Subjects -> HEALTH AND SAFETY (Total: 1572 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (744 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (390 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (115 journals)
    - PHYSICAL FITNESS AND HYGIENE (133 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (744 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 4)
ACM Transactions on Computing for Healthcare     Hybrid Journal   (Followers: 5)
Acta Informatica Medica     Open Access   (Followers: 3)
Acta Scientiarum. Health Sciences     Open Access   (Followers: 3)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 13)
Advances in Public Health     Open Access   (Followers: 32)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 4)
African Health Sciences     Open Access   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 7)
Afrimedic Journal     Open Access   (Followers: 3)
Ageing & Society     Hybrid Journal   (Followers: 48)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 9)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 4)
Akademika     Open Access   (Followers: 1)
American Journal of Family Therapy     Hybrid Journal   (Followers: 9)
American Journal of Health Economics     Full-text available via subscription   (Followers: 22)
American Journal of Health Education     Hybrid Journal   (Followers: 39)
American Journal of Health Promotion     Hybrid Journal   (Followers: 35)
American Journal of Health Sciences     Open Access   (Followers: 13)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 31)
American Journal of Public Health     Full-text available via subscription   (Followers: 299)
American Journal of Public Health Research     Open Access   (Followers: 31)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 9)
Annales des Sciences de la Santé     Open Access  
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 16)
Annals of Health Law     Open Access   (Followers: 6)
Applied Biosafety     Hybrid Journal   (Followers: 1)
Applied Ergonomics     Hybrid Journal   (Followers: 18)
Applied Research In Health And Social Sciences: Interface And Interaction     Open Access   (Followers: 5)
Apuntes Universitarios     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives of Community Medicine and Public Health     Open Access   (Followers: 3)
Archives of Medicine and Health Sciences     Open Access   (Followers: 7)
Archives of Suicide Research     Hybrid Journal   (Followers: 11)
Archivos de Prevención de Riesgos Laborales     Open Access  
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 11)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 6)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 15)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 5)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 7)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 5)
Autism & Developmental Language Impairments     Open Access   (Followers: 16)
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 7)
Biosafety and Health     Open Access   (Followers: 1)
Biosalud     Open Access   (Followers: 1)
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 7)
BMC Pregnancy and Childbirth     Open Access   (Followers: 24)
BMJ Simulation & Technology Enhanced Learning     Hybrid Journal   (Followers: 13)
Boletin Médico de Postgrado     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 53)
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 23)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos de Saúde     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 16)
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 14)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 2)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 28)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 2)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
Case Studies in Fire Safety     Open Access   (Followers: 27)
CASUS : Revista de Investigación y Casos en Salud     Open Access   (Followers: 1)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
CES Salud Pública     Open Access  
Child and Adolescent Obesity     Open Access   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 12)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access   (Followers: 3)
Christian Journal for Global Health     Open Access   (Followers: 1)
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia & Salud     Open Access   (Followers: 1)
Ciencia & Trabajo     Open Access   (Followers: 2)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud     Open Access   (Followers: 3)
Ciencia y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access   (Followers: 2)
Cities & Health     Hybrid Journal   (Followers: 4)
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
Clocks & Sleep     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 2)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 6)
Conflict and Health     Open Access   (Followers: 8)
Contact (CTC)     Open Access  
Contraception and Reproductive Medicine     Open Access   (Followers: 2)
Cuaderno de investigaciones: semilleros andina     Open Access   (Followers: 3)
Cuadernos de la Escuela de Salud Pública     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 11)
Current Opinion in Environmental Science & Health     Hybrid Journal   (Followers: 1)
Das österreichische Gesundheitswesen ÖKZ     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal  
Digital Health     Open Access   (Followers: 10)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 16)
Diversity and Equality in Health and Care     Open Access   (Followers: 9)
Diversity of Research in Health Journal     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 3)
Drogues, santé et société     Open Access   (Followers: 2)
Duazary     Open Access   (Followers: 1)
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 29)
East African Journal of Public Health     Full-text available via subscription   (Followers: 4)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 26)
EcoHealth     Hybrid Journal   (Followers: 6)
Education for Health     Open Access   (Followers: 9)
ElectronicHealthcare     Full-text available via subscription   (Followers: 4)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emerging Trends in Drugs, Addictions, and Health     Open Access   (Followers: 1)
Ensaios e Ciência : Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 4)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 6)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 7)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 24)
EsSEX : Revista Científica     Open Access   (Followers: 1)
Estudios sociales : Revista de alimentación contemporánea y desarrollo regional     Open Access   (Followers: 1)
Ethics & Human Research     Hybrid Journal   (Followers: 4)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 8)
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 8)
Ethnicity & Health     Hybrid Journal   (Followers: 16)
Eurasian Journal of Health Technology Assessment     Open Access   (Followers: 1)
EUREKA : Health Sciences     Open Access   (Followers: 3)
European Journal of Health Communication     Open Access   (Followers: 2)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 6)
European Medical, Health and Pharmaceutical Journal     Open Access   (Followers: 3)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 11)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
F&S Reports     Open Access   (Followers: 1)
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 10)
Family & Community Health     Hybrid Journal   (Followers: 15)
Family Medicine and Community Health     Open Access   (Followers: 10)
Family Relations     Partially Free   (Followers: 15)
FASEB BioAdvances     Open Access  
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 19)
Food Hydrocolloids for Health     Open Access  
Food Quality and Safety     Open Access   (Followers: 2)
Frontiers in Digital Health     Open Access   (Followers: 3)
Frontiers in Neuroergonomics     Open Access   (Followers: 1)
Frontiers in Public Health     Open Access   (Followers: 9)
Frontiers of Health Services Management     Partially Free   (Followers: 9)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access   (Followers: 1)
Ganesha Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access   (Followers: 1)
Gestão e Desenvolvimento     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Advances in Health and Medicine     Open Access  
Global Challenges     Open Access  
Global Health : Science and Practice     Open Access   (Followers: 9)
Global Health Annual Review     Open Access   (Followers: 3)
Global Health Journal     Open Access   (Followers: 3)
Global Health Promotion     Hybrid Journal   (Followers: 19)
Global Journal of Health Science     Open Access   (Followers: 12)
Global Journal of Public Health     Open Access   (Followers: 17)
Global Medical & Health Communication     Open Access   (Followers: 2)
Global Mental Health     Open Access   (Followers: 11)
Global Reproductive Health     Open Access   (Followers: 1)
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Global Transitions     Open Access   (Followers: 1)
Global Transitions Proceedings     Open Access  
Globalization and Health     Open Access   (Followers: 9)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 7)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 20)
Health & Justice     Open Access   (Followers: 6)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 17)
Health and Human Rights     Open Access   (Followers: 10)
Health and Research Journal     Open Access   (Followers: 2)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 11)

        1 2 3 4 | Last

Similar Journals
Journal Cover
Global Health : Science and Practice
Journal Prestige (SJR): 1.315
Citation Impact (citeScore): 2
Number of Followers: 9  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2169-575X - ISSN (Online) 2169-575X
Published by U.S. Agency for International Development Homepage  [1 journal]
  • What Potential Authors Should Know About Publishing in Global Health:
           Science and Practice

    • Authors: Stephen Hodgins; Sonia Abraham
      Pages: 426 - 427
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00540
      Issue No: Vol. 9, No. 3 (2021)
       
  • Multisectoral Policies and Programming: High-Income Countries Can and
           Should Be Learning From the Philippines and Other Low- and Middle-Income
           Countries

    • Authors: Madeleine Short Fabic
      Pages: 428 - 430
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00541
      Issue No: Vol. 9, No. 3 (2021)
       
  • It’s Time to Move Beyond Traditional Health Care Worker Training
           Approaches

    • Authors: Julia Bluestone; Jim Ricca, Denise Traicoff, Dieula Delissaint Tchoualeu
      Pages: 431 - 432
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00553
      Issue No: Vol. 9, No. 3 (2021)
       
  • The Conundrum of Low COVID-19 Mortality Burden in sub-Saharan Africa: Myth
           or Reality'

    • Authors: Janica Adams; Mary J. MacKenzie, Adeladza Kofi Amegah, Alex Ezeh, Muktar A. Gadanya, Akinyinka Omigbodun, Ahmed M. Sarki, Paul Thistle, Abdhalah K. Ziraba, Saverio Stranges, Michael Silverman
      Pages: 433 - 443
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00172
      Issue No: Vol. 9, No. 3 (2021)
       
  • A Quality Improvement Intervention to Inform Scale-Up of Integrated HIV-TB
           Services: Lessons Learned From KwaZulu-Natal, South Africa

    • Authors: Santhanalakshmi Gengiah; Kogieleum Naidoo, Regina Mlobeli, Maureen F. Tshabalala, Andrew J. Nunn, Nesri Padayatchi, Nonhlanhla Yende-Zuma, Myra Taylor, Pierre M. Barker, Marian Loveday
      Pages: 444 - 458
      Abstract: ABSTRACTIntroduction:In South Africa, mortality rates among HIV-TB coinfected patients are among the highest in the world. The key to reducing mortality is integrating HIV-TB services, however, a generalizable implementation method and package of tested change ideas to guide the scale-up of integrated HIV-TB services are unavailable. We describe the implementation of a quality improvement (QI) intervention, health systems’ weaknesses, change ideas, and lessons learned in improving integrated HIV-TB services.Methods:Between December 1, 2016, and December 31, 2018, 8 nurse supervisors overseeing 20 primary health care (PHC) clinics formed a learning collaborative to improve a set of HIV-TB process indicators. HIV-TB process indicators comprised: HIV testing services (HTS), TB screening among PHC clinic attendees, isoniazid preventive therapy (IPT) for eligible HIV patients, antiretroviral therapy (ART) for HIV-TB coinfected patients, and viral load (VL) testing at month 12. Routine HIV-TB process data were collected and analyzed.Results:Key change interventions, generated by health care workers, included: patient-flow redesign, daily data quality checks; prior identification of patients eligible for IPT and VL testing. Between baseline and post-QI intervention, IPT initiation rates increased from 15.9% to 76.4% (P=.019), HTS increased from 84.8% to 94.5% (P=.110), TB screening increased from 76.2% to 85.2% (P=.040), and VL testing increased from 61.4% to 74.0% (P=.045). ART initiation decreased from 95.8% to 94.1% (P=.481).Discussion:Although integrating HIV-TB services is standard guidance, existing process gaps to achieve integration can be closed using QI methods. QI interventions can rapidly improve the performance of processes, particularly if baseline performance is low. Improving data quality enhances the success of QI initiatives.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00157
      Issue No: Vol. 9, No. 3 (2021)
       
  • Social and Political Dimensions of Disseminating Research Findings on
           Emerging Zoonotic Viruses: Our Experience in Sierra Leone

    • Authors: Dorothy Peprah; James Bangura, Mohamed Vandi, Harold Thomas, Monica Dea, Anton Schneider, Kendra Chittenden
      Pages: 459 - 466
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-20-00321
      Issue No: Vol. 9, No. 3 (2021)
       
  • Protecting Mental Health Data Privacy in India: The Case of Data Linkage
           With Aadhaar

    • Authors: Ameya Bondre; Soumitra Pathare, John A. Naslund
      Pages: 467 - 480
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-20-00346
      Issue No: Vol. 9, No. 3 (2021)
       
  • Strategies for Improving Quality and Safety in Global Health: Lessons From
           Nontechnical Skills for Surgery Implementation in Rwanda

    • Authors: Daniel Josef Lindegger; Egide Abahuje, Kenneth Ruzindana, Elizabeth Mwachiro, Gilbert Rutayisire Karonkano, Wendy Williams, George Ntakiyiruta, Robert Riviello, Steven Yule, Simon Paterson-Brown
      Pages: 481 - 486
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00042
      Issue No: Vol. 9, No. 3 (2021)
       
  • Applying Adult Learning Best Practices to Design Immunization Training for
           Health Care Workers in Ghana

    • Authors: Denise Traicoff; Dieula Delissaint Tchoualeu, Joseph Opare, Melissa Wardle, Pamela Quaye, Hardeep S. Sandhu, George Bonsu
      Pages: 487 - 497
      Abstract: ABSTRACTIntroduction:A 2016 assessment of frontline health care workers (HCWs) in Ghana identified knowledge, skill, and attitude gaps related to immunization during the second year of life (2YL). The U.S. Centers for Disease Control and Prevention subsequently supported the Ghana Health Service Immunization Program to apply best practices of adult learning and training of trainers (TOT) for a cascade training program for 2YL.Methods:Five districts from each of the 3 regions (Greater Accra, Northern, and Volta) were selected for the TOT based on key measles and rubella vaccination coverage indicators. The design incorporated best practices of adult learning and TOT. The curriculum integrated 3 major topical themes: technical (immunization topics), operational, and training adults. The technical and operational content was based on HCW tasks most directly affecting 2YL objectives. A cross-functional team developed all classroom, field activity, and training evaluation materials.Results:Seventy-four participants attended TOT workshops in 2017. Based on a rubric defined by the course designers, 99% of the participants reported an acceptable level of confidence to apply and teach the course content. After the TOTs, participants conducted 65 workshops, 43 field visits, and 4 review meetings, reaching 1,378 HCWs within 7 months. Fifty-four percent of HCWs who received training from TOT participants reported an acceptable level of confidence in using the skills, and 92% reported they would prioritize applying the skills acquired during the training.Discussion:The success factors for effective adult learning and TOT can be applied to design and implement high-quality TOT even in resource-limited settings. The factors include using a variety of approaches, spending enough class time to prepare TOT participants for their training role, setting specific expectations for cascading the training, and following up through mentorship and reporting. Strong collaboration across the administrative levels of the Ghana Health Service enabled cascade training.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00090
      Issue No: Vol. 9, No. 3 (2021)
       
  • Evaluation of the Impact of Immunization Second Year of Life Training
           Interventions on Health Care Workers in Ghana

    • Authors: Dieula Delissaint Tchoualeu; Bonnie Harvey, Mawuli Nyaku, Joseph Opare, Denise Traicoff, George Bonsu, Pamela Quaye, Hardeep S. Sandhu
      Pages: 498 - 507
      Abstract: ABSTRACTIntroduction:As part of a suite of training interventions to improve the knowledge and practice of immunization in the second year of life (2YL), training of trainers workshops were conducted with regional and district health management teams (DHMTs) in 15 districts in 3 regions of Ghana. Using adult learning principles, DHMTs implemented several capacity-building activities at the subdistrict and health facility levels, including health facility visits, on-the-job training, and review meetings. The current evaluation investigated whether frontline health care workers (HCWs) reported or demonstrated improvements in knowledge, attitudes, and practices after training interventions.Methods:Quantitative and qualitative methods with a utilization-focused approach guided the framework for this evaluation. A systematic random sample of 115 HCWs in 3 regions of Ghana was selected to complete a competency survey before and after training, which focused on 3 core competency areas—Expanded Programme on Immunization (EPI) policy; communication with caregivers; and immunization data management, recording, and use. Interviews and direct observations by data collectors were done to assess HCWs’ knowledge, self-reported attitude, and behavior changes in practices.Results:Of 115 HCWs, 102 were surveyed before and 4 months after receiving capacity-building interventions. Modest but not statistically significant improvements were found in knowledge on EPI policy, immunization data management, and communication skills with caregivers. HCWs reported that they had improved several attitudes and practices after the 2YL training. The most improved practice reported by HCWs and observed in all 3 regions was the creation of a defaulter list.Discussion:Findings of this evaluation provide encouraging evidence in taking the first step toward improving HCW knowledge, attitudes, and practices for 3 core immunization competency areas. The use of learner-focused teaching methods combined with adult learning principles is helpful in solving specific performance problems (such as lack of knowledge of EPI policy).
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00091
      Issue No: Vol. 9, No. 3 (2021)
       
  • Young People’s Experiences With an Empowerment-Based Behavior Change
           Intervention to Prevent Sexual Violence in Nairobi Informal Settlements: A
           Qualitative Study

    • Authors: Anna E. Kagesten; Phoene Mesa Oware, Wendy Ntinyari, Nickson Langat, Benȷamin Mboya, Anna Mia Ekstrom
      Pages: 508 - 522
      Abstract: ABSTRACTPurpose:Young people in sub-Saharan Africa face one of the world’s highest burdens of sexual violence. Previous impact evaluations indicated that a 6-week empowerment-based behavioral intervention in Nairobi informal (slum) settlements can reduce sexual assault. This qualitative study investigated girls’ and boys’ experiences of the intervention to identify potential mechanisms of change.Methods:We conducted a qualitative study in Nairobi slums with students (aged 15–21 years) who had participated in 2 parallel school-based curriculums called IMPower (girls) and Your Moment of Truth (boys) at least 1 year ago. Data were collected via 10 focus group discussions (5 for boys, 5 for girls) with 6–11 participants in each and 21 individual in-depth interviews (11 boys, 10 girls) that explored participants’ experiences of the intervention and their suggestions for improvement. Findings were analyzed using thematic network analysis guided by empowerment theory.Results:Girls described how the intervention enabled them to recognize and resist sexual assault via verbal and physical strategies for self-protection, negotiate sexual consent, and exercise agency. Boys described increased ability to avoid risky behaviors and “bad” peer groups and to understand and respect consent. Girls also described how the intervention strengthened their self-confidence, and boys said that it boosted positive life values and gender-equal attitudes. Skilled facilitators and interactive and relevant content were highlighted as key to intervention success. Areas of improvement included expanding the curriculum to contain more content on sexual and reproductive health and rights and involving out-of-school youth, parents, teachers, and communities.Conclusion:Findings indicate that a relatively short, behavioral school-based intervention can empower both girls and boys to prevent various forms of sexual violence in a low-income setting where it is endemic. Incorporating multilevel support structures, such as involving communities and families, could further enhance young people’s long-term safety, health, and well-being.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00105
      Issue No: Vol. 9, No. 3 (2021)
       
  • Income Inequalities in Hepatitis B Vaccination and Willingness to Pay
           Among Women of Reproductive Age in Hanoi, Vietnam

    • Authors: Xuan Thi Thanh Le; Nguyen Thao Thi Nguyen, Huong Thi Le, Toan Thanh Thi Do, Thang Huu Nguyen, Huong Lan Thi Nguyen, Trang Ha Nguyen, Linh Gia Vu, Bach Xuan Tran, Carl A. Latkin, Cyrus S.H. Ho, Roger C.M. Ho
      Pages: 523 - 531
      Abstract: ABSTRACTBackground:Hepatitis B virus (HBV) infection is endemic in Vietnam and can be transmitted from mother to child. Vaccination of women of reproductive age (WRA) can reduce this transmission. Because adult HBV vaccination in Vietnam follows a fee-for-service model, research is needed to determine the effect of household income on willingness to pay (WTP) to ensure equitable access to the vaccine.Methods:A cross-sectional study was performed in Hanoi, Vietnam, in April 2018, among WRA. Questionnaires were administered to assess household income, HBV history, vaccination status, vaccine awareness, and WTP for the vaccine. Multivariable logistic and interval regression were performed to assess the impact of household income on WTP for HBV vaccine.Results:This study found that 62.3% of all participants were willing to pay for the HBV vaccine with no differences in WTP across income quintiles. There were significant differences among household income levels in awareness of HBV vaccination and WTP amount beyond US$4.50 with the lowest awareness and WTP amount among women from the lowest income quintiles.Conclusions:Our data suggest the need to subsidize HBV vaccination for low-income women to ensure more equitable access to HBV vaccination. We propose that a sliding-scale payment method may be an effective strategy in light of limited funding to support vaccination expansion. An education campaign focusing on lower-income households should also be implemented in conjunction with this program. Further research would be required to evaluate consumer acceptance of this payment scheme and to develop an appropriate sliding scale to maximize vaccine uptake.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-20-00480
      Issue No: Vol. 9, No. 3 (2021)
       
  • Mapping the Antimicrobial Supply Chain in Bangladesh: A
           Scoping-Review-Based Ecological Assessment Approach

    • Authors: E.S.F. Orubu; M.A. Samad, M.T. Rahman, M.H. Zaman, V.J. Wirtz
      Pages: 532 - 547
      Abstract: ABSTRACTIntroduction:Maintaining access to antimicrobials while preventing misuse is essential to combating the threat of antimicrobial resistance (AMR). The study objectives are to propose a framework of 16 indicators that can be used at the national level to assess the capacity to ensure access and curtail inappropriate use and to profile the antimicrobial supply chain for Bangladesh.Methods:Using a framework based on a rational construct, we assessed the antimicrobial supply chain of Bangladesh, with a focus on key players and products using a scoping review to obtain and describe information on 16 indicators. With players, we mapped linkages, manufacturers’ production capacity, and ownership, among others, and demand point characteristics—pharmacy and pharmacist density, pharmacy/medicine outlets dispersion, veterinary clinic/hospitals, veterinarians’ density, product quality, and regulation. We assessed product characteristics including listing on the World Health Organization (WHO) Model Essential Medicines List (EML) and WHO Access, Watch, and Reserve (AWaRe) classification of the major (top 10) antibiotics for human use; the proportion of medically important antimicrobials (MIAs) in veterinary use; and pricing. Production capacity and price controls were used to assess access and listing on the WHO EML, AWaRe/MIA classification, and a calculated pharmacy-to-pharmacist ratio to assess use.Results:Bangladesh has a high (98%) local antibiotic production capacity with pricing controls indicating the ability to ensure access. The presence of a high proportion of medicine outlets not under the control of pharmacists (4:1) and the high percentages of WHO Watch (54%) and MIAs (90%) of the major antibiotics are indicators of possible misuse.Discussion:Most of the data used in the framework were publicly available. Bangladesh has the capacity to ensure access but needs to strengthen its ability to regulate the quality of antimicrobials and prevent their inappropriate use through antimicrobial stewardship at the community (medicine outlet) levels to check AMR. There may also be a need for more regulations on licensing of MIAs.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-20-00502
      Issue No: Vol. 9, No. 3 (2021)
       
  • Trends in National-Level Governance and Implementation of the
           Philippines’ Responsible Parenthood and Reproductive Health Law from
           2014 to 2020

    • Authors: Vanessa T. Siy Van; Jhanna Uy, Joy Bagas, Valerie Gilbert T. Ulep
      Pages: 548 - 564
      Abstract: ABSTRACTIn 2012, the Philippines passed the Responsible Parenthood and Family Planning Law, a landmark legislation billed as a multisectoral and rights-based approach to further sustainable human development. This article is part of the first comprehensive evaluation of the implementation of the law by national-level actors. This evaluation is intended to assess the progress of implementers in the conduct of mandates, roles, and responsibilities described in the law and its implementing guidelines. Interviews with key national government officials and data from official documents and literature revealed 3 major trends in governance and implementation from 2014 to 2020. First, despite being a multisectoral policy, performance was siloed within individual units of implementing agencies, with limited interagency coordination. Second, although the law explicitly called for interventions to invest in human capital and address socioeconomic disparities for sustainable human development, performance focused on biomedical and health interventions, particularly in the area of family planning. Third, national-level governance for reproductive health interventions concentrated on programmatic and operational concerns. Overall, this case in the Philippines illustrates that fragmented implementation has contributed to the slow improvement of reproductive health outcomes. This study highlights the challenges of governance and multisectoral coordination to implement multidimensional interventions in a low- and middle-income country, and it provides potential areas for political and administrative reform in reproductive health governance in the Philippines. By creating a common narrative and onboarding multiple sectors, officials can better identify and address structural determinants with holistic policy solutions to improve reproductive health outcomes.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00184
      Issue No: Vol. 9, No. 3 (2021)
       
  • Negative Incentives for Noninstitutional Births Are Associated With a
           Higher Rate of Facility-Based Births in the Eastern Visaya Region,
           Philippines

    • Authors: Shogo Kanamori; Marcelyn D. Bonhaon, Minerva Peregrino Molon
      Pages: 565 - 574
      Abstract: ABSTRACTIn the Philippines, the “no home-birthing policy” implemented in 2008 has encouraged local governments to endorse ordinances that prohibit noninstitutional deliveries (NIDs). The Philippines’ social insurance scheme has also enabled them to provide incentive payments to women who deliver at birthing facilities (BFs). This study evaluated whether these positive and/or negative incentives were associated with an increased facility-based delivery (FBD) rate and examined challenges in implementing those incentive measures in the Eastern Visaya Region of the Philippines. Cross-sectional data were collected regarding delivery locations during 2017, and barangay-level data were collected regarding positive and negative incentives and the characteristics of 4,371 barangays in the region. Multivariate logistic regression analysis, using “ordinance with nonmonetary sanction” as the reference category, indicated that no ordinance to prohibit NIDs was significantly associated with a lower FBD rate (odds ratio [OR]: 0.90, P=.013), and ordinance with low cash penalty (OR: 1.37, P
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-20-00616
      Issue No: Vol. 9, No. 3 (2021)
       
  • Readiness to Provide Antenatal Corticosteroids for Threatened Preterm
           Birth in Public Health Facilities in Northern India

    • Authors: Ankita Kankaria; Mona Duggal, Anshul Chauhan, Debarati Sarkar, Suresh Dalpath, Akash Kumar, Gursharan Singh Dhanjal, Vijay Kumar, Vanita Suri, Rajesh Kumar, Praveen Kumar, James A. Litch
      Pages: 575 - 589
      Abstract: ABSTRACTIntroduction:In 2014, the Government of India (GOI) released operational guidelines on the use of antenatal corticosteroids (ACS) in preterm labor. However, without ensuring the quality of childbirth and newborn care at facilities, the use of ACS in low- and middle-income countries is potentially harmful. This study assessed the readiness to provide ACS at primary and secondary care public health facilities in northern India.Methods:A cross-sectional study was conducted in 37 public health facilities in 2 districts of Haryana, India. Facility processes and program implementation for ACS delivery were assessed using pretested study tools developed from the World Health Organization (WHO) quality of care standards and WHO guidelines for threatened preterm birth.Results:Key gaps in public health facilities’ process of care to provide ACS for threatened preterm birth were identified, particularly concerning evidence-based practices, competent workforce, and actionable health information system. Emphasis on accurate gestational age estimation, quality of childbirth care, and quality of preterm care were inadequate. Shortage of trained staff was widespread, and a disconnect was found between knowledge and attitudes regarding ACS use. ACS administration was provided only at district or subdistrict hospitals, and these facilities did not uniformly record ACS-specific indicators. All levels lacked a comprehensive protocol and job aids for identifying and managing threatened preterm birth.Conclusions:ACS operational guidelines were not widely disseminated or uniformly implemented. Facilities require strengthened supervision and standardization of threatened preterm birth care. Facilities need greater readiness to meet required conditions for ACS use. Increasing uptake of a single intervention without supporting it with adequate quality of maternal and newborn care will jeopardize improvement in preterm birth outcomes. We recommend updating and expanding the existing GOI ACS operational guidelines to include specific actions for the safe and effective use of ACS in line with recent scientific evidence.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-20-00716
      Issue No: Vol. 9, No. 3 (2021)
       
  • Care Around Birth Approach: A Training, Mentoring, and Quality Improvement
           Model to Optimize Intrapartum and Immediate Postpartum Quality of Care in
           India

    • Authors: Gunjan Taneja; Enisha Sarin, Devina Bajpayee, Saumyadripta Chaudhuri, Geeta Verma, Rakesh Parashar, Nidhi Chaudhry, Jaya Swarup Mohanty, Nitin Bisht, Anil Gupta, Shailendra Singh Tomar, Rachana Patel, V.S. Sridhar, Anurag Joshi, Chitra Rathi, Dinesh Baswal, Sachin Gupta, Rajeev Gera
      Pages: 590 - 610
      Abstract: ABSTRACTBackground:With the highest risk of maternal and newborn mortality occurring during the period around birth, quality of care during the intrapartum and immediate postpartum periods is critical for maternal and neonatal survival.Methods:The United States Agency for International Development’s Scaling Up Reproductive, Maternal, Newborn, Child, and Adolescent Health Interventions project, also known as the Vriddhi project, collaborated with the national and 6 state governments to design and implement the Care Around Birth approach in 141 high caseload facilities across 26 high-priority districts of India from January 2016 to December 2017. The approach aimed to synergize evidence-based technical interventions with quality improvement (QI) processes, respectful maternity care, and health system strengthening efforts. The approach was designed using experiential training, mentoring, and a QI model. A baseline assessment measured the care ecosystem, staff competencies, and labor room practices. At endline, the approach was externally evaluated.Results:Availability of logistics, recording and reporting formats, and display of protocols improved across the intervention facilities. At endline (October–December 2017), delivery and newborn trays were available in 98% of facilities compared to 66% and 55% during baseline (October–December 2015), respectively. Competency scores (> 80%) for essential newborn care and newborn resuscitation improved from 7% to 70% and from 5% to 82% among health care providers, respectively. The use of partograph in monitoring labor improved from 29% at the baseline to 61%; administration of oxytocin within 1 minute of delivery from 35% to 93%; newborns successfully resuscitated from 71% to 96%; and postnatal monitoring of mothers from 52% to 94%.Conclusion:The approach successfully demonstrated an operational design to improve the provision and experience of care during the intrapartum and immediate postpartum periods, thereby augmenting efforts aimed at ending preventable child and maternal deaths.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-20-00368
      Issue No: Vol. 9, No. 3 (2021)
       
  • A Mixed-Methods Process Evaluation: Integrating Depression Treatment Into
           HIV Care in Malawi

    • Authors: Melissa A. Stockton; Caroline E. Minnick, Kazione Kulisewa, Steven M. Mphonda, Mina C. Hosseinipour, Bradley N. Gaynes, Joanna Maselko, Audrey E. Pettifor, Vivian Go, Michael Udedi, Brian W. Pence
      Pages: 611 - 625
      Abstract: ABSTRACTBackground:Depression is highly prevalent among people living with HIV in Malawi. Depression can undermine engagement in HIV care and worsen HIV morbidity and mortality. The Ministry of Health integrated a pilot depression management program into HIV care at 2 clinics. This program included a measurement-based care protocol for prescribing antidepressants and an adapted Friendship Bench psychotherapy protocol for providing problem solving. Early evaluations indicated successful integration of the initial stages of training and depression screening, diagnosis, and treatment initiation. This follow-up mixed-method investigation contextualizes our previous findings and shares insights from the implementation experience.Methods:We conducted a mixed-methods process evaluation drawing on both patient clinical data and qualitative interviews with patients and clinic staff. We focus on the following implementation outcomes: fidelity, acceptability, and sustainability.Results:Although fidelity to depression screening and treatment initiation was high, fidelity to the follow-up treatment protocol was poor. Antidepressants and problem-solving therapy were acceptable to patients, but clinic staff found delivering treatment challenging given constrained human resources and infrastructure. The program was not sustained after the project. Key identified needs included substantial support to supervise the implementation of the program, continue to build and maintain the capacity of providers, integrate the program into the electronic medical records system, and ensure the availability of Friendship Bench counselors.Conclusions:Although initial steps were successful, sustained integration of this depression treatment program into HIV care in this setting met greater challenges. Implementation science studies that support both implementation and evaluation should recognize the potential for clinical implementers to rely on evaluation staff for clinical support and consider distancing evaluation staff from the actual program implementation. Further research is needed to test enhanced implementation strategies for integrating evidence-based mental health interventions into existing health care systems in a sustainable fashion, particularly in low-resource settings.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-20-00607
      Issue No: Vol. 9, No. 3 (2021)
       
  • Prioritizing Health-Sector Interventions for Noncommunicable Diseases and
           Injuries in Low- and Lower-Middle Income Countries: National NCDI Poverty
           Commissions

    • Authors: Neil Gupta; Ana Mocumbi, Said H. Arwal, Yogesh Jain, Abraham M. Haileamlak, Solomon T. Memirie, Nancy C. Larco, Gene F. Kwan, Mary Amuyunzu-Nyamongo, Gladwell Gathecha, Fred Amegashie, Vincent Rakotoarison, Jones Masiye, Emily Wroe, Bhagawan Koirala, Biraj Karmacharya, Jeanine Condo, Jean Pierre Nyemazi, Santigie Sesay, Sarah Maogenzi, Mary Mayige, Gerald Mutungi, Isaac Ssinabulya, Ann R. Akiteng, Justice Mudavanhu, Sharon Kapambwe, David Watkins, Ole Norheim, Julie Makani, Gene Bukhman, NCDI Poverty National Commissions Authorship Group; NCDI Poverty Network Secretariat
      Pages: 626 - 639
      Abstract: ABSTRACTHealth sector priorities and interventions to prevent and manage noncommunicable diseases and injuries (NCDIs) in low- and lower-middle-income countries (LLMICs) have primarily adopted elements of the World Health Organization Global Action Plan for NCDs 2013–2020. However, there have been limited efforts in LLMICs to prioritize among conditions and health-sector interventions for NCDIs based on local epidemiology and contextually relevant risk factors or that incorporate the equitable distribution of health outcomes. The Lancet Commission on Reframing Noncommunicable Diseases and Injuries for the Poorest Billion supported national NCDI Poverty Commissions to define local NCDI epidemiology, determine an expanded set of priority NCDI conditions, and recommend cost-effective, equitable health-sector interventions. Fifteen national commissions and 1 state-level commission were established from 2016–2019. Six commissions completed the prioritization exercise and selected an average of 25 NCDI conditions; 15 conditions were selected by all commissions, including asthma, breast cancer, cervical cancer, diabetes mellitus type 1 and 2, epilepsy, hypertensive heart disease, intracerebral hemorrhage, ischemic heart disease, ischemic stroke, major depressive disorder, motor vehicle road injuries, rheumatic heart disease, sickle cell disorders, and subarachnoid hemorrhage. The commissions prioritized an average of 35 health-sector interventions based on cost-effectiveness, financial risk protection, and equity-enhancing rankings. The prioritized interventions were estimated to cost an additional US$4.70–US$13.70 per capita or approximately 9.7%–35.6% of current total health expenditure (0.6%–4.0% of current gross domestic product). Semistructured surveys and qualitative interviews of commission representatives demonstrated positive outcomes in several thematic areas, including understanding NCDIs of poverty, informing national planning and implementation of NCDI health-sector interventions, and improving governance and coordination for NCDIs. Overall, national NCDI Poverty Commissions provided a platform for evidence-based, locally driven determination of priorities within NCDIs.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00035
      Issue No: Vol. 9, No. 3 (2021)
       
  • Animal Source Food Social and Behavior Change Communication Intervention
           Among Girinka Livestock Transfer Beneficiaries in Rwanda: A Cluster
           Randomized Evaluation

    • Authors: Valerie L. Flax; Emily Ouma, Lambert Izerimana, Mary-Ann Schreiner, Alice O. Brower, Eugene Niyonzima, Carine Nyilimana, Adeline Ufitinema, Agnes Uwineza
      Pages: 640 - 653
      Abstract: ABSTRACTAnimal source foods (ASFs), including cow’s milk, contain essential nutrients and contribute to a healthy diet, but frequency of intake is low among children in low- and middle-income countries. We hypothesized that an ASF social and behavior change communication (SBCC) intervention implemented by community health workers (CHWs) would increase child milk consumption and dietary diversity in households that received a cow from the Government of Rwanda’s Girinka livestock transfer program. We tested the 9-month SBCC intervention among children aged 12–29 months at baseline in administrative cells randomly assigned to the intervention or control. Most mothers in the intervention group were exposed to CHWs’ home visits (90.7%) or community-level activities (82.8%). At endline, more mothers in the intervention group compared with the control group knew that cow’s milk was an ASF (90.1% vs. 81.7%, P=.03) and could be introduced to children at 12 months (41.7% vs. 18.7%, P
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00082
      Issue No: Vol. 9, No. 3 (2021)
       
  • Qualitative Review of Organizational Responses to Rumors in the 2014-2016
           Ebola Virus Disease Outbreak in Liberia and Sierra Leone

    • Authors: Amelia J. Brandt; Bonnie Katalenich, David W. Seal
      Pages: 654 - 667
      Abstract: ABSTRACTIntroduction:Rumors and misperceptions were a persistent challenge in the response to the 2014–2016 Ebola Virus Disease (EVD) outbreak in West Africa. This study aimed to document organizational approaches to identifying and addressing rumors and provide practical recommendations for future outbreaks.Methods:We conducted semistructured interviews with 34 individuals who participated in the EVD response in Liberia and/or Sierra Leone. Interviews focused on the general organizational approach and organizational response to specific rumors. Interviews were recorded and transcribed verbatim.Results:Most respondents reported that rumors were considered an organizational priority and their importance increased over time. Formal rumor identification systems using community-level reporters were described in Liberia and Sierra Leone as well as varied informal systems. A wide range of approaches was used to address rumors including Community Led Ebola Action, Community Led Total Sanitation, drama performances, Ebola Treatment Center/Unit-based approaches, radio, leveraging community leaders as an information source, and organization change. Interpersonal and community-led approaches were described most often. Staff whose professional roles did not involve rumor management reported informally addressing rumors with colleagues and beneficiaries. Rumors reflecting valid concerns with the EVD response, such as potential infection in health care facilities, were addressed through organizational change and improvement.Discussion:Interpersonal and community-led approaches were considered effective by participants and hold promise for future outbreaks. Informal systems developed at Ebola Treatment Centers/Units highlighted how these facilities may be utilized as an information hub. Professionals who interact with beneficiaries, especially local staff, are likely to address rumors informally and organizations may benefit from considering local staff an asset in rumor management. Rumors alerted responders to issues in the EVD response, but this may not be the most efficient mechanism to receive and address concerns.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00203
      Issue No: Vol. 9, No. 3 (2021)
       
  • Using mHealth to Improve Timeliness and Quality of Maternal and Newborn
           Health in the Primary Health Care System in Ethiopia

    • Authors: Zeleke Yimechew Nigussie; Nebreed Fesseha Zemicheal, Gizachew Tadele Tiruneh, Yibeltal Tebekaw Bayou, Getnet Alem Teklu, Esubalew Sebsibe Kibret, Kristin Eifler, Sarah E. Hodsdon, Dessalew Emaway Altaye, Leona Rosenblum, Yeshiwork Aklilu Getu, Zinar Nebi, Ephrem Tekle Lemango, Eyob Kebede, Wuleta Aklilu Betemariam
      Pages: 668 - 681
      Abstract: ABSTRACTThe Last Ten Kilometers 2020 Project (L10K 2020) designed a strategy for piloting, implementing, and scaling a mobile health (mHealth) digital solution to improve the quality of community-level maternal and child health service delivery in Ethiopia. L10K 2020 first conducted a landscape assessment to design a context-appropriate smartphone-based mHealth solution for the Health Extension Workers and tablets for their supervisors and the midwives managing the same clients at the health center level. These applications included multiple modules and packages including client registration and appointment management; follow-up and notifications; digital job aids for each of the maternal and child health program packages (for Health Extension Workers only); and referral and client tracking systems.Findings from the process evaluation of the mHealth app usage and user experience indicated that the application was user-friendly and facilitated real-time information exchange, defaulter tracing, referral, and feedback systems. It improved the timely identification and registration of pregnant mothers. Adherence to treatment protocols also increased in all domains across the pregnancy continuum of care.L10K 2020 has developed a user-friendly model for implementing mHealth solutions at the community level through stakeholder engagement across levels when developing, testing, and deploying the applications, which was critical to effectively cultivating ownership as well as skills and knowledge transfer at all levels. To replicate and scale this model, context-based scoping, resource analysis, and mapping are essential to determine the infrastructure, cost, time, risks, and key stakeholders involved throughout the implementation of the intervention. During implementation, vigilance in consistently mitigating the challenges related to mHealth infrastructure, such as mobile data capacity, electricity, smartphones and tablets, solar chargers, and internet connectivity, is critical for continued success.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-20-00685
      Issue No: Vol. 9, No. 3 (2021)
       
  • Translating Implementation Experiences and Lessons Learned From Polio
           Eradication Into a Global Health Course: Insights From an International
           Consortium

    • Authors: Anna Kalbarczyk; Svea Closser, Aditi Rao, Oluwaseun Akinyemi, Humarya Binte Anwar, Eric Mafuta, Piyusha Majumdar, Olakunle O. Alonge
      Pages: 682 - 689
      Abstract: ABSTRACTLessons learned from one global health program can inform responses to challenges faced by other programs. One way to disseminate these lessons is through courses. However, such courses are often delivered by and taught to people based in high-income countries and thus may not present a truly global perspective. The Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) is a consortium of 8 institutions in Afghanistan, Bangladesh, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, and the United States that seeks to carry out such a transfer of the lessons learned in polio eradication. This short report describes the collaborative process of developing content and curriculum for an international course, the learnings that emerged, the barriers we faced, and recommendations for future similar efforts. Various parts of our course were developed by teams of researchers from countries across South Asia and sub-Saharan Africa. We held a series of regional in-person team meetings hosted in different countries to improve rapport and provide a chance to work together in person. The course content reflects the diversity of team members’ knowledge in a variety of contexts. Challenges to this effort included team coordination (e.g., scheduling across time zones); hierarchies across and between countries; and the coronavirus disease (COVID-19) pandemic. We recommend planning for these hierarchies ahead of time and ensuring significant in-person meeting time to make the most of international collaboration.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-20-00460
      Issue No: Vol. 9, No. 3 (2021)
       
  • An International Virtual Classroom: The Emergency Department Experience at
           Weill Cornell Medicine and Weill Bugando Medical Center in Tanzania

    • Authors: Lynn G. Jiang; Peter W. Greenwald, Michael J. Alfonzo, Jane Torres-Lavoro, Manish Garg, Ally Munir Akrabi, Erasto Sylvanus, Shahzmah Suleman, Radhika Sundararajan
      Pages: 690 - 697
      Abstract: ABSTRACTEmergency medicine (EM) is rapidly being recognized as a specialty around the globe. This has particular promise for low- and middle-income countries (LMICs) that experience the largest burden of disease for emergency conditions. Specialty education and training in EM remain essentially an apprenticeship model. Finding the required expertise to educate graduate learners can be challenging in regions where there are low densities of specialty providers.We describe an initiative to implement a sustainable, bidirectional partnership between the Emergency Medicine Departments of Weill Cornell Medicine (WCM) in New York, NY, USA, and Bugando Medical Center (BMC) in Mwanza, Tanzania. We used synchronous and asynchronous telecommunication technology to enhance an ongoing emergency medicine education collaboration.The Internet infrastructure for this collaboration was created by bolstering 4G services available in Mwanza, Tanzania. By maximizing the 4G signal, sufficient bandwidth could be created to allow for live 2-way audio/video communication. Using synchronous and asynchronous applications such as Zoom and WhatsApp, providers at WCM and BMC can attend real-time didactic lectures, participate in discussion forums on clinical topics, and collaborate on the development of clinical protocols. Proof of concept exercises demonstrated that this system can be used for real-time mentoring in EKG interpretation and ultrasound technique, for example. This system was also used to share information and develop operations flows during the COVID-19 pandemic. The use of telecommunication technology and e-learning in a format that promotes long-term, sustainable interaction is practical and innovative, provides benefit to all partners, and should be considered as a mechanism by which global partnerships can assist with training in emergency medicine in LMICs.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00005
      Issue No: Vol. 9, No. 3 (2021)
       
  • Implementation of GeneXpert for TB Testing in Low- and Middle-Income
           Countries: A Systematic Review

    • Authors: Scott Brown; Justine E. Leavy, Jonine Jancey
      Pages: 698 - 710
      Abstract: ABSTRACTIntroduction:Current evidence indicates that the impact of GeneXpert for diagnosing TB in low- and middle-income countries (LMICs) has not demonstrated equivalent outcomes when compared to Xpert evaluations in upper-middle-income countries. Challenges associated with implementation are possible contributing factors preventing this innovative diagnostic technology from achieving more significant public health outcomes. This review aimed to assess the use of implementation science frameworks when reporting the enablers and barriers for the implementation of GeneXpert for diagnosing TB in LMICs.Methods:We conducted a qualitative systematic review of the peer-reviewed literature using PubMed, Medline, and Scopus. Eligible articles were those published between January 2010 and March 2020 that identified enablers and barriers to GeneXpert implementation, as well as the implementation approach delivered in an LMIC.Results:Eleven studies were included in the review. Implementation barriers were found to be relatively consistent across studies and included patient-level factors, human resources, material resources, service implementation, service coordination, and technical operations. Few studies (n=5) identified enabling factors in the implementation of Xpert for TB testing. Identified enablers included strategies such as active case finding, expanding diagnostic algorithms, and daily transport of samples. The public health impact of Xpert TB testing interventions was commonly influenced by implementation barriers (n=4). Of the 11 studies, only 3 reported against an implementation framework.Conclusion:This review identified a commonality in implementation barriers and enablers that influenced the overall public health impact of GeneXpert. With greater transparency of these barriers and enablers, program planners can promote a more collaborative approach and adapt interventions. It is recommended that program planners use implementation science frameworks when conducting research and publishing. This will build an evidence base focused on implementation and thereby support programs to address implementation barriers and include enabling factors in program design.
      PubDate: 2021-09-30T05:37:00-07:00
      DOI: 10.9745/GHSP-D-21-00121
      Issue No: Vol. 9, No. 3 (2021)
       
 
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