Health Policy & Planning: A framework on the emergence and effectiveness of global health networks

CITATION: A framework on the emergence and effectiveness of global health networks

Jeremy Shiffman, Kathryn Quissell, Hans Peter Schmitz, David L. Pelletier, Stephanie L. Smith, David Berlan, Uwe Gneiting, David Van Slyke, Ines Mergel, Mariela Rodriguez, Gill Walt.

Health Policy and Planning 2015;1–14

doi:10.1093/heapol/czu046

ABSTRACT

Since 1990 mortality and morbidity decline has been more extensive for some conditions prevalent in low- and middle-income countries than for others. One reason may be differences in the effectiveness of global health networks, which have proliferated in recent years. Some may be more capable than others in attracting attention to a condition, in generating funding, in developing interventions and in convincing national governments to adopt policies. This article introduces a supplement on the emergence and effectiveness of global health networks. The supplement examines networks concerned with six global health problems: tuberculosis (TB), pneumonia, tobacco use, alcohol harm, maternal mortality and newborn deaths. This article presents a conceptual framework delineating factors that may shape why networks crystallize more easily surrounding some issues than others, and once formed, why some are better able than others to shape policy and public health outcomes. All supplement papers draw on this framework. The framework consists of 10 factors in three categories: (1) features of the networks and actors that comprise them, including leadership, governance arrangements, network composition and framing strategies; (2) conditions in the global policy environment, including potential allies and opponents, funding availability and global expectations concerning which issues should be prioritized; (3) and characteristics of the issue, including severity, tractability and affected groups. The article also explains the design of the project, which is grounded in comparison of networks surrounding three matched issues: TB and pneumonia, tobacco use and alcohol harm, and maternal and newborn survival. Despite similar burden and issue characteristics, there has been considerably greater policy traction for the first in each pair. The supplement articles aim to explain the role of networks in shaping these differences, and collectively represent the first comparative effort to understand the emergence and effectiveness of global health networks.

KEY MESSAGES

1. Global health networks — webs of individuals and organizations linked by a shared concern for a health condition—now exist for most high-burden health problems that low- and middle-income countries face. However, scholars have paid them scant attention, so we know little about their origins and the influence they have in global health.

2. These networks vary in their capacities to attract attention, generate funding, develop interventions and convince national governments to adopt policies and carry out programmes. This variance may help explain why mortality and morbidity have declined more rapidly for some conditions than others.

3. The emergence and effectiveness of global health networks can be understood by considering three categories of factors: features of the networks and actors that comprise them, their policy environments and particular characteristics of the issues they address.

The final feature is ‘framing strategy’ (Factor 4) (Snow et al. 1986; Benford and Snow 2000; McInnes and Lee 2012; McInnes et al. 2012): how network actors publicly position an issue in order to attract attention and resources. Networks may differ in their capacities to discover frames that work. HIV/AIDS communities have been particularly adept at this: when HIV/AIDS was understood as a public health problem afflicting only certain population groups it had difficulty attracting resources; when advocates reframed it as an exceptional disease that posed an existential threat to humanity, politicians began to pay attention (Prins 2004; Harris and Siplon 2007).

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

PLoS One: Effectiveness of Provider & Community Interventions to Improve Treatment of Uncomplicated #Malaria, Nigeria

‘Presumptive treatment of uncomplicated malaria remains an ingrained behaviour that is difficult to change’, say the authors of a new study from Nigeria. In the conclusion of the full text, they say: ‘Given the challenges we have outlined, it will be particularly important to consider whether it is cost-effective for the government to support the roll-out of RDTs in the private sector and we would recommend further investigation of this issue.’

This is an interesting point: Whether to abandon RDTs (rapid diagnostic tests) on the basis that it is too difficult to persuade healthcare providers to use them appropriately, or to continue to seek better ways to encourage such use. Are HIFA members aware of examples of successful introduction of RDTs in Nigeria or other malaria-endemic countries?

CITATION: Effectiveness of Provider & Community Interventions to Improve Treatment of Uncomplicated #Malaria, Nigeria

Obinna Onwujekwe, Lindsay Mangham-Jefferies, Bonnie Cundill, Neal Alexander, Julia Langham, Ogochukwu Ibe, Benjamin Uzochukwu, Virginia Wiseman

Published: August 26, 2015DOI: 10.1371/journal.pone.0133832

@PLOSONE http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0133832

ABSTRACT

The World Health Organization recommends that malaria be confirmed by parasitological diagnosis before treatment using Artemisinin-based Combination Therapy (ACT). Despite this, many health workers in malaria endemic countries continue to diagnose malaria based on symptoms alone. This study evaluates interventions to help bridge this gap between guidelines and provider practice. A stratified cluster-randomized trial in 42 communities in Enugu state compared 3 scenarios: Rapid Diagnostic Tests (RDTs) with basic instruction (control); RDTs with provider training (provider arm); and RDTs with provider training plus a school-based community intervention (provider-school arm). The primary outcome was the proportion of patients treated according to guidelines, a composite indicator requiring patients to be tested for malaria and given treatment consistent with the test result. The primary outcome was evaluated among 4946 (93%) of the 5311 patients invited to participate. A total of 40 communities (12 in control, 14 per intervention arm) were included in the analysis. There was no evidence of differences between the three arms in terms of our composite indicator (p = 0.36): stratified risk difference was 14% (95% CI -8.3%, 35.8%; p = 0.26) in the provider arm and 1% (95% CI -21.1%, 22.9%; p = 0.19) in the provider-school arm, compared with control. The level of testing was low across all arms (34% in control; 48% provider arm; 37% provider-school arm; p = 0.47). Presumptive treatment of uncomplicated malaria remains an ingrained behaviour that is difficult to change. With or without extensive supporting interventions, levels of testing in this study remained critically low. Governments and researchers must continue to explore alternative ways of encouraging providers to deliver appropriate treatment and avoid the misuse of valuable medicines.

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

WONCA News September 2015

Dear colleagues,

We have had a number of WONCA conferences this year, with WONCA Europe still to come in Istanbul in October. This month we begin collating photographs from those conferences here. If you know of any other readily accessible collections please e-mail editor@wonca.net.

A reminder that the Society of Teachers of Family Medicine scholarship application closes on September 30. This scholarship is to attend their annual conference in April in Minneapolis, and is for someone from Mexico, Central or South America.

Find out about two of our newer Special Interest Groups (SIG) – on Point of Care Testing and also on Conflict and Catastrophe Medicine.

This month’s featured doctors are Viviana Martinez-Bianchi (well-known in both North and South America regions) and Enrique Barros (from Brazil), who has just been appointed the pro tem chair of the WONCA Working Party on the Environment.

Dr Karen Flegg, WONCA Editor

See Online

From the President: WONCA and the new UN Sustainable Development Goals

As a frequent visitor to Brazil and other countries in Central and South America over the past few years, I am very impressed by the work our WONCA member organisations are doing in this part of the world, especially to ensure both quality and equity in family medicine for the people of this region of the world.

From the CEO’s desk: reminders from vacation

The CEO is on vacation but has found time to give us some timely reminders on next year’s conferences including announcing two new speakers for the world conference in Rio.

Policy Bite: Gender and health – a major equity agenda

A new publication from colleagues in the Nederlands came my way this month, and reminded me of why I got involved with WONCA in the 1990s. The report was drawn to my attention by Professor Toine Lagro-Janssen, who was an academic colleague of our Past President Prof Chris van Weel.

Scholarship to attend the Society of Teachers of Family Medicine’s 2016 Annual Spring Conference

We’d like to inform you of a scholarship opportunity for one International Scholar to attend the Society of Teachers of Family Medicine’s Annual Spring Conference, April 30-May 4, 2016 in Minneapolis, Minnesota.

Rural Round-up: a history of the WONCA Working Party on Rural Practice

Ian Couper, Roger Strasser, Jim Rourke, John Wynn-Jones have published a history of the WONCA Working Party on Rural Practice 1992 to 2012 in the journal “Rural and Remote Health”. It includes some fascinating memories and conclusions about the state of play at the moment.

2015 WONCA conference photos

2015 has been a big year for WONCA conferences – with more still to come. A collection of links leading to photos of WONCA conferences held so far in 2015.

Africa Regional Meeting on Digital Health

The news item below is forwarded from K4Health. Reading this, together with the 78 million dollar Mobile Hub announced recently, suggests an explosion of global mHealth programmes backed by hundreds of millions of dollars. Are all these programmes competing with one another or are they truly cooperating? Meanwhile it is essential that more funding is made available for those organisations that produce and distribute actionable mHealth content for citizens, such as Global Health Media Content, Medial Aid Films, Hesperian, HealthPhone and many others represented on HIFA. (See our article in The Lancet Global Health: http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00054-6/fulltext )

Meeting Report: Africa Regional Meeting on Digital Health for Overcoming Barriers to Ending Preventable Child and Maternal Deaths and Achieving Universal Health Coverage

‘K4Health participated in the “Africa Regional Meeting on Digital Health for Overcoming Barriers to Ending Preventable Child and Maternal Deaths and Achieving Universal Health Coverage” in Malawi, May 12-15, 2015. The meeting was convened by the U.S. Agency for International Development (USAID) and the United Nations Foundation (UNF) with collaboration from the Government of Malawi. With more than 150 government, private sector, and donor participants, the event aimed to strengthen and expand opportunities for public-private partnerships in digital health across Africa. K4Health’s Director of ICT and Innovation, James BonTempo, led a knowledge café session on mHealth Knowledge http://www.mhealthknowledge.org/ a portal providing access tools and resources in mhealth, mHealth Evidence https://www.mhealthevidence.org/ a portal housing the world’s literature on mHealth, and the mHealth Working Group website https://www.mhealthworkinggroup.org/ an international community with more than 1,900 members represennting more than 500 organizations in 78 countries. For more information, access the meeting report.’

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

Global Health eLearning Center is Now Available Via Mobile Devices in Tanzania

The news item below is forwarded from K4Health. Further information here:

http://www.globalhealthlearning.org/

“Join the network and start making free calls to your fellow medical practitioners.”

‘The Global Health eLearning Center (GHeL) is now available to a growing number of health workers in Tanzania via their mobile devices free of charge. Earlier this month, GHeL was included as a free domain to members of the Health Network Programme. Members of this network can now take GHeL courses?critical resources for continuing professional developmentt?on their mobile devices without incurring data charges. The Healthh Network Programme makes it easier for health workers to seek advice, refer clients, and improve patient care nationwide. When doctors, assistant medical officers, and clinical officers in Tanzania join this network they can call and text each other and access select websites for free. The network facilitates collaboration among geographically dispersed health workers—particularly those working in isolated or remote areas. The Health Network Programme was created in close partnership with Vodacom, the Ministry of Health & Social Welfare, the Medical Association of Tanzania and Switchboard, acquired recently by IntraHealth International.’

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

A systematic review of barriers to data sharing in public health

‘Benefits of data sharing have been widely recognized – transparency and cooperation, reproducibility of research, cost-efficiency and preventing redundancies, acceleration of discovery and innovation, and saving lives through more efficient and effective public health programs…’

‘The simultaneous effect of multiple interacting barriers ranging from technical to intangible issues has greatly complicated advances in public health data sharing’, concludes a paper in BMC Public Health (with thanks to Isabelle Wachsmuth-Huguet and HIFA-EVIPNet-French). This has negative consequences for decision-making by public health agencies (ranging from international health agencies to ministries of health to local institutions), and also obstructs their use in academic research and technology development.

Below is the citation and abstract. The full text is available here: http://www.biomedcentral.com/1471-2458/14/1144

It is notable that the current study (like many reviews, and for obvious reasons) is limited to English-language studies only.

CITATION: A systematic review of barriers to data sharing in public health

Willem G van Panhuis, Proma Paul, Claudia Emerson, John Grefenstette, Richard Wilder, Abraham J Herbst, David Heymann and Donald S Burke

van Panhuis et al. BMC Public Health 2014, 14:1144

ABSTRACT

Background: In the current information age, the use of data has become essential for decision making in public health at the local, national, and global level. Despite a global commitment to the use and sharing of public health data, this can be challenging in reality. No systematic framework or global operational guidelines have been created for data sharing in public health. Barriers at different levels have limited data sharing but have only been anecdotally discussed or in the context of specific case studies. Incomplete systematic evidence on the scope and variety of these barriers has limited opportunities to maximize the value and use of public health data for science and policy.

Methods: We conducted a systematic literature review of potential barriers to public health data sharing. Documents that described barriers to sharing of routinely collected public health data were eligible for inclusion and reviewed independently by a team of experts. We grouped identified barriers in a taxonomy for a focused international dialogue on solutions.

Results: Twenty potential barriers were identified and classified in six categories: technical, motivational, economic, political, legal and ethical. The first three categories are deeply rooted in well-known challenges of health information systems for which structural solutions have yet to be found; the last three have solutions that lie in an international dialogue aimed at generating consensus on policies and instruments for data sharing.

Conclusions: The simultaneous effect of multiple interacting barriers ranging from technical to intangible issues has greatly complicated advances in public health data sharing. A systematic framework of barriers to data sharing in public health will be essential to accelerate the use of valuable information for the global good.

The authors say ‘more research is needed to expand the evidence base of these barriers. As knowledge on these barriers will increase, so will opportunities for solutions’.

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review

Source: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001847

Abstract

Background: Despite growing recognition of neglectful, abusive, and disrespectful treatment of women during childbirth in health facilities, there is no consensus at a global level on how these occurrences are defined and measured. This mixed-methods systematic review aims to synthesize qualitative and quantitative evidence on the mistreatment of women during childbirth in health facilities to inform the development of an evidence-based typology of the phenomenon.

Methods and Findings: We searched PubMed, CINAHL, and Embase databases and grey literature using a predetermined search strategy to identify qualitative, quantitative, and mixed-methods studies on the mistreatment of women during childbirth across all geographical and income-level settings. We used a thematic synthesis approach to synthesize the qualitative evidence and assessed the confidence in the qualitative review findings using the CERQual approach. In total, 65 studies were included from 34 countries. Qualitative findings were organized under seven domains: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) stigma and discrimination, (5) failure to meet professional standards of care, (6) poor rapport between women and providers, and (7) health system conditions and constraints. Due to high heterogeneity of the quantitative data, we were unable to conduct a meta-analysis; instead, we present descriptions of study characteristics, outcome measures, and results. Additional themes identified in the quantitative studies are integrated into the typology.

Conclusions: This systematic review presents a comprehensive, evidence-based typology of the mistreatment of women during childbirth in health facilities, and demonstrates that mistreatment can occur at the level of interaction between the woman and provider, as well as through systemic failures at the health facility and health system levels. We propose this typology be adopted to describe the phenomenon and be used to develop measurement tools and inform future research, programs, and interventions.

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

Sharing individual-level data in low and middle income settings – special issue and online eLearning course

Sharing individual-level data in low and middle income settings – special issue and online eLearning course

A Special issue of the Journal of Empirical Research on Human Research Ethics http://jre.sagepub.com/content/10/3 , launched today, focuses on the ethical implications of sharing health research data in low and middle income settings. To accompany the special issue, Bioethics, Research Ethics & Review has launched an online resource (https://bioethicsresearchreview.tghn.org/research-data-sharing/) which brings together resources about ethical best practices for data sharing, policies and processes for data curation and data sharing, and links to repositories for data sharing.  The online resource includes a new eLearning Course (https://globalhealthtrainingcentre.tghn.org/ethics-and-best-practices-sharing-individual-level-data-clinical-and-public-health-research/) on Ethics and Best Practices in Sharing Individual-level Research Data. The special issue, online resource and eLearning course are all free to download and use, and your contributions to the online resource are welcomed.

With the globalization of biomedical research and growing concerns about possible pandemics of diseases such as HIV, SARS, and Ebola, international data-sharing practices are of growing interest to the biomedical science community. But what are the advantages and disadvantages of sharing data in low and middle-income settings? What challenges stand in the way for researchers in countries such as India, Kenya, and Vietnam?

The special issue of JERHRE publishes research funded by the Wellcome Trust, on behalf of the Public Health Research Data Forum. The special issue outlines the views of researchers and gatekeepers of biomedical research in five developing countries – India, Kenya, South Africa, Thailand, and Vietnam – on the possibility of expanding the sharing of their individual-level biomedical research data.

“Data sharing enables researchers worldwide to build on the efforts of others in a cost-effective way. Base-line data will be in place when epidemics strike. The political, scientific, and economic problems of understanding and stopping new diseases will be vastly reduced when an infrastructure and baseline data are readily available to scientists,” Sieber wrote. “Each discipline raises its own set of challenges, risks, and benefits of data sharing, but with ingenuity, the risks can be overcome.”

Author: Dr Susan Bull

Tamzin Furtado

Project Manager

The Global Health Network

Open Access to a Professional Level Point-Of-Care Medical Summary

I see an open access point-of-care medical summary as having the potential to do for medicine what open access journals have already done for science. I have published in PLOS Medicine a call out to all those who believe in the goal of health information for all to seriously consider moving their content to an open license (note not the same as free access) http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001868

PLOS has also indicated their desire to be involved in this initiative. http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001870 If all those in the field of getting high quality information out to those who need it most work together we can accomplish this goal.

James Heilman

MD, CCFP-EM, Wikipedian

The Wikipedia Open Textbook of Medicine

www.opentextbookofmedicine.com

United Nations Sustainable Development Summit 2015 – Outcome document: Transforming our world: the 2030 Agenda for Sustainable Development

United Nations Sustainable Development Summit 2015 – Outcome document: Transforming our world: the 2030 Agenda for Sustainable Development

[PAHO/WHO Equity list & Knowledge network]

Contribution from our valuable members. Thank you!!

United Nations Sustainable Development Summit 2015

Outcome document: Transforming our world: the 2030 Agenda for Sustainable Development

25 – 27 September  2015

The United Nations summit [https://sustainabledevelopment.un.org/post2015/summit] for the adoption of the post-2015 development agenda will be held from 25 to 27 September 2015, in New York and convened as a high-level plenary meeting of the General Assembly.

Preamble:

This Agenda is a plan of action for people, planet and prosperity. It also seeks to strengthen universal peace in larger freedom. We recognise that eradicating poverty in all its forms and dimensions, including extreme poverty, is the greatest global challenge and an indispensable requirement for sustainable development.

All countries and all stakeholders, acting in collaborative partnership, will implement this plan. We are resolved to free the human race from the tyranny of poverty and want and to heal and secure our planet. We are determined to take the bold and transformative steps which are urgently needed to shift the world onto a sustainable and resilient path. As we embark on this collective journey, we pledge that no one will be left behind.

The 17 Sustainable Development Goals and 169 targets which we are announcing today demonstrate the scale and ambition of this new universal Agenda. They seek to build on the Millennium Development Goals and complete what these did not achieve. They seek to realize the human rights of all and to achieve gender equality and the empowerment of all women and girls. They are integrated and indivisible and balance the three dimensions of sustainable development: the economic, social and environmental.

Keywords / Palabras clave: Sustainable Development; Millennium Development Goals (MGDs); Inequalities; Universal Health Coverage; Global Health; United Nations

How to obtain this report / Como obtener este informe: click here.

https://sustainabledevelopment.un.org/content/documents/7891Transforming%20Our%20World.pdf

Visit the Portal/Blog of the PAHO/WHO Equity List & Knowledge network : http://equity.bvsalud.org/

Visite el Sítio/Blog de la Lista de Equidad y Red de Conocimiento: : http://equity.bvsalud.org/es/

For additional information of the Equity List or contributions please contact Mrs. Eliane P. Santos, Advisor, Library and Information Networks – KBR/ Pan American Health Organization, Regional Office of the World Health Organization – pereirae@paho.org

Pan American Health Organization, Regional Office of the World Health Organization for the Americas

Office of the Assistant Director

Area of Knowledge Management, Bioethics and Research (KBR)

http://www.paho.org

Global Handwashing Day Social Media Toolkit

(with thanks to Communication for Development Network)

[forwarded from http://globalhandwashing.org/resources/global-handwashing-day-social-media-toolkit/ ]

Blue Raise a Hand

Updated for 2015, this social media toolkit has sample messages, blog ideas, and resources to help celebrants and handwashing champions spread the word about Global Handwashing Day.

Resource Attachments:

http://globalhandwashing.org/wp-content/uploads/2015/03/Global-Handwashing-Day-2015-Social-Media-Toolkit.pdf

Best wishes,

Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  


This year in particular has seen the profile of hand hygiene raised to new levels across the globe.

On 5 May 2015, one part of WHO’s SAVE LIVES: Clean Your Hands campaign was a very successful social media campaign with #safeHANDS photos posted from people all over the world.

http://www.who.int/gpsc/5may/EN_PSP_GPSC1_5May_2015/en/

Based on the Ebola outbreak response, the collaboration between WASH and health care infection prevention strategies has been enhanced including in support of hand hygiene action and this week (world water week #wwweek) saw numerous messages posted emphasising this important link.

Whatever the day to raise awareness to hand hygiene, collaboration and learning from easily accessible years of activities/experience will serve the public and health care communities well.

Thank you

Claire.


The tippy-tap is a brilliant solution: a hands free way to wash hands in places with difficult access to running water.  It can be made from simple salvaged materials and is operated by a foot lever.  It uses very little water for each hand wash: only 40 ml of water compared to 500 ml using a mug.  

This website shows examples, including how to build one: http://www.tippytap.org/wp-content/uploads/2011/03/How-to-build-a-tippy-tap-manual.pdf

warm regards,

Deb

What a wonderful initiative to celebrate the Global Handwashing Day. I want to share with you a very appropriate animation on handwashing:

http://sawbo-illinois4.org/Handwashing

Sincerely,

Julia Bello Bravo, PhD

Assistant Director

Center for African Studies (CAS)/Illinois Strategic


CHW Data for Decision Making

For the month of September, the One Million Community Health Workers (1mCHW) Campaign and mPowering Frontline Health Workers are supporting HIFA to hold an in-depth exploration around the need for improved data on community health worker (CHW) programs, and how we can meet these needs in the post-2015 era.

You can read more about this discussion here:

http://1millionhealthworkers.org/data-for-decision-making/

CHWs deliver vital health education and life-saving interventions. They have made an important contribution to the major reductions in child and maternal mortality in middle- and low-income countries over the past 10 years. Several countries, including Ethiopia, Rwanda and, more recently, Ghana, have supported national scale-up of CHWs. There is agreement that further expansion of CHWs is needed globally.

Currently, information on CHWs -­ including demographics, deployment details, services provided, and service delivery – is inconsistently collected in parallel by multiple actors. There is clearly massive

duplication and wasted effort, which leads to inaccurate data collection and utilization. This is the next challenge that we must work together to overcome.

Recently the 1mCHW Campaign and mPowering interviewed 8 senior decision-makers, academics, and program managers in a blog series about CHW data for decision making.

To each we asked three core questions:

1. What are the most pressing challenges in the development of scale-up of CHW programs today?

2. Why is data on frontline health workers, particularly CHWs, important?

3. In your opinion, what are the largest gaps in data on frontline health workers, particularly CHWs, right now?

and invited them also to answer one or more supplemental questions:

4. In what ways is your organization using innovative solutions to collect data on frontline health workers?

5. With better information and data, how could NGOs and governments overcome these challenges to improve CHW programs and programmatic decision-making?

6. How can we begin to close data gaps?

You can read their responses here:

http://mpoweringhealth.org/category/data-for-decision-making-series/

On September 1st we shall open the discussion on HIFA around the same questions. We hope to solicit perspectives from the full range of stakeholders represented on HIFA: ministries of health, CHW managers, individual NGOs, and INGOs; frontline health workers, policy makers, information professionals, publishers, researchers, and more.

The results of this discussion, combined with the interviews, will be compiled into a short report and disseminated by the 1mCHW Campaign and mPowering. This multi-stakeholder input will help inform the post-2015 era of global CHW scale-up and we look forward to engaging your views in the discussion.

Please do forward this message widely to your contacts and colleagues and invite them to join the discussion via the HIFA website: www.hifa2015.org

Thank you,

Cindil, Carolyn, & Neil

NHI chugs along, working to cut through the red tape

THE government is poised to take the next step in implementing its ambitious National Health Insurance (NHI) plans, Health Minister Aaron Motsoaledi promised MPs on Friday, reiterating the refrain by officials and ministers for the past three years. The ANC’s commitment to NHI is clearly articulated in the policy discussion documents it released earlier this month, but progress has been much slower than it anticipated when it published its Green Paper in August 2011, raising questions on the feasibility of its 14-year time line…..more

CHWs Address Community Needs and Demonstrate Patient-Centered Care

CHWs Address Community Needs and Demonstrate Patient-Centered Care

The Penn Center for Community Health Workers, based in the U.S. state of Pennsylvania, has a staff of 40 employees that are fully supported by the Penn Medicine Health System. The Center began as a collaboration between the Philadelphia community and Penn Medicine researchers. Most employees are CHWs and collectively  provide support to 1,500 vulnerable, high-risk patients in West and Southwest Philadelphia.

Using information from CHW-led in-depth patient interviews, the Center created the IMPaCT (Individualized Management towards Patient Centered Targets) model to address barriers to care. IMPaCT CHWs work with both patients and providers to set health goals and action plans for reaching them.

The Penn research team also identified historical limitations of CHW programs, that were systematically addressed in the IMPaCT model:

1.     To prevent high turnover, clear CHW hiring guidelines were developed

2.     To reduce the disjointed care that could arise from disease-specific interventions, patient-centered care is emphasized

3.     To ensure measurable results, the model is scientifically tested

4.     To promote cohesive patient care, the program is well integrated into a traditional healthcare system

5.     To improve CHW performance, specific work protocols were established

The model, tested in a randomized control trial of 446 patients, demonstrated higher quality hospital discharge communication, and fewer recurrent hospital readmissions. These and other results from ongoing randomized controlled trials were used in a business model that led to Penn Medicine’s creation of the Penn Center for CHWs in 2014.

The center also attempted to address the disconnect with physicians by partnering with the Perelman School of Medicine to create a medical student course called the IMPaCT teaching service. In the course, students shadow CHWs for four weeks in order to understand the various life issues affecting the patients they treat.  Along the way students learn a few CHW skills, from connecting patients to social services to motivational interviewing to deep listening.

Find the full blog on www.chwcentral.org

1. Kangovi S, Grande D,Trinh-Shevrin C. From Rhetoric to Reality-Community Health Workers in Post-Reform U.S. Health Care. New England Journal of Medicine) 06/2015; 372(24):2277-9. DOI: 10.1056/NEJMp1502569

2. Kangovi S, Mitra N, Grande D, et al. Patient-Centered Community Health Worker Intervention to Improve Posthospital Outcomes: A Randomized Clinical Trial. JAMA Intern Med. 2014;174(4):535-543. doi:10.1001/jamainternmed.2013.14327.

3. IMPaCT (Individualized Management for Patient-Centered Targets) Manuals, http://chw.upenn.edu/toolkit

Donna Bjerregaard

Senior Technical Advisor, Initiatives Inc.

264 Beacon Street, Boston, MA 02116

Tel:  617 262 0293 / Fax: 617 262 2514

www.initiativesinc.com / www.chwcentral.org

How can we improve access to different formats required by different users in different contexts? Abstracts

The Cochrane Systematic Reviews have plain language summaries. More details about these summaries are available at:

http://nnlm.gov/mcr/wysym2012/Cochrane%20Handout%202012.pdf

Vasumathi Sriganesh

QMed Knowledge Foundation

(Trust – Reg No: E-24663)

A-3, Shubham Centre, Cardinal Gracious Road

Chakala, Andheri East, Mumbai 400099

Tel: 91-22-40054474    Mob: +919867292230

Web: www.qmed.org.in   www.indianmedicalsites.in

Access to Health Research: How can we improve the availability and use of health research in LMICs through social media, CoPs, blogs…?

I would like to highlight the Powerpoint presentation ‘Social Media for Research Communication’ by Anand Sheombar. You can view the presentation here:

http://www.slideshare.net/anandsheombar/social-media-for-research-communication

Below is an extract:

Benefits of Social Media for Research Communication

– promote your research and increase its visibility

– communicate directly and quickly with others who have an interest in your research

– develop new relationships and build networks

– reach new audiences, both within and outside academia

– seek and give advice and feedback

– generate ideas

– share information and links, e.g. journal articles and news items

– keep up-to-date with the latest news and developments, and forward it to others instantly – follow and contribute to discussions on events, e.g. conferences that you can’t get to in person – express who you are as a person. Source: Economic and Social Research Council

The author includes two particularly interesting slides:

Building Blocks of the Networked Scholar (Slide 9)

Suggestions for use of Social Media in Research Life Cycle (Slide 13)

Best wishes,

Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

USAID’s MCSP and WHO evidence brief: Postnatal Care for Mothers and Newborns

USAID’s flagship Maternal and Child Survival Program (MCSP) along with World Health Organization is excited to introduce our latest evidence brief, Postnatal Care for Mothers and Newborns.

This evidence brief provides highlights and key messages from World Health Organization’s 2013 Guidelines on postnatal care for mothers and newborns. These updated guidelines address the timing and content of postnatal care for mothers with a special focus on resource-limited settings in low- and middle-income countries. This brief is intended for policy-makers, programme managers, educators and providers who care for women and newborns after birth.

Find the brief here – http://bit.ly/1KrsU07

Full WHO recommendations here – http://apps.who.int/iris/bitstream/10665/97603/1/9789241506649_eng.pdf?ua=1

Help us spread the word to others by sharing this email with your networks and sending out a message on social media. Here are a few sample messages that you and your organizations can use:

The postnatal period is a critical time for #MomandBaby. Learn more from @WHO’s Guidelines for PNC brief http://bit.ly/1KrsU07

Most maternal & infant deaths occur in 1st month after birth. See brief of @WHO’s Guidelines for PNC to learn more http://bit.ly/1KrsU07

See brief from @MCSPglobal highlighting KEY msgs from @WHO’s 2013 Guidelines on PNC for mothers & newborns http://bit.ly/1KrsU07

Please contact me if you have any additional questions. Apologies for any cross-posting.

Sincerely,

Jillian Rossman

Administrative Coordinator, Maternal and Child Survival Program, USAID Grantee

1776 Massachusetts Avenue, NW, Suite 300, Washington, DC 20036

tel: 202.835.3112 / skype: jillrossman / www.mcsprogram.org / Facebook | Twitter | YouTube | Flickr

From the American People

Rural and Remote Health: Free open access medical education

CITATION: Leeuwenburg TJ, Parker C.  Free open access medical education can help rural clinicians deliver ‘quality care, out there’. Rural and Remote Health 15: 3185. (Online) 2015. Available: http://www.rrh.org.au/articles/showarticlenew.asp?ArticleID=3185

ABSTRACT

Rural clinicians require expertise across a broad range of specialties, presenting difficulty in maintaining currency of knowledge and application of best practice. Free open access medical education is a new paradigm in continuing professional education. Use of the internet and social media allows a globally accessible crowd-sourced adjunct, providing inline (contextual) and offline (asynchronous) content to augment traditional educational principles and the availability of relevant resources for life-long learning. This markedly reduces knowledge translation (the delay from inception of a new idea to bedside implementation) and allows rural clinicians to further expertise by engaging in discussion of cutting edge concepts with peers worldwide.

EXTRACTS (selected by Neil PW)

‘Conceived in 2012, free open access medical education (FOAMed) is an evolving paradigm, which was initially enthusiastically adopted by emergency and critical care clinicians.

If you want to know how we practised medicine five years ago, read a textbook.

If you want to know how we practised medicine two years ago, read a journal.

If you want to know how we practise medicine now, go to a (good) conference.

If you want to know how we will practise medicine in the future, listen in the hallways and use FOAM.’

‘Social media use is gaining acceptance within medical education circles; FOAMed merely extends the paradigm to disseminate free information and encourage content creation, collation, curation and communication.’

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

Access to Health Research: Open access

I was encouraged to read this piece about SciELO and open access in Latin America. I have reproduced the text below (open access) or you can read direct online here:

https://thewinnower.com/papers/1670-open-access-in-latin-america-a-paragon-for-the-rest-of-the-world

Open Access in Latin America: a Paragon for the Rest of the World

Juan Pablo Alperin et al.

Latin America is one of the world’s most progressive regions in terms of open access and adoption of sustainable, cooperative models for disseminating research; models that ensure that researchers and citizens have access to the results of research conducted in their region.

SciELO is a remarkable decentralized publishing platform harboring over 1,200 peer-reviewed journals from fifteen countries located in four continents – South America. Central-North America, Europe and Africa. Redalyc, based in Mexico, is another extraordinary system hosting almost 1,000 journals from fourteen Latin American countries plus Spain and Portugal. Governments around the world spend billions of dollars on infrastructure to support research excellence; platforms such as SciELO and Redalyc are extensions of this much larger investments in research. They reflect an enlightened understanding in Latin America that the wide dissemination of and access to research results is as important as the research itself. The rest of the world would do well to take note.

In a recent blog post, these two initiatives were discredited by Jeffrey Beall. In the post, Beall compared the two publishing platforms to favelas, resulting in a mean-spirited insult to both favela dwellers on the one hand, and SciELO and Redalyc on the other. Rather than maligning these initiatives, they should be held up as examples of best practice for the rest of the world.

Furthermore, just because some in North America do not know about SciELO and Redalyc does not render them irrelevant. This is an extremely elitist and narrow view of the world. Although these platforms may not be well known in some places, SciELO and Redalyc do raise the visibility and accessibility of the journals they host, particularly with their local communities. If these journals were published by the big commercial publishers, the vast majority of researchers in Latin America would simply not have access to the articles in those journals. What value is visibility, if people cannot access the articles?

One of the United Nations Sustainable Development Goals, which were finalized on August 1, 2015, is to “Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation”. Both Scielo and Redalyc are excellent exemplars of this type of infrastructure. These types of networked meta-publishers allow for central governance of policies, procedures and controls, but are intentionally decentralized to support the development of local capacity and infrastructure ensuring greater sustainability and alignment with local policies and priorities. What Beall advocates for, namely to let powerful foreign players come in and take over local capacity building, is exactly the opposite of what sustainable development is about.

For these reasons, we believe that SciELO and Redalyc are very nice neighbourhoods indeed!

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

Tweeting and using other social media to share research widely

Microblogging tools such as Twitter provide powerful ways to share published research papers and other web content.

Twitter is easy to use and – unlike email – it needn’t add to your workload. A Twitter “feed” is like a stream you can step in an out of and, when you want to sail a little boat down that stream you send a tweet. You can simply write a short message, but it’s far more powerful if you include in your message a web link to some substantive content, eg a journal article or another web page.

You make the stream yourself by selecting (“following”) the Twitter accounts that interest you. 1000s of academic journals, health organisations, universities, news media, and individuals now have Twitter accounts. You can find them by searching on twitter or – more easily – by typing something like “Trish Groves BMJ twitter” into Google or another search engine.

You don’t have reply or respond to anyone if you don’t want to. Tweeters aren’t messaging you personally; they’re broadcasting. You can control how much you want to interact with Twitter, and you can decide what to watch, when to switch it on and off, and when to broadcast something yourself.

Here’s a broadcasting analogy that might help. Imagine you’re watching the news on TV and, at the bottom of the screen, there’s a running caption of headlines (sometimes called a “ticker”). When you see a headline that catches your attention, you click on it and the newsreader switches to that story. You may not have that kind of service on your TV (yet!), but I hope this helps to understand the concept of Twitter.

Two free resources about the uses of twitter in academia are:

Teaching Tips for academics

http://blogs.lse.ac.uk/impactofsocialsciences/files/2011/11/Published- Twitter_Guide_Sept_2011.pdf

A Powerpoint presentation by me, for early career health researchers:

http://www.slideshare.net/TrishGroves1/blogging-tweeting-sharing-your-work-to-reach-policy-makers

Best wishes

Trish (I’m @trished on Twitter if you’d like to follow me)

Dr Trish Groves

Head of Research, BMJ

& Editor-in-chief, BMJ Open

BMJ, BMA House, Tavistock Square, London, WC1H 9JR

T: 020 7383 6018

E: tgroves@bmj.com

W: bmj.com/company

twitter@trished

pinterest.com/trishedpin