in England experienced high incidences of SARS-CoV-2 in 2020–21 and measles outbreaks (2018–19) due to suboptimal childhood vaccination coverage. The objective of our study was to explore how the coronavirus vaccination programme (CVP) was co-delivered between public health services and an Orthodox Jewish health organisation.Methods included 28 semi-structured interviews conducted virtually with public health professionals, community welfare and religious representatives, and household members. We examined CVP delivery from the perspectives of those involved in organising services and vaccine beneficiaries. Interview data was contextualised within debates of the CVP in Orthodox (Haredi) Jewish print and social media. Thematic analysis generated five considerations: i) Prior immunisation-related collaboration with public health services carved a role for Jewish health organisations to host and promote coronavirus vaccination sessions, distribute appointments, and administer vaccines ii) Public health services maintained responsibility for training, logistics, and maintaining vaccination records; iii) The localised approach to service delivery promoted vaccination in a minority with historically suboptimal levels of coverage; iv) Co-delivery promoted trust in the CVP, though a minority of participants maintained concerns around safety; v) Provision of CVP information and stakeholders’ response to situated (context-specific) challenges and concerns.Drawing on this example of CVP co-delivery, we propose that a localised approach to delivering immunisation programmes could address service provision gaps in ways that involve trusted community organisations. Localisation of vaccination services can include communication or implementation strategies, but both approaches involve consideration of investment, engagement and coordination, which are not cost-neutral. Localising vaccination services in collaboration with welfare groups raises opportunities for the on-going CVP and other immunisation programmes, and constitutes an opportunity for ethnic and religious minorities to collaborate in safeguarding community health.

Family Pediatrician and Public Health collaboration, an alliance to increase vaccination coverage: an experience with MenB vaccination in Italy.

Invasive Meningococcal Disease is a severe disease mainly affecting infants and young children. Most infections are caused by serogroups A, B, C, W, X, and Y. In the last 10 years, serogroup B has been the main cause of Invasive Meningococcal Disease in Europe. Recent data resulting from an observational study conducted in Italy show a significant reduction in the number of Invasive Meningococcal Disease cases due to Neisseria meningitidis B after the introduction of vaccine 4CMenB. Thus, the Naples Team of Federation of Italian Primary Care Pediatricians and the Public Health Department started an active collaboration focused on vaccination process management (named "Progetto Via") with the aim of increasing Meningococcal B vaccination coverage. Source of data is the regional platform "GE.VA.". Every Primary care Pediatrician uses daily to record vaccination activity. This platform is integrated with data entered by operators of the District/Vaccination Center. Time: January 2019 - December 2019. The Federation of Italian Primary Care Pediatricians/Naples organized a meeting to identify six coordinators. The pediatricians could choose to counsel in their own offices and send children to the vaccination center or to counsel and vaccinate directly in their own clinics. A total of 78 pediatricians took part in the project: 46 did only counseling and 32 did both counseling and vaccination in their medical clinic. Data obtained show an overall average vaccination coverage growth of about 13% in the first 4 months of the survey, and a further growth of about 11% in the following seven months, with a total growth in the entire period of 24%. The pediatricians' counseling is essential to recover non-compliant subjects, considering both the relationship of trust with the families and the visits already scheduled as an ideal moment for vaccinations' status check. The project highlights how an effective collaboration between family pediatricians and the Local Health Authority becomes valuable in getting closer to reach the Ministerial goal of 95%. Vaccination coverage increased significantly when family pediatricians supported the activity of vaccine centers in distress in many regional situations. The trust relationship, the hourly availability and the capillary network of family pediatricians' clinics were key elements for the success of this project and were also recognized by parents.

Adapting Longstanding Public Health Collaborations between Government of Kenya and CDC Kenya in Response to the COVID-19 Pandemic, 2020-2021.

Kenya's Ministry of Health (MOH) and the US Centers for Disease Control and Prevention in Kenya (CDC Kenya) have maintained a 40-year partnership during which measures were implemented to prevent, detect, and respond to disease threats. During the COVID-19 pandemic, the MOH and CDC Kenya rapidly responded to mitigate disease impact on Kenya's 52 million residents. We describe activities undertaken jointly by the MOH and CDC Kenya that lessened the effects of COVID-19 during 5 epidemic waves from March through December 2021. Activities included establishing national and county-level emergency operations centers and implementing workforce development and deployment, infection prevention and control training, laboratory diagnostic advancement, enhanced surveillance, and information management. The COVID-19 pandemic provided fresh impetus for the government of Kenya to establish a national public health institute, launched in January 2022, to consolidate its public health activities and counter COVID-19 and future infectious, vaccine-preventable, and emerging zoonotic diseases.

How does housing affect end-of-life care and bereavement in low-income communities? A qualitative study of the experiences of bereaved individuals and service providers in the United Kingdom.

Background:Access to affordable, appropriate housing is one of the key social determinants of health, affecting well-being across the lifecourse. However, beyond a recognition that housing quality is linked to place of death, little is known about the ways in which housing status impacts social, emotional, and practical aspects of dying and bereavement.Method:The Checking Out project is a qualitative study aiming to explore the ways in which socio-economic status impacts people’s experiences of, and attitudes towards, death, dying, and bereavement in the United Kingdom. Qualitative interviews were carried out with 14 bereaved individuals with experience of poverty at end of life or in bereavement, and 15 professionals supporting individuals in low-income communities. Interviews were conducted via phone/video call, and data include experiences of end of life and bereavement both before and during the pandemic. Transcripts were examined using thematic analysis.Results:Housing emerged as an important factor affecting people’s experiences, with 7 of the 14 bereaved individuals and all except 1 of the professionals discussing housing-related issues. Participants described ways in which unsuitable housing and housing insecurity impacted practical aspects of dying but also emotional and social well-being at end of life. Housing-related issues affected both patients and their families, though families found it difficult to air these concerns when their relative was dying.Conclusion:The paper demonstrates how trusted professionals are able to advocate or address the issues faced by bereaved individuals and suggests implications for policy and practice. A greater awareness of the potential impact of housing status across public services, including healthcare practitioners, welfare support, and housing providers, could better support patients and practitioners to address these issues proactively. Housing providers and policy-makers should be included as key partners in collaborative public health approaches to palliative care.