Poverty Mapping Project: Global Subnational Prevalence of Child Malnutrition

Data.gov (United States)

National Aeronautics and Space Administration — The Global Subnational Prevalence of Child Malnutrition dataset consists of estimates of the percentage of children with weight-for-age z-scores that are more than...

Predicting Subnational Ebola Virus Disease Epidemic Dynamics from Sociodemographic Indicators.

Directory of Open Access Journals (Sweden)

Linda Valeri

Full Text Available The recent Ebola virus disease (EVD outbreak in West Africa has spread wider than any previous human EVD epidemic. While individual-level risk factors that contribute to the spread of EVD have been studied, the population-level attributes of subnational regions associated with outbreak severity have not yet been considered.To investigate the area-level predictors of EVD dynamics, we integrated time series data on cumulative reported cases of EVD from the World Health Organization and covariate data from the Demographic and Health Surveys. We first estimated the early growth rates of epidemics in each second-level administrative district (ADM2 in Guinea, Sierra Leone and Liberia using exponential, logistic and polynomial growth models. We then evaluated how these growth rates, as well as epidemic size within ADM2s, were ecologically associated with several demographic and socio-economic characteristics of the ADM2, using bivariate correlations and multivariable regression models.The polynomial growth model appeared to best fit the ADM2 epidemic curves, displaying the lowest residual standard error. Each outcome was associated with various regional characteristics in bivariate models, however in stepwise multivariable models only mean education levels were consistently associated with a worse local epidemic.By combining two common methods-estimation of epidemic parameters using mathematical models, and estimation of associations using ecological regression models-we identified some factors predicting rapid and severe EVD epidemics in West African subnational regions. While care should be taken interpreting such results as anything more than correlational, we suggest that our approach of using data sources that were publicly available in advance of the epidemic or in real-time provides an analytic framework that may assist countries in understanding the dynamics of future outbreaks as they occur.

A new multidimensional population health indicator for policy makers: absolute level, inequality and spatial clustering - an empirical application using global sub-national infant mortality data

Directory of Open Access Journals (Sweden)

Benn K.D. Sartorius

2014-11-01

Full Text Available The need for a multidimensional measure of population health that accounts for its distribution remains a central problem to guide the allocation of limited resources. Absolute proxy measures, like the infant mortality rate (IMR, are limi- ted because they ignore inequality and spatial clustering. We propose a novel, three-part, multidimensional mortality indi- cator that can be used as the first step to differentiate interventions in a region or country. The three-part indicator (MortalityABC index combines absolute mortality rate, the Theil Index to calculate mortality inequality and the Getis-Ord G statistic to determine the degree of spatial clustering. The analysis utilises global sub-national IMR data to empirically illu- strate the proposed indicator. The three-part indicator is mapped globally to display regional/country variation and further highlight its potential application. Developing countries (e.g. in sub-Saharan Africa display high levels of absolute mortality as well as variable mortality inequality with evidence of spatial clustering within certain sub-national units (“hotspots”. Although greater inequality is observed outside developed regions, high mortality inequality and spatial clustering are com- mon in both developed and developing countries. Significant positive correlation was observed between the degree of spatial clustering and absolute mortality. The proposed multidimensional indicator should prove useful for spatial allocation of healthcare resources within a country, because it can prompt a wide range of policy options and prioritise high-risk areas. The new indicator demonstrates the inadequacy of IMR as a single measure of population health, and it can also be adapted to lower administrative levels within a country and other population health measures.

National and Subnational Population-Based Incidence of Cancer in Thailand: Assessing Cancers with the Highest Burdens

Directory of Open Access Journals (Sweden)

Shama Virani

2017-08-01

Full Text Available In Thailand, five cancer types—breast, cervical, colorectal, liver and lung cancer—contribute to over half of the cancer burden. The magnitude of these cancers must be quantified over time to assess previous health policies and highlight future trajectories for targeted prevention efforts. We provide a comprehensive assessment of these five cancers nationally and subnationally, with trend analysis, projections, and number of cases expected for the year 2025 using cancer registry data. We found that breast (average annual percent change (AAPC: 3.1% and colorectal cancer (female AAPC: 3.3%, male AAPC: 4.1% are increasing while cervical cancer (AAPC: −4.4% is decreasing nationwide. However, liver and lung cancers exhibit disproportionately higher burdens in the northeast and north regions, respectively. Lung cancer increased significantly in northeastern and southern women, despite low smoking rates. Liver cancers are expected to increase in the northern males and females. Liver cancer increased in the south, despite the absence of the liver fluke, a known factor, in this region. Our findings are presented in the context of health policy, population dynamics and serve to provide evidence for future prevention strategies. Our subnational estimates provide a basis for understanding variations in region-specific risk factor profiles that contribute to incidence trends over time.

Understanding the Complexities of Subnational Incentives in Supporting a National Market for Distributed Photovoltaics

Energy Technology Data Exchange (ETDEWEB)

Bush, B.; Doris, E.; Getman, D.

2014-09-01

Subnational policies pertaining to photovoltaic (PV) systems have increased in volume in recent years and federal incentives are set to be phased out over the next few. Understanding how subnational policies function within and across jurisdictions, thereby impacting PV market development, informs policy decision making. This report was developed for subnational policy-makers and researchers in order to aid the analysis on the function of PV system incentives within the emerging PV deployment market. The analysis presented is based on a 'logic engine,' a database tool using existing state, utility, and local incentives allowing users to see the interrelationships between PV system incentives and parameters, such as geographic location, technology specifications, and financial factors. Depending on how it is queried, the database can yield insights into which combinations of incentives are available and most advantageous to the PV system owner or developer under particular circumstances. This is useful both for individual system developers to identify the most advantageous incentive packages that they qualify for as well as for researchers and policymakers to better understand the patch work of incentives nationwide as well as how they drive the market.

Multilevel governance challenges in transitioning towards a national approach for REDD+: evidence from 23 subnational REDD+ initiatives

Directory of Open Access Journals (Sweden)

Ashwin Ravikumar

2015-09-01

Full Text Available Although REDD+ was conceived as a national approach to reducing emissions from deforestation and degradation, many of the early advances have been at the subnational level. It is critical to link these subnational efforts to emerging national REDD+ frameworks, including with respect to finance and benefit distribution, setting reference levels, measurement, reporting and verification (MRV, land policy and safeguards. We use evidence from interviews with proponents from 23 subnational REDD+ initiatives in six countries to characterize the multilevel governance challenges for REDD+. We analyse the differences in perceived challenges between subnational jurisdictional programs and project-based initiatives, and then analyse proponents’ perceptions of the relationship between government policies at multiple levels and these REDD+ initiatives. We find important multilevel governance challenges related to vertical coordination and information sharing and horizontal and inter-sectoral tensions, as well as concerns over accountability, equity and justice. Though the shift to a nested, jurisdictional or national REDD+ is sometimes approached as a technical design issue, this must be accompanied by an understanding of the interests and power relations among actors at different levels. We outline challenges and suggest priority areas for future research and policy, as countries move towards a national REDD+ system.

Air pollution co-benefits of low carbon policies in road transport: a sub-national assessment for India

Science.gov (United States)

Mittal, Shivika; Hanaoka, Tatsuya; Shukla, Priyadarshi R.; Masui, Toshihiko

2015-08-01

This letter assesses low carbon scenarios for India at the subnational level in the passenger road transport sector. We estimate the future passenger mobility demand and assess the impact of carbon mitigation policies using the Asia-Pacific Integrated Assessment/Enduse models. This letter focuses on the transitions of energy and emissions of passenger transport in India in alternate scenarios i.e. the business-as-usual scenario and a low carbon scenario that aligns to the 2 °C temperature stabilization target agreed under the global climate change negotiations. The modelling results show that passenger mobility demand will rise in all sub-national regions of India in the coming few decades. However, the volume and modal structure will vary across regions. Modelling assessment results show that aligning global low carbon policies with local policies has potential to deliver significant air quality co-benefits. This analysis provides insights into the comparative dynamics of environmental policymaking at sub-national levels.

Air pollution co-benefits of low carbon policies in road transport: a sub-national assessment for India

International Nuclear Information System (INIS)

Mittal, Shivika; Hanaoka, Tatsuya; Masui, Toshihiko; Shukla, Priyadarshi R

2015-01-01

This letter assesses low carbon scenarios for India at the subnational level in the passenger road transport sector. We estimate the future passenger mobility demand and assess the impact of carbon mitigation policies using the Asia–Pacific Integrated Assessment/Enduse models. This letter focuses on the transitions of energy and emissions of passenger transport in India in alternate scenarios i.e. the business-as-usual scenario and a low carbon scenario that aligns to the 2 °C temperature stabilization target agreed under the global climate change negotiations. The modelling results show that passenger mobility demand will rise in all sub-national regions of India in the coming few decades. However, the volume and modal structure will vary across regions. Modelling assessment results show that aligning global low carbon policies with local policies has potential to deliver significant air quality co-benefits. This analysis provides insights into the comparative dynamics of environmental policymaking at sub-national levels. (letter)

Impacts of National Decarbonization Targets for Subnational Societal Priorities

Science.gov (United States)

Peng, W.; Iyer, G.

2017-12-01

Carbon mitigation has well-recognized linkages with other environmental and socioeconomic priorities, such as air pollution, economic development, employment, etc. While climate change is a global issue, many other societal priorities are local concerns. Since local efforts form the pillars of achieving co-benefits and avoiding dis-benefits at the national level, it is critical to go beyond national-level analyses and focus on the synergies and tradeoffs at the subnational level. Here we use the United States as an example to evaluate the impacts of mid-century national-level deep decarbonization target for state-level societal priorities. Based on the Global Change Assessment Model with state-level details for the US (GCAM-USA), we design two mid-century scenarios: A Reference scenario that assumes the U.S. undertakes no additional climate mitigation policy, and a Deep Decarbonization Scenario that assumes the U.S. achieves the NDC goal through 2025 (26-28% reduction relative to 2005 levels) and then follows a straight-line trajectory to 80% reductions in economy-wide GHG emissions by 2050 relative to 2005. We then compare these two scenarios for a variety of metrics of carbon mitigation and other societal priorities in 2050. We highlight two findings. First, the synergies and tradeoffs of carbon mitigation with other societal goals at the subnational level can be quite different from the national level. For example, while deep decarbonization could improve national energy security by reducing the overall dependence on energy imports, it may exacerbate energy independence goals for some states by increasing inter-state electricity imports. Second, achieving national-level decarbonization target could result in unequal regional impacts across states. We find uneven geographic impacts for air pollution (more co-reductions occur in the eastern states), economic costs (energy prices increase more in the northeastern states) and employment (jobs increase in the western

Policy stakeholders and deployment of wind power in the sub-national context: A comparison of four U.S. states

International Nuclear Information System (INIS)

Fischlein, Miriam; Larson, Joel; Hall, Damon M.; Chaudhry, Rumika; Rai Peterson, Tarla; Stephens, Jennie C.; Wilson, Elizabeth J.

2010-01-01

As climate change mitigation gains attention in the United States, low-carbon energy technologies such as wind power encounter both opportunities and barriers en route to deployment. This paper provides a state-level context for examining wind power deployment and presents research on how policy stakeholders perceive wind energy in four states: Massachusetts, Minnesota, Montana, and Texas. Through semi-structured interviews, state-level energy policy stakeholders were asked to explain their perceptions of wind energy technology within their state. Interview texts were coded to assess how various drivers promote or hinder the deployment of wind power in sub-national contexts. Responses were dominated by technical, political, and economic frames in all four states, but were often driven by a very different rationale. Environmental, aesthetic, and health/safety frames appeared less often in the discourse. This analysis demonstrates that each state arrived at its current level of deployment via very different political, economic, and technical paths. In addition to helping explain why and how wind technology was - or was not - deployed in each of these states, these findings provide insight into the diversity of sub-national dialogues on deployment of low-carbon energy technologies.

Innovations in Sub-National Government in Europe Innovations in Sub-National Government in Europe

Directory of Open Access Journals (Sweden)

Linze Schaap

2010-12-01

Full Text Available La mejora del gobierno se encuentra arraigada con frecuencia en los niveles descentralizados. En este artículo es el cambio dentro del gobierno mismo, principalmente la emergencia de la “gobernanza” y el cambio en el tamaño administrativo. Las reformas estructurales adoptan formas diversas: el aumento del tamaño para mejorar la capacidad del sistema, el aumento del tamaño para favorecer la participación ciudadana, y la reducción del tamaño para favorecer asimismo la participación ciudadana. Además, se advierten nuevas formas de acción dentro de los mismos gobiernos: cooperación transfronteriza, cooperación intermunicipal y nuevas formas de evaluación del rendimiento y de la gestión financiera. Los autores concluyen el artículo mencionando algunos desafíos para los académicos y para los gobiernos.Improvement in government is often rooted in decentralised layers of government. In this article the authors discuss the recent history of innovations in sub-national government in Europe. They focus on two general trends and developments. Cases of interesting practices and developments illustrate the general trends. For each general trend a distinction is made between two kinds of innovations: structural reforms and new ways of working within existing institutional settings. The first trend concerns changing relations between government, civil society and citizens, in response to the increased contestation of the nature of traditional representative democracy. Examples of structural reforms are: increased citizen participation, the expanded use of referenda and the introduction of the directly elected mayor. New ways of working are: forms of coproduction between the public sector and the third sector. The second trend described in this article is change within government itself, mainly the rise of ‘governance’ and changing administrative scales. Structural reforms take several forms: scale enlargement to enhance system capacity

One Health stakeholder and institutional analysis in Kenya

Science.gov (United States)

Kimani, Tabitha; Ngigi, Margaret; Schelling, Esther; Randolph, Tom

2016-01-01

Introduction One Health (OH) can be considered a complex emerging policy to resolve health issues at the animal–human and environmental interface. It is expected to drive system changes in terms of new formal and informal institutional and organisational arrangements. This study, using Rift Valley fever (RVF) as a zoonotic problem requiring an OH approach, sought to understand the institutionalisation process at national and subnational levels in an early adopting country, Kenya. Materials and methods Social network analysis methodologies were used. Stakeholder roles and relational data were collected at national and subnational levels in 2012. Key informants from stakeholder organisations were interviewed, guided by a checklist. Public sector animal and public health organisations were interviewed first to identify other stakeholders with whom they had financial, information sharing and joint cooperation relationships. Visualisation of the OH social network and relationships were shown in sociograms and mathematical (degree and centrality) characteristics of the network summarised. Results and discussion Thirty-two and 20 stakeholders relevant to OH were identified at national and subnational levels, respectively. Their roles spanned wildlife, livestock, and public health sectors as well as weather prediction. About 50% of national-level stakeholders had made significant progress on OH institutionalisation to an extent that formal coordination structures (zoonoses disease unit and a technical working group) had been created. However, the process had not trickled down to subnational levels although cross-sectoral and sectoral collaborations were identified. The overall binary social network density for the stakeholders showed that 35 and 21% of the possible ties between the RVF and OH stakeholders existed at national and subnational levels, respectively, while public health actors’ collaborations were identified at community/grassroots level. We recommend

Sub-national entities’ participation in Brazil’s foreign policy and in regional integration processes

Directory of Open Access Journals (Sweden)

Deisy Ventura

2012-09-01

Full Text Available This article focuses on how sub-national entities’ gradual participation in Brazilian foreign policy has come about, with reference to a decentralised scenario of the decision-making process in Itamaraty, where the ministries and presidential organs have a voice on many strategic themes, mainly concerning development. The article examines the insertion of sub-national entities into the decision-making process in the Southern Common Market (Mercosur, and concludes that in spite of the incipient participation, relevant contributions to the process of regional integration have arisen. Regarding the hypothesis that the participation of the federative entities in the decision-making process generates local and regional development, we argue that this is an alternative to increasing state efficiency. In conclusion, and despite the incipient institutionalisation that does not guarantee their vote in the decision-making process, at least their voice is heard.

SECURITY RISKS, MYTHS IN A TRANSITIONING SUB-NATIONAL REGIONAL ECONOMY (CROSS RIVER STATE AND IMAGINATIVE GEOGRAPHIES OF NIGERIA

Directory of Open Access Journals (Sweden)

J. K. UKWAYI

2015-03-01

Full Text Available The emergence of an “international community” through accumulation of perceived risks that contrasts with those risks (of considerably lower levels of seriousness compared to those perceived constitutes one of the interesting (or intriguing subjects of risks and disaster studies surrounding the 9/11 era. The constructions of “imaginative geographies”, have frequently been biased in the practices that underlie the mapping of the foreign places tend to put-down the affected regions in their “paintings” for the global community. The latter are subsequently “demonized” in their ratings of competence for participating in world trade, tourism, travel, among other social/cultural, and economic and political activities. The objective of this article is to highlight how the exaggeration of risks (contrasted to actually existing/lived risks, practices that are frequently associated with such adverse “imaginative geographies” poses sub-national regional development dilemma in Nigeria’s Niger Delta. We trace the roots of adverse “imaginative geographies” of Nigeria to the Abacha dictatorship (1993-1997. Then we highlight the mixed characteristics of the Niger Delta conditions during the “return of positive image recapture” by Nigeria’s federal government (re-democratisation of the Fourth Republic, 1999-present, re-branding campaigns; as well as adverse conditions present. Most significantly, we show that despite these adversities, a combination of favorable geographical size, differentiation, sub-national regional security programme formulation and management taking aims at diversification have created “large oases” of peace and security in Cross River State, a part of the Niger Delta that has been completely unscathed by insurgencies of the nearby sub-national region and further away national origin. Apart from identifying sub-national regions qualifying for delisting from “adverse imaginative geographies” due to

A systematic review of sub-national food insecurity research in South Africa: Missed opportunities for policy insights

Science.gov (United States)

Misselhorn, Alison

2017-01-01

Food insecurity is an intractable problem in South Africa. The country has a tradition of evidence-based decision making, grounded in the findings of national surveys. However, the rich insights from sub-national surveys remain a largely untapped resource for understandings of the contextual experience of food insecurity. A web-based search identified 169 sub-national food insecurity studies conducted in the post-apartheid period between 1994 and 2014. The systematic review found that the studies used 27 different measures of food insecurity, confounding the comparative analysis of food insecurity at this level. While social grants have brought a measure of poverty relief at household level, unaffordable diets were the root cause of food insecurity. The increasing consumption of cheaper, more available and preferred ‘globalised’ foods with high energy content and low nutritional value lead to overweight and obesity alongside child stunting. Unless a comparable set of indicators is used in such surveys, they are not able to provide comparable information on the scope and scale of the problem. Policy makers should be engaging with researchers to learn from these studies, while researchers need to share this wealth of sub-national study findings with government to strengthen food security planning, monitoring, and evaluation at all levels. PMID:28829787

A systematic review of sub-national food insecurity research in South Africa: Missed opportunities for policy insights.

Directory of Open Access Journals (Sweden)

Alison Misselhorn

Full Text Available Food insecurity is an intractable problem in South Africa. The country has a tradition of evidence-based decision making, grounded in the findings of national surveys. However, the rich insights from sub-national surveys remain a largely untapped resource for understandings of the contextual experience of food insecurity. A web-based search identified 169 sub-national food insecurity studies conducted in the post-apartheid period between 1994 and 2014. The systematic review found that the studies used 27 different measures of food insecurity, confounding the comparative analysis of food insecurity at this level. While social grants have brought a measure of poverty relief at household level, unaffordable diets were the root cause of food insecurity. The increasing consumption of cheaper, more available and preferred 'globalised' foods with high energy content and low nutritional value lead to overweight and obesity alongside child stunting. Unless a comparable set of indicators is used in such surveys, they are not able to provide comparable information on the scope and scale of the problem. Policy makers should be engaging with researchers to learn from these studies, while researchers need to share this wealth of sub-national study findings with government to strengthen food security planning, monitoring, and evaluation at all levels.

A Subnational Perspective for Comparative Research: Education and Development in Northeast Brazil and Northeast Thailand.

Science.gov (United States)

Fry, Gerald; Kempner, Ken

1996-01-01

Case studies of northeast Brazil and northeast Thailand highlight the importance of a subnational approach to comparative research. Compares geographic and economic conditions, regional culture, ethnicity and gender issues, migration patterns, religion, literacy, and educational underdevelopment. Points out that neglect of a region and its people…

Neo-Patrimonialism and Subnational Authoritarianism in Mexico. The Case of Oaxaca Neopatrimonialismo y autoritarismo subnacional en México. El caso de Oaxaca

Directory of Open Access Journals (Sweden)

Julián Durazo Herrmann

2010-01-01

Full Text Available How do subnational authoritarian enclaves emerge (or survive ina democratic transition at the federal level? How can they endure large-scalesocial protests, like the one that shook Oaxaca in 2006? While federal tolerancefor subnational authoritarian practices is a necessary condition, it isinsufficient in itself to explain why subnational political systems sustain andeventually reproduce authoritarian practices in the first place. In this article,therefore, I focus on the internal dimension of subnational authoritarianism.I argue that, because of its reliance on two distinct sources of legitimacy,Oaxaca’s neo-patrimonial domination system was able to respond to theformal democratizing pressures emanating from the federal transition withoutlosing its authoritarian nature. This process of hybridization transformedOaxacan institutions, but left social structures and the political dynamics thatemerge from them – the sources of subnational authoritarianism – almostintact. By exploring the evolution of neo-patrimonialism and hybridizationin Oaxaca from a theoretical perspective, I address the issues of change andcontinuity in the emergence of subnational authoritarian enclaves, in Mexicoand elsewhere. ¿Cómo es que algunos enclaves autoritarios subnacionales emergen (o susbsisten tras las transiciones a la democracia de sus federaciones? ¿Cómo sobreviven a movilizaciones masivas como las que conoció Oaxaca en 2006? La tolerancia federal es una condición necesaria para el desarrollo de las prácticas autoritarias subnacionales, pero es insuficiente para explicar cómo dichas prácticas aparecen y se reproducen en algunos sistemas políticos subnacionales. Por ello, en este artículo estudio la dimensión interna del autoritarismo subnacional. Arguyo que, al basarse en dos fuentes distintas de legitimidad, el sistema oaxaqueño de dominación neopatrimonial fue capaz de responder a las presiones democráticas provenientes de la federaci

Internal Variations in Health-care Federalism in Canada and the United States

Directory of Open Access Journals (Sweden)

Vandna Bhatia

2014-12-01

Full Text Available Federal systems are prone to dividing health benefits inconsistently across subnational jurisdictions. In this article, we examine how federalism intersects with economic and social factors, particularly gender and immigration status, to create structural barriers to accessing and receiving necessary healthcare. Drawing on insights from the historical institutionalist literature and the experiences of immigrant women in the Canadian and American health systems, we find significant subnational variations in access to health services and insurance coverage. Gaps in service – which are filled (if at all by costly, inaccessible private provision – are the product of piecemeal policymaking, as new programs and services are layered onto existing systems which are themselves outdated and anachronistic. Our analysis demonstrates the need to move beyond analyses of federal state architectures to an intersectional approach to better understand the differential negative impact of subnational variations on equity between social groups and their ability to access to basic health services.

Public Health Authority of the Slovak Republic

International Nuclear Information System (INIS)

Gaal, P.

2005-01-01

In this presentation author deals with the role of the Public Health Authority of the Slovak Republic in radiation protection in the Slovak Republic. Public Health Authority is budgetary organization, which depends on the funding of the Ministry of Health. As the state administration authority performs execution of state regulatory activities in the field of health protection in Slovak republic and radiation protection as well. Radiation Protection Supervision is performed according to the act on public health protection. Organization scheme of radiation protection in the Slovak Republic is presented

Inequalities in health: approaches by health authorities in an English health region.

Science.gov (United States)

McCarron, P; Yates, B

2000-06-01

In 1995 the Department of Health published Variations in health: what can the Department of Health do? This recommended that health authorities should have a comprehensive plan for identifying and tackling variations in health. We investigated how health authorities in the South and West Region were taking forward this work. Semi-structured interviews and reviews of documentation were conducted in all health authorities in the South and West Region of England. All health authorities viewed tackling inequalities in health as important; however, explicit strategies did not exist and Health of the Nation targets were a vehicle for determining priorities of inequalities. Explicit corporate commitment was often weak. Analyses were being conducted to determine the magnitude of local health inequalities and to assist in designing appropriate interventions. The importance of alliance working was highlighted; much work was being done although success was variable. Efforts are being made throughout the South and West region to tackle inequalities in health. Although strategic vision at the corporate level was often lacking, there was evidence of commitment to taking the inequalities agenda forward within public health directorates. Strengthening of primary care and alliance working roles is essential. Recent national strategy documents, forthcoming legislation, and a review of health inequalities recognize the health effects of inequalities and require health authorities to collaborate with local partners to tackle these, and will offer opportunities to improve corporate commitment and alliance working. Uptake and success of these opportunities will have a major influence on progress in tackling health inequalities.

National and subnational all-cause and cause-specific child mortality in China, 1996-2015: a systematic analysis with implications for the Sustainable Development Goals.

Science.gov (United States)

He, Chunhua; Liu, Li; Chu, Yue; Perin, Jamie; Dai, Li; Li, Xiaohong; Miao, Lei; Kang, Leni; Li, Qi; Scherpbier, Robert; Guo, Sufang; Rudan, Igor; Song, Peige; Chan, Kit Yee; Guo, Yan; Black, Robert E; Wang, Yanping; Zhu, Jun

2017-02-01

China has achieved Millennium Development Goal 4 to reduce under-5 mortality rate by two-thirds between 1990 and 2015. In this study, we estimated the national and subnational levels and causes of child mortality in China annually from 1996 to 2015 to draw implications for achievement of the SDGs for China and other low-income and middle-income countries. In this systematic analysis, we adjusted empirical data on levels and causes of child mortality collected in the China Maternal and Child Health Surveillance System to generate representative estimates at the national and subnational levels. In adjusting the data, we considered the sampling design and probability, applied smoothing techniques to produce stable trends, fitted livebirth and age-specific death estimates to natvional estimates produced by the UN for international comparison, and partitioned national estimates of infrequent causes produced by independent sources to the subnational level. Between 1996 and 2015, the under-5 mortality rate in China declined from 50·8 per 1000 livebirths to 10·7 per 1000 livebirths, at an average annual rate of reduction of 8·2%. However, 181 600 children still died before their fifth birthday, with 93 400 (51·5%) deaths occurring in neonates. Great inequity exists in child mortality across regions and in urban versus rural areas. The leading causes of under-5 mortality in 2015 were congenital abnormalities (35 700 deaths, 95% uncertainty range [UR] 28 400-45 200), preterm birth complications (30 900 deaths, 24 200-40 800), and injuries (26 600 deaths, 21 000-33 400). Pneumonia contributed to a higher proportion of deaths in the western region of China than in the eastern and central regions, and injury was a main cause of death in rural areas. Variations in cause-of-death composition by age were also examined. The contribution of preterm birth complications to mortality decreased after the neonatal period; congenital abnormalities remained an

Contextualizing Obesity and Diabetes Policy: Exploring a Nested Statistical and Constructivist Approach at the Cross-National and Subnational Government Level in the United States and Brazil

Directory of Open Access Journals (Sweden)

Eduardo J. Gómez

2017-11-01

Full Text Available Background This article conducts a comparative national and subnational government analysis of the political, economic, and ideational constructivist contextual factors facilitating the adoption of obesity and diabetes policy. Methods We adopt a nested analytical approach to policy analysis, which combines cross-national statistical analysis with subnational case study comparisons to examine theoretical prepositions and discover alternative contextual factors; this was combined with an ideational constructivist approach to policy-making. Results Contrary to the existing literature, we found that with the exception of cross-national statistical differences in access to healthcare infrastructural resources, the growing burden of obesity and diabetes, rising healthcare costs and increased citizens’ knowledge had no predictive affect on the adoption of obesity and diabetes policy. We then turned to a subnational comparative analysis of the states of Mississippi in the United States and Rio Grande do Norte in Brazil to further assess the importance of infrastructural resources, at two units of analysis: the state governments versus rural municipal governments. Qualitative evidence suggests that differences in subnational healthcare infrastructural resources were insufficient for explaining policy reform processes, highlighting instead other potentially important factors, such as state-civil societal relationships and policy diffusion in Mississippi, federal policy intervention in Rio Grande do Norte, and politicians’ social construction of obesity and the resulting differences in policy roles assigned to the central government. Conclusion We conclude by underscoring the complexity of subnational policy responses to obesity and diabetes, the importance of combining resource and constructivist analysis for better understanding the context of policy reform, while underscoring the potential lessons that the United States can learn from Brazil.

Estimation of maternal and neonatal mortality at the subnational level in Liberia.

Science.gov (United States)

Moseson, Heidi; Massaquoi, Moses; Bawo, Luke; Birch, Linda; Dahn, Bernice; Zolia, Yah; Barreix, Maria; Gerdts, Caitlin

2014-11-01

To establish representative local-area baseline estimates of maternal and neonatal mortality using a novel adjusted sisterhood method. The status of maternal and neonatal health in Bomi County, Liberia, was investigated in June 2013 using a population-based survey (n=1985). The standard direct sisterhood method was modified to account for place and time of maternal death to enable calculation of subnational estimates. The modified method of measuring maternal mortality successfully enabled the calculation of area-specific estimates. Of 71 reported deaths of sisters, 18 (25.4%) were due to pregnancy-related causes and had occurred in the past 3 years in Bomi County. The estimated maternal mortality ratio was 890 maternal deaths for every 100 000 live births (95% CI, 497-1301]. The neonatal mortality rate was estimated to be 47 deaths for every 1000 live births (95% CI, 42-52). In total, 322 (16.9%) of 1900 women with accurate age data reported having had a stillbirth. The modified direct sisterhood method may be useful to other countries seeking a more regionally nuanced understanding of areas in which neonatal and maternal mortality levels still need to be reduced to meet Millennium Development Goals. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Implementing a sub-national strategic framework to reduce the illicit tobacco market to support national strategies

Directory of Open Access Journals (Sweden)

Ailsa Rutter

2018-03-01

The success of this strategic framework demonstrates that activity can be co-ordinated locally or sub-nationally to support national strategies to reduce the illicit tobacco market. Activity should always be placed within the broader context of 'all tobacco kills' and should contain measures to reduce both supply and demand. Useful resources for other programmes and settings can be found at www.illicit-tobacco.co.uk.

Combining high-resolution gross domestic product data with home and personal care product market research data to generate a subnational emission inventory for Asia.

Science.gov (United States)

Hodges, Juliet Elizabeth Natasha; Vamshi, Raghu; Holmes, Christopher; Rowson, Matthew; Miah, Taqmina; Price, Oliver Richard

2014-04-01

Environmental risk assessment of chemicals is reliant on good estimates of product usage information and robust exposure models. Over the past 20 to 30 years, much progress has been made with the development of exposure models that simulate the transport and distribution of chemicals in the environment. However, little progress has been made in our ability to estimate chemical emissions of home and personal care (HPC) products. In this project, we have developed an approach to estimate subnational emission inventory of chemical ingredients used in HPC products for 12 Asian countries including Bangladesh, Cambodia, China, India, Indonesia, Laos, Malaysia, Pakistan, Philippines, Sri Lanka, Thailand, and Vietnam (Asia-12). To develop this inventory, we have coupled a 1 km grid of per capita gross domestic product (GDP) estimates with market research data of HPC product sales. We explore the necessity of accounting for a population's ability to purchase HPC products in determining their subnational distribution in regions where wealth is not uniform. The implications of using high resolution data on inter- and intracountry subnational emission estimates for a range of hypothetical and actual HPC product types were explored. It was demonstrated that for low value products (500 US$ per capita/annum required to purchase product) the implications on emissions being assigned to subnational regions can vary by several orders of magnitude. The implications of this on conducting national or regional level risk assessments may be significant. Further work is needed to explore the implications of this variability in HPC emissions to enable the HPC industry and/or governments to advance risk-based chemical management policies in emerging markets. © 2013 SETAC.

Carbon inequality at the sub-national scale: A case study of provincial-level inequality in CO2 emissions in China 1997-2007

International Nuclear Information System (INIS)

Clarke-Sather, Afton; Qu Jiansheng; Wang Qin; Zeng Jingjing; Li Yan

2011-01-01

This study asks whether sub-national inequalities in carbon dioxide (CO 2 ) emissions mirror international patterns in carbon inequality using the case study of China. Several studies have examined global-level carbon inequality; however, such approaches have not been used on a sub-national scale. This study examines inter-provincial inequality in CO 2 emissions within China using common measures of inequality (coefficient of variation, Gini Index, Theil Index) to analyze provincial-level data derived from the IPCC reference approach for the years 1997-2007. It decomposes CO 2 emissions inequality into its inter-regional and intra-regional components. Patterns of per capita CO 2 emissions inequality in China appear superficially similar to, though slightly lower than, per capita income inequality. However, decomposing these inequalities reveals different patterns. While inter-provincial income inequality is highly regional in character, inter-provincial CO 2 emissions inequality is primarily intra-regional. While apparently similar, global patterns in CO 2 emissions are not mirrored at the sub-national scale. - Highlights: → Carbon inequality is different in character within China than at global scale. → Interprovincial CO 2 emissions inequality in China is slightly lower than income inequality. → Interprovincial GDP inequality in China is regional in character. → Interprovincial CO 2 emissions inequality in China is not regional in character.

Carbon inequality at the sub-national scale: A case study of provincial-level inequality in CO{sub 2} emissions in China 1997-2007

Energy Technology Data Exchange (ETDEWEB)

Clarke-Sather, Afton, E-mail: Afton.Clarke-Sather@colorado.edu [Scientific Information Center for Resources and Environment, Lanzhou Branch of the National Science Library, Chinese Academy of Sciences, 8 Middle Tianshui Road, Lanzhou 730000 (China); Department of Geography, University of Colorado, Boulder, 260 UCB, Boulder, CO 80309 (United States); Qu Jiansheng [Scientific Information Center for Resources and Environment, Lanzhou Branch of the National Science Library, Chinese Academy of Sciences, 8 Middle Tianshui Road, Lanzhou 730000 (China); MOE Key Laboratory of Western China' s Environmental Systems, Research School of Arid Environment and Climate Change, Lanzhou University, Lanzhou (China); Wang Qin [MOE Key Laboratory of Western China' s Environmental Systems, Research School of Arid Environment and Climate Change, Lanzhou University, Lanzhou (China); Zeng Jingjing [Scientific Information Center for Resources and Environment, Lanzhou Branch of the National Science Library, Chinese Academy of Sciences, 8 Middle Tianshui Road, Lanzhou 730000 (China); Li Yan [MOE Key Laboratory of Western China' s Environmental Systems, Research School of Arid Environment and Climate Change, Lanzhou University, Lanzhou (China)

2011-09-15

This study asks whether sub-national inequalities in carbon dioxide (CO{sub 2}) emissions mirror international patterns in carbon inequality using the case study of China. Several studies have examined global-level carbon inequality; however, such approaches have not been used on a sub-national scale. This study examines inter-provincial inequality in CO{sub 2} emissions within China using common measures of inequality (coefficient of variation, Gini Index, Theil Index) to analyze provincial-level data derived from the IPCC reference approach for the years 1997-2007. It decomposes CO{sub 2} emissions inequality into its inter-regional and intra-regional components. Patterns of per capita CO{sub 2} emissions inequality in China appear superficially similar to, though slightly lower than, per capita income inequality. However, decomposing these inequalities reveals different patterns. While inter-provincial income inequality is highly regional in character, inter-provincial CO{sub 2} emissions inequality is primarily intra-regional. While apparently similar, global patterns in CO{sub 2} emissions are not mirrored at the sub-national scale. - Highlights: > Carbon inequality is different in character within China than at global scale. > Interprovincial CO{sub 2} emissions inequality in China is slightly lower than income inequality. > Interprovincial GDP inequality in China is regional in character. > Interprovincial CO{sub 2} emissions inequality in China is not regional in character.

Global Interconnectedness - Local Authorities and Transnational Networking

Directory of Open Access Journals (Sweden)

Hans Krause Hansen

2006-09-01

Full Text Available This article argues that, in their continuous and proclaimed efforts at "modernizing" themselves, public sector organizations, also at the sub-national level, increasingly envision the new media as an object of policy making and intervention. At the same time, this focus on the new media facilitates transborder networking, taking the shape of globalizing webs that connect the actors internationally through pro- cesses af mediation and with implications for relations af authority and modes of governance. As such, these webs both constitute and facilitate a form of everyday political globalization which is on the rise. Empirically, our account is based on studies of two local authorities, the cities of Vina del Mar in Chile and Bremen in Germany, as two of the transnational networks that connect them.

The impact of global health initiatives on the health system in Angola.

Science.gov (United States)

Craveiro, Isabel; Dussault, Gilles

2016-01-01

We assessed the impact of global health initiatives (GHIs) on the health care system of Angola, as a contribution to documenting how GHIs, such as the Global Fund, GAVI and PEPFAR, influence the planning and delivery of health services in low-income countries and how national systems respond. We collected the views of national and sub-national key informants through 42 semi-structured interviews between April 2009 and May 2011 (12 at the national level and 30 at the sub-national level). We used a snowball technique to identify respondents from government, donors and non-governmental organisations. GHIs stimulated the formulation of a health policy and of plans and strategies, but the country has yet to decide on its priorities for health. At the regional level, managers lack knowledge of how GHIs' function, but they assess the effects of external funds as positive as they increased training opportunities, and augment the number of workers engaged in HIV or other specific disease programmes. However, GHIs did not address the challenge of attraction and retention of qualified personnel in provinces. Since Angola is not entirely dependent on external funding, national strategic programmes and the interventions of GHIs co-habit well, in contrast to countries such as Mozambique, which heavily depend on external aid.

[The absence of stewardship in the Chilean health authority after the 2004 health reform].

Science.gov (United States)

Herrera, Tania; Sánchez, Sergio

2014-11-26

Stewardship is the most important political function of a health system. It is a government responsibility carried out by the health authority. Among other dimensions, it is also a meta-function that includes conduction and regulation. The Health Authority and Management Act, which came about from the health reform of 2004, separated the functions of service provision and stewardship with the aim of strengthening the role of the health authority. However, the current structure of the health system contains overlapping functions between the different entities that leads to lack of coordination and inconsistencies, and a greater weight on individual health actions at the expense of collective ones. Consequently, a properly funded national health strategy to improve the health of the population is missing. Additionally, the components of citizen participation and governance are weak. It is necessary, therefore, to revisit the Chilean health structure in order to develop one that truly enables the exercise of the health authority’s stewardship role.

Assessing global, regional, national and sub-national capacity for public health research: a bibliometric analysis of the Web of Science(TM) in 1996-2010.

Science.gov (United States)

Badenhorst, Anna; Mansoori, Parisa; Chan, Kit Yee

2016-06-01

The past two decades have seen a large increase in investment in global public health research. There is a need for increased coordination and accountability, particularly in understanding where funding is being allocated and who has capacity to perform research. In this paper, we aim to assess global, regional, national and sub-national capacity for public health research and how it is changing over time in different parts of the world. To allow comparisons of regions, countries and universities/research institutes over time, we relied on Web of Science(TM) database and used Hirsch (h) index based on 5-year-periods (h5). We defined articles relevant to public health research with 98% specificity using the combination of search terms relevant to public health, epidemiology or meta-analysis. Based on those selected papers, we computed h5 for each country of the world and their main universities/research institutes for these 5-year time periods: 1996-2000, 2001-2005 and 2006-2010. We computed h5 with a 3-year-window after each time period, to allow citations from more recent years to accumulate. Among the papers contributing to h5-core, we explored a topic/disease under investigation, "instrument" of health research used (eg, descriptive, discovery, development or delivery research); and universities/research institutes contributing to h5-core. Globally, the majority of public health research has been conducted in North America and Europe, but other regions (particularly Eastern Mediterranean and South-East Asia) are showing greater improvement rate and are rapidly gaining capacity. Moreover, several African nations performed particularly well when their research output is adjusted by their gross domestic product (GDP). In the regions gaining capacity, universities are contributing more substantially to the h-core publications than other research institutions. In all regions of the world, the topics of articles in h-core are shifting from communicable to non

75 FR 27348 - Public Health Services Act; Delegation of Authority

Science.gov (United States)

2010-05-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Services Act; Delegation of Authority Notice is hereby given that I have delegated to the Director, Office of Public Health Preparedness and Response (OPHPR), with authority to redelegate, the authority to...

Equity in climate-economy scenarios: the importance of subnational income distribution

International Nuclear Information System (INIS)

Baer, Paul

2009-01-01

It is widely accepted that climate change raises equity considerations, and this has been addressed in various explicit and implicit ways in scenario-based climate and climate-policy research. In this paper I look in particular at the IPCC's well-known 'Special Report on Emissions Scenarios', in which equity is primarily quantified as the distribution of income between countries, and highlight the need for more explicit treatment of equity both within and across national borders. I apply an existing method for modeling subnational income distributions and show that this affects the results of welfare calculations of the type used in economic analyses of climate policy. Additionally, I suggest ways in which this kind of equity analysis could be applied to questions that address broader considerations of climate policy and development, such as burden sharing in the allocation of obligations, and conclude with remarks that frame the scenario development process in the context of what I call 'the contested storyline of the present'.

Allocation of authority in European health policy.

Science.gov (United States)

Adolph, Christopher; Greer, Scott L; Massard da Fonseca, Elize

2012-11-01

Although many study the effects of different allocations of health policy authority, few ask why countries assign responsibility over different policies as they do. We test two broad theories: fiscal federalism, which predicts rational governments will concentrate information-intensive operations at lower levels, and redistributive and regulatory functions at higher levels; and "politicized federalism", which suggests a combination of systematic and historically idiosyncratic political variables interfere with efficient allocation of authority. Drawing on the WHO Health in Transition country profiles, we present new data on the allocation of responsibility for key health care policy tasks (implementation, provision, finance, regulation, and framework legislation) and policy areas (primary, secondary and tertiary care, public health and pharmaceuticals) in the 27 EU member states and Switzerland. We use a Bayesian multinomial mixed logit model to analyze how different countries arrive at different allocations of authority over each task and area of health policy, and find the allocation of powers broadly follows fiscal federalism. Responsibility for pharmaceuticals, framework legislation, and most finance lodges at the highest levels of government, acute and primary care in the regions, and provision at the local and regional levels. Where allocation does not follow fiscal federalism, it appears to reflect ethnic divisions, the population of states and regions, the presence of mountainous terrain, and the timing of region creation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Cultural vs. Economic: Re-Visiting the Determinants of Fertility at a Sub-National Level in the U.S, 1990 - 2000

Directory of Open Access Journals (Sweden)

Jeremy R. Porter

2013-07-01

Full Text Available It is widely accepted that through the past century, and especially since 1950, the world population has grown at an accelerating pace landing the current world's population at about 6.5 billion and, according to UN projections, it is expected to reach 9.1 billion by 2050 (Bongaarts 2005. However, this growth is not uniform and tends to vary both regionally and intra-regionally around the world (Bongaarts 1998. There are competing theories as to the true determinants of fertility levels and these identified patterns (Caldwell 2001. The bulk of these theories pit economic determinants versus socio-cultural determinants as the primary indicators concerning the onset of fertility decline. However, most of this work has had an international focus with very few examining sub-national trends in fertility patterns. This paper draws on the work of one study which examined sub-national trends in the U.S. in hopes of better understanding current trends in determining fertility in the U.S. (Cutright 1983. An OLS regression approach is employed allowing for the examination of the two competing theories. Findings suggest that, while both are certainly significant, the role of economic determinants.

Trends in contraceptive use and distribution of births with demographic risk factors in Ethiopia: a sub-national analysis

OpenAIRE

Shiferaw, Solomon; Abdullah, Muna; Mekonnen, Yared; Ma?ga, Abdoulaye; Akinyemi, Akanni; Amouzou, Agbessi; Friedman, Howard; Barros, Aluisio J. D.; Hounton, Sennen

2015-01-01

Background: Evidence shows that family planning contributes to the decline in child mortality by decreasing the proportions of births that are considered high risk. The main objective of the present analysis was to examine the trends in use of modern contraceptives and their relationship with total fertility rate (TFR) and distribution of births by demographic risk factors as defined by mother’s age, birth interval, and birth order at the sub-national level in Ethiopia.Design: Analyses used d...

The absence of stewardship in the Chilean health authority after the 2004 health reform

Directory of Open Access Journals (Sweden)

Tania Herrera

2014-11-01

Full Text Available Stewardship is the most important political function of a health system. It is a government responsibility carried out by the health authority. Among other dimensions, it is also a meta-function that includes conduction and regulation. The Health Authority and Management Act, which came about from the health reform of 2004, separated the functions of service provision and stewardship with the aim of strengthening the role of the health authority. However, the current structure of the health system contains overlapping functions between the different entities that leads to lack of coordination and inconsistencies, and a greater weight on individual health actions at the expense of collective ones. Consequently, a properly funded national health strategy to improve the health of the population is missing. Additionally, the components of citizen participation and governance are weak. It is necessary, therefore, to revisit the Chilean health structure in order to develop one that truly enables the exercise of the health authority’s stewardship role

NATIONAL AND SUB-NATIONAL OFFSHORING IMPACT ON EMPLOYMENT: AN APPLICATION TO MADRID REGION

Directory of Open Access Journals (Sweden)

María Ángeles Tobarra Gómez

2016-07-01

Full Text Available The effect of delocalization on a national economy has been widely studied, however subnational delocalization remains as an unvisited field for researchers. This paper studies the effects of fragmentation and the subsequent localization outside or abroad on the level of industrial and services employment in Madrid region. We work with Madrid data from regional input-output tables and estimate a labour demand function using panel data. Our results show a significant and small negative effect on regional employment of intra-industrial inputs from the national economy and abroad, while imported inputs from other sectors and origins are complementary to employment, resulting in a positive net effect on employment. The increasing specialization in main activities and the use of external providers by firms have a positive impact on the employment of Madrid region.

Contributions of national and global health estimates to monitoring health-related sustainable development goals.

Science.gov (United States)

Bundhamcharoen, Kanitta; Limwattananon, Supon; Kusreesakul, Khanitta; Tangcharoensathien, Viroj

2016-01-01

The millennium development goals triggered an increased demand for data on child and maternal mortalities for monitoring progress. With the advent of the sustainable development goals and growing evidence of an epidemiological transition toward non-communicable diseases, policymakers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons. This paper discusses lessons learned from Thailand's burden of disease (BOD) study on capacity development on NHEs and discusses the contributions and limitations of GHEs in informing policies at the country level. Through training and technical support by external partners, capacities are gradually strengthened and institutionalized to enable regular updates of BOD at national and subnational levels. Initially, the quality of cause-of-death reporting in death certificates was inadequate, especially for deaths occurring in the community. Verbal autopsies were conducted, using domestic resources, to determine probable causes of deaths occurring in the community. This method helped to improve the estimation of years of life lost. Since the achievement of universal health coverage in 2002, the quality of clinical data on morbidities has also considerably improved. There are significant discrepancies between the Global Burden of Disease 2010 study estimates for Thailand and the 1999 nationally generated BOD, especially for years of life lost due to HIV/AIDS, and the ranking of priority diseases. National ownership of NHEs and an effective interface between researchers and decision-makers contribute to enhanced country policy responses, whereas subnational data are intended to be used by various subnational partners. Although GHEs contribute to benchmarking country achievement compared with global health

Subnational mobility and consumption-based environmental accounting of US corn in animal protein and ethanol supply chains

Science.gov (United States)

Smith, Timothy M.; Kim, Taegon; Pelton, Rylie E. O.; Suh, Kyo; Schmitt, Jennifer

2017-01-01

Corn production, and its associated inputs, is a relatively large source of greenhouse gas emissions and uses significant amounts of water and land, thus contributing to climate change, fossil fuel depletion, local air pollutants, and local water scarcity. As large consumers of this corn, corporations in the ethanol and animal protein industries are increasingly assessing and reporting sustainability impacts across their supply chains to identify, prioritize, and communicate sustainability risks and opportunities material to their operations. In doing so, many have discovered that the direct impacts of their owned operations are dwarfed by those upstream in the supply chain, requiring transparency and knowledge about environmental impacts along the supply chains. Life cycle assessments (LCAs) have been used to identify hotspots of environmental impacts at national levels, yet these provide little subnational information necessary for guiding firms’ specific supply networks. In this paper, our Food System Supply-Chain Sustainability (FoodS3) model connects spatial, firm-specific demand of corn purchasers with upstream corn production in the United States through a cost minimization transport model. This provides a means to link county-level corn production in the United States to firm-specific demand locations associated with downstream processing facilities. Our model substantially improves current LCA assessment efforts that are confined to broad national or state level impacts. In drilling down to subnational levels of environmental impacts that occur over heterogeneous areas and aggregating these landscape impacts by specific supply networks, targeted opportunities for improvements to the sustainability performance of supply chains are identified. PMID:28874548

Subnational mobility and consumption-based environmental accounting of US corn in animal protein and ethanol supply chains.

Science.gov (United States)

Smith, Timothy M; Goodkind, Andrew L; Kim, Taegon; Pelton, Rylie E O; Suh, Kyo; Schmitt, Jennifer

2017-09-19

Corn production, and its associated inputs, is a relatively large source of greenhouse gas emissions and uses significant amounts of water and land, thus contributing to climate change, fossil fuel depletion, local air pollutants, and local water scarcity. As large consumers of this corn, corporations in the ethanol and animal protein industries are increasingly assessing and reporting sustainability impacts across their supply chains to identify, prioritize, and communicate sustainability risks and opportunities material to their operations. In doing so, many have discovered that the direct impacts of their owned operations are dwarfed by those upstream in the supply chain, requiring transparency and knowledge about environmental impacts along the supply chains. Life cycle assessments (LCAs) have been used to identify hotspots of environmental impacts at national levels, yet these provide little subnational information necessary for guiding firms' specific supply networks. In this paper, our Food System Supply-Chain Sustainability (FoodS 3 ) model connects spatial, firm-specific demand of corn purchasers with upstream corn production in the United States through a cost minimization transport model. This provides a means to link county-level corn production in the United States to firm-specific demand locations associated with downstream processing facilities. Our model substantially improves current LCA assessment efforts that are confined to broad national or state level impacts. In drilling down to subnational levels of environmental impacts that occur over heterogeneous areas and aggregating these landscape impacts by specific supply networks, targeted opportunities for improvements to the sustainability performance of supply chains are identified.

Wheat yield loss attributable to heat waves, drought and water excess at the global, national and subnational scales

Science.gov (United States)

Zampieri, M.; Ceglar, A.; Dentener, F.; Toreti, A.

2017-06-01

Heat waves and drought are often considered the most damaging climatic stressors for wheat. In this study, we characterize and attribute the effects of these climate extremes on wheat yield anomalies (at global and national scales) from 1980 to 2010. Using a combination of up-to-date heat wave and drought indexes (the latter capturing both excessively dry and wet conditions), we have developed a composite indicator that is able to capture the spatio-temporal characteristics of the underlying physical processes in the different agro-climatic regions of the world. At the global level, our diagnostic explains a significant portion (more than 40%) of the inter-annual production variability. By quantifying the contribution of national yield anomalies to global fluctuations, we have found that just two concurrent yield anomalies affecting the larger producers of the world could be responsible for more than half of the global annual fluctuations. The relative importance of heat stress and drought in determining the yield anomalies depends on the region. Moreover, in contrast to common perception, water excess affects wheat production more than drought in several countries. We have also performed the same analysis at the subnational level for France, which is the largest wheat producer of the European Union, and home to a range of climatic zones. Large subnational variability of inter-annual wheat yield is mostly captured by the heat and water stress indicators, consistently with the country-level result.

Towards medicines regulatory authorities' quality performance improvement: value for public health.

Science.gov (United States)

Pejović, Gordana; Filipović, Jovan; Tasić, Ljiljana; Marinković, Valentina

2016-01-01

The purpose of this article is to explore the possibility of implementing total quality management (TQM) principles in national medicines regulatory authorities in Europe to achieve all public health objectives. Bearing in mind that medicines regulation is a governmental function that serves societal objectives to protect and promote public health, measuring the effective achievement of quality objectives related to public health is of utmost importance. A generic TQM model for meeting public health objectives was developed and was tested on 10 European national medicines regulatory authorities with different regulatory performances. Participating national medicines regulatory authorities recognised all TQM factors of the proposed model in implemented systems with different degrees of understanding. An analysis of responses was performed within the framework of two established criteria-the regulatory authority's category and size. The value of the paper is twofold. First, the new generic TQM model proposes to integrate four public health objectives with six TQM factors. Second, national medicines regulatory authorities were analysed as public organisations and health authorities to develop a proper tool for assessing their regulatory performance. The paper emphasises the importance of designing an adequate approach to performance measurement of quality management systems in medicines regulatory authorities that will support their public service missions. Copyright © 2014 John Wiley & Sons, Ltd.

Health physics educational program in the Tennessee Valley Authority

International Nuclear Information System (INIS)

Holley, Wesley L.

1978-01-01

In the spring of 1977, the Radiological Hygiene Branch of the Tennessee Valley Authority (TVA) instituted a training program for health physics technicians to ensure availability of qualified personnel for the agency, which is rapidly becoming the world's largest nuclear utility. From this, a health physics education program is developing to also include health physics orientation and retraining for unescorted entry into nuclear power plants, health physics training for employees at other (non-TVA) nuclear plants, specialized health physics training, and possibly theoretical health physics courses to qualify technician-level personnel for professional status. Videotaped presentations are being used extensively, with innovations such as giving examinations by videotape of real-life, in-plant experiences and acted out scenarios of health physics procedures; and teaching health physics personnel to observe, detect, and act on procedural, equipment, and personnel deficiencies promptly. Video-taped lectures are being used for review and to complement live lectures. Also, a 35-mm slide and videotape library is being developed on all aspects of the operational health physics program for nuclear plants using pressurized and boiling water reactors. (author)

Integrated Pollution Prevention and Control: a review of health authorities' experience.

Science.gov (United States)

Lanser, Shelley; Pless-Mulloli, Tanja

2003-09-01

In August 2000, health authorities in England and Wales became statutory consultees for permits issued to industry by the Environment Agency as part of the implementation of EU directives. This responsibility has since been delegated to Primary Care Trusts. To assess health authority responses to applications made under the Integrated Pollution Prevention and Control (IPPC) regulations, we collected data from public registers during the first 12 months of this new regulatory regime. There was evidence of 27 applications, of which 59 per cent had substantive comments from health authorities. There was wide variation in the length and content. Responses were from Consultants in Communicable Disease Control (57 per cent) or Directors of Public Health (43 per cent). Only two health authorities had a dedicated resource for responding to IPPC applications. Capacity and capability are lacking and require resources invested for consistent, effective public health input to the process of permitting potentially polluting industries.

[Strengthening of the steering role of health++ authorities in health care reforms].

Science.gov (United States)

Marín, J M

2000-01-01

Strengthening the ability of health authorities to provide leadership and guidance, now and in the future, is an important issue within the context of health sector reform. It means, among other things, redefining the role of health in light of leading social and economic trends seen in the world at the beginning of the 21st century, increasing participation in health by nongovernmental entities, moving toward participatory democracy in many countries, and modifying concepts of what is considered "public" and "private." Within this scenario, it is necessary to redirect the role of the health sector toward coordinating the mobilization of national resources, on a multisectoral scale, in order to improve equity and social well-being and to channel the limited available resources to the most disadvantaged groups in society. The liberalization of the production and distribution of health-related goods and services, including insurance, challenges the exercise of authority in the area of health. Furthermore, the formation of regional economic blocks and the enormous weight wielded by multinational companies in the areas of pharmaceuticals and other medical supplies and technologies are forcing the health sector to seek ways of harmonizing health legislation and international negotiations. According to many experts, all of these demands surpass the ability of Latin American ministries of health to effectively respond, given most countries' current organizational, legal, and political conditions and technical infrastructure. The countries of the Americas must make it a priority to strengthen their health officials' ability to provide leadership and guidance in order to meet present and future challenges.

The Role of Sub-National Actors in Climate Change Policy. The Case of Tokyo

International Nuclear Information System (INIS)

Roppongi, Hitomi

2016-06-01

Tokyo is known as a pioneer throughout the history of Japan's environmental policy, often being compared to California in the United States or Paris in France. Following the global trend of growing local initiatives tackling climate change, Tokyo introduced a cap-and-trade scheme in 2010 ahead of a national implementation. The Tokyo Cap-and-Trade Program is the first of its kind that regulates CO_2 emissions from all business sectors, where energy consumers are defined in terms of the business establishments they own. Tokyo's initiative is largely seen as a reaction to the modest national commitment, following the tradition of center-local rivalry. This study first explains the centre-local relationship in the history of Japan's environmental governance. It then analyzes the development of the Tokyo's flagship climate policy and its implications for national and other sub-national governments in Japan. The tactics used by the Tokyo Metropolitan Government to overcome business opposition typically seen in the introduction of GHG control, and future policy challenges are also discussed. The study finds that Tokyo's policy encourages behavioral changes and technological improvement in the business sector, going a step beyond the existing culture of energy conservation in Japan. An emission trading scheme is often associated with the collapse of carbon markets and the 'money game', rather than a practical tool to reduce CO_2 emissions, but the Tokyo Cap-and-Trade Program has demonstrated a policy impact that recasts such an image. A known case of policy diffusion to Saitama prefecture, an immediate neighbor of Tokyo with the fifth largest population in Japan, is also discussed to elaborate on the potential domestic diffusion of the policy. (author)

Health in All (Foreign) Policy: challenges in achieving coherence.

Science.gov (United States)

Labonté, Ronald

2014-06-01

Health in All Policies (HiAP) approach is generally perceived as an intersectoral approach to national or sub-national public policy development, such that health outcomes are given full consideration by non-health sectors. Globalization, however, has created numerous 'inherently global health issues' with cross-border causes and consequences, requiring new forms of global governance for health. Although such governance often includes both state and non-state (private, civil society) actors in agenda setting and influence, different actors have differing degrees of power and authority and, ultimately, it is states that ratify intergovernmental covenants or normative declarations that directly or indirectly affect health. This requires public health and health promotion practitioners working within countries to give increased attention to the foreign policies of their national governments. These foreign policies include those governing national security, foreign aid, trade and investment as well as the traditional forms of diplomacy. A new term has been coined to describe how health is coming to be positioned in governments' foreign policies: global health diplomacy. To become adept at this nuanced diplomatic practice requires familiarity with the different policy frames by which health might be inserted into the foreign policy deliberations, and thence intergovernmental/global governance negotiations. This article discusses six such frames (security, trade, development, global public goods, human rights, ethical/moral reasoning) that have been analytically useful in assessing the potential for greater and more health-promoting foreign policy coherence: a 'Health in All (Foreign) Policies' approach. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Falling through the Coverage Cracks: How Documentation Status Minimizes Immigrants' Access to Health Care.

Science.gov (United States)

Joseph, Tiffany D

2017-10-01

Recent policy debates have centered on health reform and who should benefit from such policy. Most immigrants are excluded from the 2010 Affordable Care Act (ACA) due to federal restrictions on public benefits for certain immigrants. But, some subnational jurisdictions have extended coverage options to federally ineligible immigrants. Yet, less is known about the effectiveness of such inclusive reforms for providing coverage and care to immigrants in those jurisdictions. This article examines the relationship between coverage and health care access for immigrants under comprehensive health reform in the Boston metropolitan area. The article uses data from interviews conducted with a total of 153 immigrants, health care professionals, and immigrant and health advocacy organization employees under the Massachusetts and ACA health reforms. Findings indicate that respondents across the various stakeholder groups perceive that immigrants' documentation status minimizes their ability to access health care even when they have health coverage. Specifically, respondents expressed that intersecting public policies, concerns that using health services would jeopardize future legalization proceedings, and immigrants' increased likelihood of deportation en route to medical appointments negatively influenced immigrants' health care access. Thus, restrictive federal policies and national-level anti-immigrant sentiment can undermine inclusive subnational policies in socially progressive places. Copyright © 2017 by Duke University Press.

The Politics of Subnational Undemocratic Regime Reproduction in Argentina and Mexico La política de reproducción de los regímenes subnacionales no democráticos en Argentina y México

Directory of Open Access Journals (Sweden)

Agustina Giraudy

2010-01-01

Full Text Available This article studies the continued existence of subnational undemocraticregimes in Argentina and Mexico, two countries that have recently experiencednational democratization. The first part of the article offers a conceptualizationof subnational democracy and measures its territorial extension across all subnational units. The second part explores a common, albeit not systematically tested explanation about subnational undemocratic regime continuity, namely, that these regimes persist because they meet national incumbents’ strategic political needs. This claim is tested using statistical analyses to contrast patterns of spending across undemocratic subnational units during the presidencies of Menem (1989-1999, De la Rúa (2000-2001, Duhalde (2002, and Kirchner (2003-2007 in Argentina, and Fox (2000-2006 in Mexico. Contradicting conventional wisdom, the results show that presidents only reproduce a handful of subnational undemocratic regimes, as not all of them can meet presidential needs. In addition, the results reveal that the strategic calculation of presidents regarding this  reproduction is dictated by factors that have been largely overlooked by the literature. Este artículo estudia la existencia de regímenes subnacionales no-democráticos en Argentina y México, dos pa��ses que recientemente han experimentado procesos de democratización a nivel nacional. La primera parte del artículo conceptualiza y define la democracia subnacional y mide su extensión territorial en la totalidad de los distritos subnacionales. La segunda parte explora la validez de una de las explicaciones más habituales en esta área de estudio según la cual los regímenes subnacionales no-democráticos permanecen en el poder debido a que son útiles para satisfacer las necesidades políticas de los funcionarios nacionales. La validez de esta explicación se testea con análisis estadísticos que determinan los patrones de distribución territorial de

[Regulating radiological protection and the role of health authorities].

Science.gov (United States)

Arias, César F

2006-01-01

This article summarizes the development of protection against ionizing radiation and explains current thinking in the field. It also looks at the decisive role that regulatory agencies for radiological protection must play and the important contributions that can be made by health authorities. The latter should take an active part in at least three aspects: the formal education of health personnel regarding radiological protection; the medical care of individuals who are accidentally overexposed, and the radiological protection of patients undergoing radiological procedures. To this end, health professionals must possess sufficient knowledge about radiological protection, promote the use of proper equipment, and apply the necessary quality assurance procedures. Through their effective intervention, national health authorities can greatly contribute to reducing unnecessary doses of radiation during medical procedures involving radiation sources and decrease the chances that radiological accidents will take place.

Sustainability Assessment in Development Planning in Sub-National Territories: Regional Development Strategies in Chile

Directory of Open Access Journals (Sweden)

Iván Franchi-Arzola

2018-05-01

Full Text Available In Chile, the increasing occurrence of socio-environmental conflicts demonstrates that Regional Development Strategies—Estrategia Regional de Desarrollo (ERD—as the main development policy of subnational territories (Regions, must consider sustainability as a central objective. The Taxonomy of Sustainability constitutes an assessment method that allows us to determine the correlation between the definitions of these public policies and the strategies for transition to sustainable development. The ERD of the Antofagasta and Aysén regions are the ones presenting the highest Taxonomic Index; this indicates a higher strategic content for the promotion of sustainability. It is also noted that the political will that conditions the principles and values on which the ERD are based is strongly determined by investment projects and socio-environmental conflicts, which represent the tension between environmental protection and the capacity and interests of regional society in the development project.

Regression Analysis to Identify Factors Associated with Urinary Iodine Concentration at the Sub-National Level in India, Ghana, and Senegal

Science.gov (United States)

Knowles, Jacky; Kupka, Roland; Dumble, Sam; Garrett, Greg S.; Pandav, Chandrakant S.; Yadav, Kapil; Touré, Ndeye Khady; Foriwa Amoaful, Esi; Gorstein, Jonathan

2018-01-01

Single and multiple variable regression analyses were conducted using data from stratified, cluster sample design, iodine surveys in India, Ghana, and Senegal to identify factors associated with urinary iodine concentration (UIC) among women of reproductive age (WRA) at the national and sub-national level. Subjects were survey household respondents, typically WRA. For all three countries, UIC was significantly different (p regression analysis, UIC was significantly associated with strata and household salt iodine category in India and Ghana (p < 0.001). Estimated UIC was 1.6 (95% confidence intervals (CI) 1.3, 2.0) times higher (India) and 1.4 (95% CI 1.2, 1.6) times higher (Ghana) among WRA from households using adequately iodised salt than among WRA from households using non-iodised salt. Other significant associations with UIC were found in India, with having heard of iodine deficiency (1.2 times higher; CI 1.1, 1.3; p < 0.001) and having improved dietary diversity (1.1 times higher, CI 1.0, 1.2; p = 0.015); and in Ghana, with the level of tomato paste consumption the previous week (p = 0.029) (UIC for highest consumption level was 1.2 times lowest level; CI 1.1, 1.4). No significant associations were found in Senegal. Sub-national data on iodine status are required to assess equity of access to optimal iodine intake and to develop strategic responses as needed. PMID:29690505

A partial solution: a local mental health authority for the UK.

Science.gov (United States)

Hadley, Trevor R.; Goldman, Howard H.

1998-07-01

BACKGROUND: the structural problems of the mental health system in the UK have been analyzed by a number of authors over the past several years as the "reforms" of the health and social service systems have continued (Kavanagh and Knapp, 1995; Mechanic, 1995). In a recent article, Hadley and Goldman (1995) suggest that one possible solution to some of these issues may be the creation of a local mental health authority. Such an authority would consolidate the funding, authority and responsibility in a single entity. We believe this model, which is typical of many local public mental health systems in the US, is at least part of the solution to the current problem of financial and service fragmentation of the current system in the UK. The numerous "reforms" of the health and social service systems (which include the Community Care Act, the development of the Internal Market, GP fundholding and the purchaser-provider split) were not designed for the care of the mentally ill (Han, 1996). These policy changes in the design of health and social services have created a complicated and difficult context in which services must be delivered. Too many agencies play a significant role in the delivery and management of mental health services. Health authorities, social service agencies and GP fundholders are direct and indirect funders of the system while community care trusts, social service agencies and GPs are service providers (Hadley, 1996a). RESULTS AND A PROPOSAL: We believe that the development of local mental health authorities may be part of the solution to the structural and economic problems of the current system in the UK. It is not the answer to limited resources or limited skills, but can create a new structure, which will permit and encourage the cooperation and innovation that is now possible only with unusual effort. Local mental health authorities have a number of crucial characteristics, but, most importantly, they refocus the system on the provision of care

An Effective Health and Medical Technical Authority

Science.gov (United States)

Fogarty, Jennifer A.

2009-01-01

The NASA Governance model directed the formation of three Technical Authorities, Engineering; Safety and Mission Assurance; and Health and Medical, to ensure that risks are identified and adjudicated efficiently and transparently in concert with the spaceflight programs and projects. The Health and Medical Technical Authority (HMTA) has been implemented at the Johnson Space Center (JSC) and consists of the Chief Medical Office (CMO), the Deputy CMO, and HMTA Delegates. The JSC HMTA achieves the goals of risk identification and adjudication through the discharge of the appropriate technical expertise to human space flight programs and projects and the escalation of issues within program and technical authority boards. The JSC HMTA relies on subject matter experts (SMEs) in the Space Life Sciences Directorate at JSC as well as experts from other Centers to work crew health and performance issues at the technical level, develop requirements, oversee implementation and validation of requirements, and identify risks and non-compliances. Once a risk or potential noncompliance has been identified and reported to the programs or projects, the JSC HMTA begins to track it and closely monitor the program's or project's response. As a risk is developed or a non-compliance negotiated, positions from various levels of decision makers are sought at the program and project control boards. The HMTA may support a program or project position if it is satisfied with the decision making and vetting processes (ex. the subject matter expert voiced his/her concerns and all dissenting opinions were documented) and finds that the position both acknowledges the risk and cost of the mitigation and resolves the issue without changing NASA risk posture. The HMTA may disagree with a program or project position if the NASA risk posture has been elevated or obfuscated. If the HMTA does disagree with the program or project position, it will appeal to successively higher levels of authority so that

[The contributions of local authorities to regional public health policy].

Science.gov (United States)

de Maria, Florence; Grémy, Isabelle

2009-01-01

Local authorities in France are key players in shaping public health policy by their action on the determinants of health and through their actions aimed at specific population groups. Since the public health act of 9 August 2004 establishing the first regional public health plans, their level of involvement and role continues to grow as coordinators, funders and project managers within the greater Paris metropolitan region. Their active participation in regional policy to improve population health and reduce inequalities in health has led to a better organization of the public health programs implemented (in terms of visibility, dialogue, coordination, transparency, and better awareness of context and integration of local issues). Their participation is also a source of innovation resulting in the proposal and use of new approaches (such as the development of health surveillance and observation for advising the local decision-making process). Within the current context of the "Hospitals, patients, health and territories" bill, which entrusts the governance of regional health policy to a specific agency, the role given to local authorities in this new organizational structure must be clearly defined to take into account all of their existing and potential contributions to public health policy.

Paradoxos das políticas de descentralização de saúde no Brasil Paradoxes of health decentralization policies in Brazil

Directory of Open Access Journals (Sweden)

Dário Frederico Pasche

2006-12-01

Full Text Available The constitution of Brazil directs that the country’s health system, the Unified Health System (Sistema Único de Saúde, be politically and administratively decentralized. Nevertheless, handing over competencies, responsibilities, and resources to subnational levels, especially to municipal governments, has been a slow process, lasting almost two decades. Advances have been brought about by the Unified Health System, which, from a analytical perspective, is a public and universal system. Despite that, the decentralization process needs to overcome norms that keep all levels of management dependent on Brazil’s federal Government. The subnational levels have consistently faced difficulties in performing their macromanagement functions with autonomy, especially when it comes to financing and to the establishment or organization of health care networks. Boldness and responsibility will be needed to prevent Brazil’s health decentralization process from leading to fragmentation. New political agreements between different levels of government, with a reassignment of responsibilities and the enhancement of a culture of technical cooperation, are fundamental requisites to making the Unified Health System have a health policy that is truly public and universal.

The Health Resources Allocation Model (HRAM) for the 21st century.

Science.gov (United States)

Maire, Nicolas; Hegnauer, Michael; Nguyen, Dana; Godelmann, Lucas; Hoffmann, Axel; de Savigny, Don; Tanner, Marcel

2012-05-01

The Health Resources Allocation Model (HRAM) is an eLearning tool for health cadres and scientists introducing basic concepts of sub-national, rational district-based health planning and systems thinking under resources constraint. HRAM allows the evaluation of resource allocation strategies in relation to key outcome measures such as coverage, equity of services achieved and number of deaths and disability-adjusted life years (DALYs) prevented. In addition, the model takes into account geographical and demographic characteristics and populations' health seeking behaviour. It can be adapted to different socio-ecological and health system settings.

Variation in the link between parental divorce and children's health disadvantage in low and high divorce settings.

Science.gov (United States)

Smith-Greenaway, Emily; Clark, Shelley

2017-12-01

Like in other world regions, children with divorced parents in sub-Saharan Africa experience significant heath disadvantages relative to their peers with married parents. Preliminary evidence suggests this disadvantage may not be uniform across the subcontinent's diverse settings. Research from other world regions shows that the childhood health consequences of divorce vary across different contexts. Specifically, we hypothesize that the childhood disadvantages associated with divorce are more severe in regions of sub-Saharan Africa where divorce is rare, and less so where divorce is a more common family experience. Using Demographic and Health Survey data from 290 subnational regions within 31 sub-Saharan African countries, multilevel models document the previously shown link between having a divorced mother and child morbidity and mortality. The study results further demonstrate that the childhood health disadvantage is accentuated in subnational African regions where fewer women are divorced and muted in areas where more women are divorced. The findings demonstrate that the broader context can powerfully moderate childhood health inequalities traditionally thought of as operating at the family or individual level.

Regression Analysis to Identify Factors Associated with Urinary Iodine Concentration at the Sub-National Level in India, Ghana, and Senegal

Directory of Open Access Journals (Sweden)

Jacky Knowles

2018-04-01

Full Text Available Single and multiple variable regression analyses were conducted using data from stratified, cluster sample design, iodine surveys in India, Ghana, and Senegal to identify factors associated with urinary iodine concentration (UIC among women of reproductive age (WRA at the national and sub-national level. Subjects were survey household respondents, typically WRA. For all three countries, UIC was significantly different (p < 0.05 by household salt iodine category. Other significant differences were by strata and by household vulnerability to poverty in India and Ghana. In multiple variable regression analysis, UIC was significantly associated with strata and household salt iodine category in India and Ghana (p < 0.001. Estimated UIC was 1.6 (95% confidence intervals (CI 1.3, 2.0 times higher (India and 1.4 (95% CI 1.2, 1.6 times higher (Ghana among WRA from households using adequately iodised salt than among WRA from households using non-iodised salt. Other significant associations with UIC were found in India, with having heard of iodine deficiency (1.2 times higher; CI 1.1, 1.3; p < 0.001 and having improved dietary diversity (1.1 times higher, CI 1.0, 1.2; p = 0.015; and in Ghana, with the level of tomato paste consumption the previous week (p = 0.029 (UIC for highest consumption level was 1.2 times lowest level; CI 1.1, 1.4. No significant associations were found in Senegal. Sub-national data on iodine status are required to assess equity of access to optimal iodine intake and to develop strategic responses as needed.

The role of Swedish Radiation Protection Authority in the field of public health

International Nuclear Information System (INIS)

Cederlund, Torsten; Finck, Robert; Mjoenes, Lars; Moberg, Leif; Soederman, Ann-Louis; Wiklund, Aasa; Yuen Katarina; Oelander Guer, Hanna

2004-09-01

The Swedish Government has requested the Swedish Radiation Protection Authority (SSI) to make an account of the authority's role in the field of public health. Radiation Protection consists largely of preventive actions in order to protect man and the environment against harmful effects of radiation. The SSI thus considers most of the authority's activities to be public health related. The report describes a number of radiation protection areas from a health perspective. The measures taken by the authority in these areas are also described along with planned activities. In some areas the authority also points out additional measures

Variation in the link between parental divorce and children’s health disadvantage in low and high divorce settings

Directory of Open Access Journals (Sweden)

Emily Smith-Greenaway

2017-12-01

Full Text Available Like in other world regions, children with divorced parents in sub-Saharan Africa experience significant heath disadvantages relative to their peers with married parents. Preliminary evidence suggests this disadvantage may not be uniform across the subcontinent’s diverse settings. Research from other world regions shows that the childhood health consequences of divorce vary across different contexts. Specifically, we hypothesize that the childhood disadvantages associated with divorce are more severe in regions of sub-Saharan Africa where divorce is rare, and less so where divorce is a more common family experience. Using Demographic and Health Survey data from 290 subnational regions within 31 sub-Saharan African countries, multilevel models document the previously shown link between having a divorced mother and child morbidity and mortality. The study results further demonstrate that the childhood health disadvantage is accentuated in subnational African regions where fewer women are divorced and muted in areas where more women are divorced. The findings demonstrate that the broader context can powerfully moderate childhood health inequalities traditionally thought of as operating at the family or individual level.

75 FR 40842 - Public Health Service Act (PHS), Delegation of Authority

Science.gov (United States)

2010-07-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Service Act (PHS), Delegation of Authority Notice is hereby given that I have delegated to the Director... Secretary of Health and Human Services under the following section under Title XXVI of the Public Health...

The Health Resources Allocation Model (HRAM for the 21st century

Directory of Open Access Journals (Sweden)

Nicolas Maire

2012-05-01

Full Text Available The Health Resources Allocation Model (HRAM is an eLearning tool for health cadres and scientists introducing basic concepts of sub-national, rational district-based health planning and systems thinking under resources constraint. HRAM allows the evaluation of resource allocation strategies in relation to key outcome measures such as coverage, equity of services achieved and number of deaths and disability-adjusted life years (DALYs prevented. In addition, the model takes into account geographical and demographic characteristics and populations’ health seeking behaviour. It can be adapted to different socio-ecological and health system settings.

Equality in Maternal and Newborn Health: Modelling Geographic Disparities in Utilisation of Care in Five East African Countries.

Science.gov (United States)

Ruktanonchai, Corrine W; Ruktanonchai, Nick W; Nove, Andrea; Lopes, Sofia; Pezzulo, Carla; Bosco, Claudio; Alegana, Victor A; Burgert, Clara R; Ayiko, Rogers; Charles, Andrew Sek; Lambert, Nkurunziza; Msechu, Esther; Kathini, Esther; Matthews, Zoë; Tatem, Andrew J

2016-01-01

Geographic accessibility to health facilities represents a fundamental barrier to utilisation of maternal and newborn health (MNH) services, driving historically hidden spatial pockets of localized inequalities. Here, we examine utilisation of MNH care as an emergent property of accessibility, highlighting high-resolution spatial heterogeneity and sub-national inequalities in receiving care before, during, and after delivery throughout five East African countries. We calculated a geographic inaccessibility score to the nearest health facility at 300 x 300 m using a dataset of 9,314 facilities throughout Burundi, Kenya, Rwanda, Tanzania and Uganda. Using Demographic and Health Surveys data, we utilised hierarchical mixed effects logistic regression to examine the odds of: 1) skilled birth attendance, 2) receiving 4+ antenatal care visits at time of delivery, and 3) receiving a postnatal health check-up within 48 hours of delivery. We applied model results onto the accessibility surface to visualise the probabilities of obtaining MNH care at both high-resolution and sub-national levels after adjusting for live births in 2015. Across all outcomes, decreasing wealth and education levels were associated with lower odds of obtaining MNH care. Increasing geographic inaccessibility scores were associated with the strongest effect in lowering odds of obtaining care observed across outcomes, with the widest disparities observed among skilled birth attendance. Specifically, for each increase in the inaccessibility score to the nearest health facility, the odds of having skilled birth attendance at delivery was reduced by over 75% (0.24; CI: 0.19-0.3), while the odds of receiving antenatal care decreased by nearly 25% (0.74; CI: 0.61-0.89) and 40% for obtaining postnatal care (0.58; CI: 0.45-0.75). Overall, these results suggest decreasing accessibility to the nearest health facility significantly deterred utilisation of all maternal health care services. These results

Weber, authority and the organisation of health care.

Science.gov (United States)

Alaszewski, A; Manthorpe, J

The third paper in the series on sociology discusses the work of Max Weber. It traces the origins and main themes of his work. The parallels between his work and contemporary issues in the organisation of health care are outlined, in particular, the insights provided into bureaucracy and authority.

Russia’s Financial Markets and Financial Institutions in 2012

OpenAIRE

Andrei Alaev; Arseny Mamedov; Vladimir Nazarov

2013-01-01

This paper deals with the issue of intergovernmental fiscal relations and subnational finances in Russia. The authors focus on the issue of subnational budgets in 2012, financial support from the federal budget. The point out to how the federal authorities stimulate the constitutent territories on the Russian Federation.

Greenland as a self-governing sub-national territory in international relations: past, current and future perspectives

DEFF Research Database (Denmark)

Ackrén, Maria; Jakobsen, Uffe

2015-01-01

Greenland was used by the US as a platform and as an extended arm within its security and foreign policy during the World War II and the cold war. After this things changed, although Greenland remained important in Danish-US relations under the umbrella of NATO. Nowadays, the geostrategic position...... of Greenland between North America and Europe is gaining fresh prominence in the race for natural resources in the Arctic. Many issues arise from the prospective opening of the Arctic, all of which may have fateful impacts on future development in the region. Climate change, claims related to the extension....... This article reviews developments from the World War II to the present regarding international relations from a Greenlandic perspective. As a self-governing sub-national territory within the realm of Denmark, Greenland does not have the ultimate decision-making power within foreign and security policy. The new...

Expeditionary Economics: The Military’s Role in Conflict-Related Development

Science.gov (United States)

2012-06-08

gender equality and empower women; (4) reduce child mortality; (5) improve maternal health; (6) combat HIV/AIDS, malaria and other diseases; (7) ensure...3. Sub-national governance and the rule of law. 4. Maternal and newborn health. 5. Sustainable livelihoods. The International Monetary Fund...ability to achieve unity of effort without authoritative command is largely idiosyncratic and personality based.20 Without the authority to direct

Health preemption behind closed doors: trade agreements and fast-track authority.

Science.gov (United States)

Crosbie, Eric; Gonzalez, Mariaelena; Glantz, Stanton A

2014-09-01

Noncommunicable diseases result from consuming unhealthy products, including tobacco, which are promoted by transnational corporations. The tobacco industry uses preemption to block or reverse tobacco control policies. Preemption removes authority from jurisdictions where tobacco companies' influence is weak and transfers it to jurisdictions where they have an advantage. International trade agreements relocate decisions about tobacco control policy to venues where there is little opportunity for public scrutiny, participation, and debate. Tobacco companies are using these agreements to preempt domestic authority over tobacco policy. Other transnational corporations that profit by promoting unhealthy foods could do the same. "Fast-track authority," in which Congress cedes ongoing oversight authority to the President, further distances the public from the debate. With international agreements binding governments to prioritize trade over health, transparency and public oversight of the trade negotiation process is necessary to safeguard public health interests.

Health financing at district level in Malawi: an analysis of the distribution of funds at two points in time.

Science.gov (United States)

Borghi, Josephine; Munthali, Spy; Million, Lameck B; Martinez-Alvarez, Melisa

2018-01-01

sub-nationally to maximize equity and ensure allocations are commensurate to health need. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Health Preemption Behind Closed Doors: Trade Agreements and Fast-Track Authority

Science.gov (United States)

Crosbie, Eric; Gonzalez, Mariaelena

2014-01-01

Noncommunicable diseases result from consuming unhealthy products, including tobacco, which are promoted by transnational corporations. The tobacco industry uses preemption to block or reverse tobacco control policies. Preemption removes authority from jurisdictions where tobacco companies’ influence is weak and transfers it to jurisdictions where they have an advantage. International trade agreements relocate decisions about tobacco control policy to venues where there is little opportunity for public scrutiny, participation, and debate. Tobacco companies are using these agreements to preempt domestic authority over tobacco policy. Other transnational corporations that profit by promoting unhealthy foods could do the same. “Fast-track authority,” in which Congress cedes ongoing oversight authority to the President, further distances the public from the debate. With international agreements binding governments to prioritize trade over health, transparency and public oversight of the trade negotiation process is necessary to safeguard public health interests. PMID:25033124

75 FR 55582 - National Institutes of Health Statement of Organization, Functions, and Delegations of Authority

Science.gov (United States)

2010-09-13

... authority statement: All delegations and redelegations of authority to officers and employees of NIH that..., Functions, and Delegations of Authority Part N, National Institutes of Health, of the Statement of Organization, Functions, and Delegations of Authority for the Department of Health and Human Services (40 FR...

Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

DEFF Research Database (Denmark)

Moesgaard Iburg, Kim

2018-01-01

used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods...... and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used......·0 (14·3–23·7) in Somalia, and 23·4 (20·2–26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America...

A Socio-Ecological Approach for Identifying and Contextualising Spatial Ecosystem-Based Adaptation Priorities at the Sub-National Level.

Directory of Open Access Journals (Sweden)

Amanda Bourne

Full Text Available Climate change adds an additional layer of complexity to existing sustainable development and biodiversity conservation challenges. The impacts of global climate change are felt locally, and thus local governance structures will increasingly be responsible for preparedness and local responses. Ecosystem-based adaptation (EbA options are gaining prominence as relevant climate change solutions. Local government officials seldom have an appropriate understanding of the role of ecosystem functioning in sustainable development goals, or access to relevant climate information. Thus the use of ecosystems in helping people adapt to climate change is limited partially by the lack of information on where ecosystems have the highest potential to do so. To begin overcoming this barrier, Conservation South Africa in partnership with local government developed a socio-ecological approach for identifying spatial EbA priorities at the sub-national level. Using GIS-based multi-criteria analysis and vegetation distribution models, the authors have spatially integrated relevant ecological and social information at a scale appropriate to inform local level political, administrative, and operational decision makers. This is the first systematic approach of which we are aware that highlights spatial priority areas for EbA implementation. Nodes of socio-ecological vulnerability are identified, and the inclusion of areas that provide ecosystem services and ecological resilience to future climate change is innovative. The purpose of this paper is to present and demonstrate a methodology for combining complex information into user-friendly spatial products for local level decision making on EbA. The authors focus on illustrating the kinds of products that can be generated from combining information in the suggested ways, and do not discuss the nuance of climate models nor present specific technical details of the model outputs here. Two representative case studies from

A Socio-Ecological Approach for Identifying and Contextualising Spatial Ecosystem-Based Adaptation Priorities at the Sub-National Level

Science.gov (United States)

Bourne, Amanda; Holness, Stephen; Holden, Petra; Scorgie, Sarshen; Donatti, Camila I.; Midgley, Guy

2016-01-01

Climate change adds an additional layer of complexity to existing sustainable development and biodiversity conservation challenges. The impacts of global climate change are felt locally, and thus local governance structures will increasingly be responsible for preparedness and local responses. Ecosystem-based adaptation (EbA) options are gaining prominence as relevant climate change solutions. Local government officials seldom have an appropriate understanding of the role of ecosystem functioning in sustainable development goals, or access to relevant climate information. Thus the use of ecosystems in helping people adapt to climate change is limited partially by the lack of information on where ecosystems have the highest potential to do so. To begin overcoming this barrier, Conservation South Africa in partnership with local government developed a socio-ecological approach for identifying spatial EbA priorities at the sub-national level. Using GIS-based multi-criteria analysis and vegetation distribution models, the authors have spatially integrated relevant ecological and social information at a scale appropriate to inform local level political, administrative, and operational decision makers. This is the first systematic approach of which we are aware that highlights spatial priority areas for EbA implementation. Nodes of socio-ecological vulnerability are identified, and the inclusion of areas that provide ecosystem services and ecological resilience to future climate change is innovative. The purpose of this paper is to present and demonstrate a methodology for combining complex information into user-friendly spatial products for local level decision making on EbA. The authors focus on illustrating the kinds of products that can be generated from combining information in the suggested ways, and do not discuss the nuance of climate models nor present specific technical details of the model outputs here. Two representative case studies from rural South Africa

Spatiotemporal Evolution of Ebola Virus Disease at Sub-National Level during the 2014 West Africa Epidemic: Model Scrutiny and Data Meagreness.

Directory of Open Access Journals (Sweden)

Eva Santermans

Full Text Available The Ebola outbreak in West Africa has infected at least 27,443 individuals and killed 11,207, based on data until 24 June, 2015, released by the World Health Organization (WHO. This outbreak has been characterised by extensive geographic spread across the affected countries Guinea, Liberia and Sierra Leone, and by localized hotspots within these countries. The rapid recognition and quantitative assessment of localised areas of higher transmission can inform the optimal deployment of public health resources.A variety of mathematical models have been used to estimate the evolution of this epidemic, and some have pointed out the importance of the spatial heterogeneity apparent from incidence maps. However, little is known about the district-level transmission. Given that many response decisions are taken at sub-national level, the current study aimed to investigate the spatial heterogeneity by using a different modelling framework, built on publicly available data at district level. Furthermore, we assessed whether this model could quantify the effect of intervention measures and provide predictions at a local level to guide public health action. We used a two-stage modelling approach: a a flexible spatiotemporal growth model across all affected districts and b a deterministic SEIR compartmental model per district whenever deemed appropriate.Our estimates show substantial differences in the evolution of the outbreak in the various regions of Guinea, Liberia and Sierra Leone, illustrating the importance of monitoring the outbreak at district level. We also provide an estimate of the time-dependent district-specific effective reproduction number, as a quantitative measure to compare transmission between different districts and give input for informed decisions on control measures and resource allocation. Prediction and assessing the impact of control measures proved to be difficult without more accurate data. In conclusion, this study provides us a

Trends in contraceptive use and distribution of births with demographic risk factors in Ethiopia: a sub-national analysis.

Science.gov (United States)

Shiferaw, Solomon; Abdullah, Muna; Mekonnen, Yared; Maïga, Abdoulaye; Akinyemi, Akanni; Amouzou, Agbessi; Friedman, Howard; Barros, Aluisio J D; Hounton, Sennen

2015-01-01

Evidence shows that family planning contributes to the decline in child mortality by decreasing the proportions of births that are considered high risk. The main objective of the present analysis was to examine the trends in use of modern contraceptives and their relationship with total fertility rate (TFR) and distribution of births by demographic risk factors as defined by mother's age, birth interval, and birth order at the sub-national level in Ethiopia. Analyses used data from three Demographic and Health Surveys in Ethiopia (2000, 2005, and 2011), which are nationally representative data collected through questionnaire-based interviews from women 15-49 using a stratified, two-stage cluster sampling. First, we examined the trends of and relationship between TFR (in the 3 years before each survey) and modern contraceptive use among currently married women in all administrative regions over the time period 2000-2011 using linear regression analysis. We also examined the relationship between birth risks and under-five mortality using the no-risk group as a reference. Finally, multiple logistic regression analysis was performed to estimate the relationship between the effect of being a resident in one of the regions and having an avoidable birth risk (which includes births to mothers younger than 18 and older than 34 years, birth interval of less than 24 months and birth order higher than third) after adjusting for select covariates including wealth, educational status, residence, religion and exposure to family planning information. Sub-national-level regression analysis showed an inverse relationship between modern contraceptive use among married women and the TFR, with an average decrease of TFR by one child per woman associated with a 13 percentage point increase in modern contraceptive use between 2000 and 2011. A high percentage of births in Ethiopia (62%) fall in one of the risk categories (excluding first births), with wide regional variation from 55% in

Trends in contraceptive use and distribution of births with demographic risk factors in Ethiopia: a sub-national analysis

Directory of Open Access Journals (Sweden)

Solomon Shiferaw

2015-11-01

Full Text Available Background: Evidence shows that family planning contributes to the decline in child mortality by decreasing the proportions of births that are considered high risk. The main objective of the present analysis was to examine the trends in use of modern contraceptives and their relationship with total fertility rate (TFR and distribution of births by demographic risk factors as defined by mother's age, birth interval, and birth order at the sub-national level in Ethiopia. Design: Analyses used data from three Demographic and Health Surveys in Ethiopia (2000, 2005, and 2011, which are nationally representative data collected through questionnaire-based interviews from women 15–49 using a stratified, two-stage cluster sampling. First, we examined the trends of and relationship between TFR (in the 3 years before each survey and modern contraceptive use among currently married women in all administrative regions over the time period 2000–2011 using linear regression analysis. We also examined the relationship between birth risks and under-five mortality using the no-risk group as a reference. Finally, multiple logistic regression analysis was performed to estimate the relationship between the effect of being a resident in one of the regions and having an avoidable birth risk (which includes births to mothers younger than 18 and older than 34 years, birth interval of less than 24 months and birth order higher than third after adjusting for select covariates including wealth, educational status, residence, religion and exposure to family planning information. Results: Sub-national-level regression analysis showed an inverse relationship between modern contraceptive use among married women and the TFR, with an average decrease of TFR by one child per woman associated with a 13 percentage point increase in modern contraceptive use between 2000 and 2011. A high percentage of births in Ethiopia (62% fall in one of the risk categories (excluding first

The Association of State Rate Review Authority with Health Insurance Premiums.

Science.gov (United States)

Ticse, Caroline

2015-10-01

Key findings. (1) Adjusted premiums in the individual market in states with prior approval authority combined with loss ratio requirements were lower in 2010-2013 than premiums in states with no rate review authority or file-and-use regulations only. (2) Adjusted premiums declined modestly in prior approval states while premiums increased in states with no rate review authority or with file-and-use regulations only. (3) The findings suggest that states with prior approval authority and loss ratio requirements constrained increases in health insurance premiums.

Attempted suicide and contact with the primary health authorities

DEFF Research Database (Denmark)

Stenager, E N; Jensen, Knud

1994-01-01

In a study describing suicide attempters' approach to the health and social welfare authorities prior to a suicide attempt, it was found that one-fourth of the patients seeking help requested therapeutic consultations and only a few asked for medicinal treatment. Forty-four percent had taken newl...... with their general practitioner prior to the suicide attempt. Postgraduate courses for practitioners on depression diagnostics and suicidal behaviour are proposed as a measure in suicide prevention.......In a study describing suicide attempters' approach to the health and social welfare authorities prior to a suicide attempt, it was found that one-fourth of the patients seeking help requested therapeutic consultations and only a few asked for medicinal treatment. Forty-four percent had taken newly...... prescribed medicine for the parasuicide. It is concluded that the availability of psychological support and a more restrictive prescription of medicine could have a preventive effect on parasuicidal behaviour. Patients suffering from depression and pain have more often than other patients been in contact...

Applying the global RCP-SSP-SPA scenario framework at sub-national scale: A multi-scale and participatory scenario approach.

Science.gov (United States)

Kebede, Abiy S; Nicholls, Robert J; Allan, Andrew; Arto, Iñaki; Cazcarro, Ignacio; Fernandes, Jose A; Hill, Chris T; Hutton, Craig W; Kay, Susan; Lázár, Attila N; Macadam, Ian; Palmer, Matthew; Suckall, Natalie; Tompkins, Emma L; Vincent, Katharine; Whitehead, Paul W

2018-09-01

To better anticipate potential impacts of climate change, diverse information about the future is required, including climate, society and economy, and adaptation and mitigation. To address this need, a global RCP (Representative Concentration Pathways), SSP (Shared Socio-economic Pathways), and SPA (Shared climate Policy Assumptions) (RCP-SSP-SPA) scenario framework has been developed by the Intergovernmental Panel on Climate Change Fifth Assessment Report (IPCC-AR5). Application of this full global framework at sub-national scales introduces two key challenges: added complexity in capturing the multiple dimensions of change, and issues of scale. Perhaps for this reason, there are few such applications of this new framework. Here, we present an integrated multi-scale hybrid scenario approach that combines both expert-based and participatory methods. The framework has been developed and applied within the DECCMA 1 project with the purpose of exploring migration and adaptation in three deltas across West Africa and South Asia: (i) the Volta delta (Ghana), (ii) the Mahanadi delta (India), and (iii) the Ganges-Brahmaputra-Meghna (GBM) delta (Bangladesh/India). Using a climate scenario that encompasses a wide range of impacts (RCP8.5) combined with three SSP-based socio-economic scenarios (SSP2, SSP3, SSP5), we generate highly divergent and challenging scenario contexts across multiple scales against which robustness of the human and natural systems within the deltas are tested. In addition, we consider four distinct adaptation policy trajectories: Minimum intervention, Economic capacity expansion, System efficiency enhancement, and System restructuring, which describe alternative future bundles of adaptation actions/measures under different socio-economic trajectories. The paper highlights the importance of multi-scale (combined top-down and bottom-up) and participatory (joint expert-stakeholder) scenario methods for addressing uncertainty in adaptation decision

Evaluating sub-national building-energy efficiency policy options under uncertainty: Efficient sensitivity testing of alternative climate, technological, and socioeconomic futures in a regional integrated-assessment model

International Nuclear Information System (INIS)

Scott, Michael J.; Daly, Don S.; Zhou, Yuyu; Rice, Jennie S.; Patel, Pralit L.; McJeon, Haewon C.; Page Kyle, G.; Kim, Son H.; Eom, Jiyong

2014-01-01

Improving the energy efficiency of building stock, commercial equipment, and household appliances can have a major positive impact on energy use, carbon emissions, and building services. Sub-national regions such as the U.S. states wish to increase energy efficiency, reduce carbon emissions, or adapt to climate change. Evaluating sub-national policies to reduce energy use and emissions is difficult because of the large uncertainties in socioeconomic factors, technology performance and cost, and energy and climate policies. Climate change itself may undercut such policies. However, assessing all of the uncertainties of large-scale energy and climate models by performing thousands of model runs can be a significant modeling effort with its accompanying computational burden. By applying fractional–factorial methods to the GCAM-USA 50-state integrated-assessment model in the context of a particular policy question, this paper demonstrates how a decision-focused sensitivity analysis strategy can greatly reduce computational burden in the presence of uncertainty and reveal the important drivers for decisions and more detailed uncertainty analysis. - Highlights: • We evaluate building energy codes and standards for climate mitigation. • We use an integrated assessment model and fractional factorial methods. • Decision criteria are energy use, CO2 emitted, and building service cost. • We demonstrate sensitivity analysis for three states. • We identify key variables to propagate with Monte Carlo or surrogate models

Equality in Maternal and Newborn Health: Modelling Geographic Disparities in Utilisation of Care in Five East African Countries.

Directory of Open Access Journals (Sweden)

Corrine W Ruktanonchai

Full Text Available Geographic accessibility to health facilities represents a fundamental barrier to utilisation of maternal and newborn health (MNH services, driving historically hidden spatial pockets of localized inequalities. Here, we examine utilisation of MNH care as an emergent property of accessibility, highlighting high-resolution spatial heterogeneity and sub-national inequalities in receiving care before, during, and after delivery throughout five East African countries.We calculated a geographic inaccessibility score to the nearest health facility at 300 x 300 m using a dataset of 9,314 facilities throughout Burundi, Kenya, Rwanda, Tanzania and Uganda. Using Demographic and Health Surveys data, we utilised hierarchical mixed effects logistic regression to examine the odds of: 1 skilled birth attendance, 2 receiving 4+ antenatal care visits at time of delivery, and 3 receiving a postnatal health check-up within 48 hours of delivery. We applied model results onto the accessibility surface to visualise the probabilities of obtaining MNH care at both high-resolution and sub-national levels after adjusting for live births in 2015.Across all outcomes, decreasing wealth and education levels were associated with lower odds of obtaining MNH care. Increasing geographic inaccessibility scores were associated with the strongest effect in lowering odds of obtaining care observed across outcomes, with the widest disparities observed among skilled birth attendance. Specifically, for each increase in the inaccessibility score to the nearest health facility, the odds of having skilled birth attendance at delivery was reduced by over 75% (0.24; CI: 0.19-0.3, while the odds of receiving antenatal care decreased by nearly 25% (0.74; CI: 0.61-0.89 and 40% for obtaining postnatal care (0.58; CI: 0.45-0.75.Overall, these results suggest decreasing accessibility to the nearest health facility significantly deterred utilisation of all maternal health care services. These

42 CFR 431.620 - Agreement with State mental health authority or mental institutions.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Agreement with State mental health authority or mental institutions. 431.620 Section 431.620 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... GENERAL ADMINISTRATION Relations With Other Agencies § 431.620 Agreement with State mental health...

Annual report of the regional public health authorities in the Slovak Republic. Year 2010

International Nuclear Information System (INIS)

2011-04-01

A brief account of activities carried out by the regional public health authorities of the Public Health Authority of the Slovak Republic (UVZ SR) in 2010 is presented. These activities are reported under the headings: (1) The environment; (2) Preventive occupational medicine; (3)Hygiene of nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectivization of factors of living conditions; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Medical informatics and biostatistics.

Traditional health practitioners and the authority to issue medical ...

African Journals Online (AJOL)

The Council, as a professional body established by Parliament, gives traditional health practitioners registered with it the authority to issue medical certificates in line with the provisions of the Basic Conditions of Employment Act. However, the Council does not seem to be in a position to perform this function yet. Moreover ...

Provincial alcohol index and its relationship to alcohol-related harm in Thailand: implications for subnational alcohol policy development

Directory of Open Access Journals (Sweden)

Surasak Chaiyasong

2016-07-01

Full Text Available Abstract Background The Provincial Alcohol Index (PAI is one of the efforts to develop a composite measurement to operationalize the situation of alcohol consumption and related risk behaviors. The index offers a means for national and subnational alcohol control committees to address alcohol-related problems in their responsible jurisdiction areas. The objective of this study is to assess the relationship between PAI scores and alcohol-related problems using Thailand as an example. Methods Cross-sectional analyses of PAI scores based on the 2007 National Cigarette Smoking and Alcohol Drinking Behavior Survey (CSAD and the National Statistical Office data were conducted. CSAD data were collected from 168,285 Thai residents aged 15 years and above in 76 provinces of Thailand (population range 180,787 to 5,716,248. The PAI scores were generated using three different methods based on five indicators: 1 prevalence of adult (≥15 years drinkers, 2 prevalence of underage drinkers, 3 proportion of regular drinkers, 4 proportion of binge drinkers and 5 proportion of drink-drivers. Alcohol-related injuries and violent events together with provincial level covariates (age, gender, income and region were assessed. Correlational and linear regression analyses were performed to examine the relationship between PAI scores and alcohol-related problems. Results The PAI scores generated from the three methods were significantly correlated with one another (r > 0.7, p < 0.05 and significantly related to alcohol-related problems after adjusting for the provincial level covariates. Based on the normalized method, PAI scores had a significant and positive relationship with prevalence of alcohol-related injuries (beta = 562 cases per million population, p = 0.027 and violence (beta = 451 events per million population, p = 0.013. PAI scores were highest in the north and lowest in the south of the country. Conclusions The findings of this

Assessment, authorization and access to medicaid managed mental health care.

Science.gov (United States)

Masland, Mary C; Snowden, Lonnie R; Wallace, Neal T

2007-11-01

Examined were effects on access of managed care assessment and authorization processes in California's 57 county mental health plans. Primary data on managed care implementation were collected from surveys of county plan administrators; secondary data were from Medicaid claims and enrollment files. Using multivariate fixed effects regression, we found that following implementation of managed care, greater access occurred in county plans where assessments and treatment were performed by the same clinician, and where service authorizations were made more rapidly. Lower access occurred in county plans where treating clinicians authorized services themselves. Results confirm the significant effects of managed care processes on outcomes and highlight the importance of system capacity.

Annual report of the regional public health authorities in the Slovak Republic. Year 2011

International Nuclear Information System (INIS)

2011-07-01

A brief account of activities carried out by the regional public health authorities of the Public Health Authority of the Slovak Republic (UVZ SR) in 2011 is presented. These activities are reported under the headings: (1) The environment; (2) Preventive occupational medicine; (3)Hygiene of nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectivization of factors of living conditions; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Medical informatics and biostatistics; (12) Lectures and publications.

Annual report of the regional public health authorities in the Slovak Republic. Year 2012

International Nuclear Information System (INIS)

2013-02-01

A brief account of activities carried out by the regional public health authorities of the Public Health Authority of the Slovak Republic (UVZ SR) in 2012 is presented. These activities are reported under the headings: (1) The environment; (2) Preventive occupational medicine; (3) Hygiene of nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectivization of factors of living conditions; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Medical informatics and biostatistics; (12) Lectures and publications.

Spatial model for risk prediction and sub-national prioritization to aid poliovirus eradication in Pakistan.

Science.gov (United States)

Mercer, Laina D; Safdar, Rana M; Ahmed, Jamal; Mahamud, Abdirahman; Khan, M Muzaffar; Gerber, Sue; O'Leary, Aiden; Ryan, Mike; Salet, Frank; Kroiss, Steve J; Lyons, Hil; Upfill-Brown, Alexander; Chabot-Couture, Guillaume

2017-10-11

Pakistan is one of only three countries where poliovirus circulation remains endemic. For the Pakistan Polio Eradication Program, identifying high risk districts is essential to target interventions and allocate limited resources. Using a hierarchical Bayesian framework we developed a spatial Poisson hurdle model to jointly model the probability of one or more paralytic polio cases, and the number of cases that would be detected in the event of an outbreak. Rates of underimmunization, routine immunization, and population immunity, as well as seasonality and a history of cases were used to project future risk of cases. The expected number of cases in each district in a 6-month period was predicted using indicators from the previous 6-months and the estimated coefficients from the model. The model achieves an average of 90% predictive accuracy as measured by area under the receiver operating characteristic (ROC) curve, for the past 3 years of cases. The risk of poliovirus has decreased dramatically in many of the key reservoir areas in Pakistan. The results of this model have been used to prioritize sub-national areas in Pakistan to receive additional immunization activities, additional monitoring, or other special interventions.

Relations between authorities in the Slovenian local self-government system

Directory of Open Access Journals (Sweden)

Anja Grabner

2013-01-01

Full Text Available The paper aims to analyse the relationship between the legislative (municipal council and executive (mayor, deputy mayor branches of power in the Slovenian system of local self-government. In the centre lies the role of the mayor, the role of the director of the municipal administration and the role of the municipal council together with the relationship (which has changed significantly in the past two decades between the mayor and these two bodies. The theoretical anchor of the contribution is the work of Mouritzen and Svara (2002 where the authors categorise ideal models of executive government at the sub-national levels of government and the relations inside the executive. Based on previous empirical research studies, we analyse the functioning of the executive and legislative branches of power and their mutual relations, starting from the assumption that those relations do not correspond to the quite rigidly defined normative frameworks, but in practice often move beyond them.

Political contexts and maternal health policy: insights from a comparison of south Indian states.

Science.gov (United States)

Smith, Stephanie L

2014-01-01

Nearly 300,000 women die from pregnancy-related complications each year. One-fifth of these deaths occur in India. Maternal survival rose on India's national policy agenda in the mid-2000s, but responsibility for health policy and implementation in the federal system is largely devolved to the state level where priority for the issue and maternal health outcomes vary. This study investigates sources of variation in maternal health policy and implementation sub-nationally in India. The study is guided by four analytical categories drawn from policy process literature: constitutional, governing and social structures; political contexts; actors and ideas. The experiences of two south Indian states-Tamil Nadu a leader and Karnataka a relatively slow mover-are examined. Process-tracing, a case study methodology that helps to identify roles of complex historical events in causal processes, was employed to investigate the research question in each state. The study is informed by interviews with public health policy experts and service delivery professionals, observation of implementation sites and archival document analysis. Historical legacies-Tamil Nadu's non-Brahmin social movement and Karnataka's developmental disparities combined with decentralization-shape the states' political contexts, affecting variation in maternal health policy and implementation. Competition to advance consistent political priorities across regimes in Tamil Nadu offers fertile ground for policy entrepreneurship and strong public health system administration facilitates progress. Inconsistent political priorities and relatively weak public health system administration frustrate progress in Karnataka. These variations offer insights to the ways in which sub-national political and administrative contexts shape health policy and implementation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Measuring the authority of local public health directors in the context of organizational structure: an exploratory, multimodal approach.

Science.gov (United States)

Miner Gearin, Kimberly J; Thrash, Allison M Rick; Frauendienst, Renee; Myhre, Julie; Gyllstrom, M Elizabeth; Riley, William J; Schroeder, Janelle

2012-11-01

Studies have reported a relationship between the organization of public health services and variability in public health practice at the local and state levels. A national research agenda has prioritized practice-based research to understand pathways that lead to this variation and examine the impact of these differences on outcomes. To measure the extent to which Minnesota local health directors report having key authorities and examine the relationship between organizational structure and authority of local health directors. : Multimodal. Minnesota local health departments. Directors of Minnesota local health departments. Director authorities. Most Minnesota local health directors reported having 6 key authorities related to budget preparation and modification and interaction with local elected officials (n = 51, 71%). Twelve directors (16%) reported that they have 4 or fewer of the 6 authorities. The authority most commonly reported as lacking was the authority to initiate communication with locally elected officials (n = 15, 21%). The percentage of directors who reported having all 6 authorities was higher among those in stand-alone departments (82%) than those in combined organizations (50%). This descriptive study illustrates that emerging practice-based research networks can successfully collaborate on small-scale research projects with immediate application for systems development. Study findings are being used by local public health officials to help articulate their role, aid in succession planning, and inform elected officials, who need to consider the public health implications of potential changes to local public health governance and organization. More studies are needed to refine measurement of authority and structure.

Conceptions of authority within contemporary social work practice in managed mental health care organizations.

Science.gov (United States)

Bransford, Cassandra L

2005-07-01

This article examines how social workers may use their authority to create managed mental health care organizations that support the principles and values of professional social work practice. By exploring research and theoretical contributions from a multidisciplinary perspective, the author suggests ways that social workers may incorporate empowerment strategies into their organizational practices to create more socially responsible and humane mental health organizations. (c) 2005 APA, all rights reserved.

76 FR 58006 - Office of the National Coordinator for Health Information Technology; Delegation of Authority

Science.gov (United States)

2011-09-19

... for Health Information Technology; Delegation of Authority Notice is hereby given that I have delegated to the National Coordinator for Health Information Technology (National Coordinator), or his or... information technology as it relates to health information and health promotion, preventive health services...

The Modernization of the Audit Courts of Brazil: PROMOEX deployment assessment in Audit Courts subnational

Directory of Open Access Journals (Sweden)

Diones Gomes da Rocha

2017-09-01

Full Text Available Mainly since the Brazilian Federal Constitution of 1988, the Brazilian Courts of Accounts (TC had expanded its expertise to carry out the control of management of public entities on different perspectives, such as operational, accounting, budgetary and financial. The differences between these institutions in terms of economic, technological and human resources were factors that made it difficult to adapt these institutions to the new acquired competences. The Promoex then emerged as a solution for modernization of Brazilian subnational Courts of Accounts. Such solution had funds of US $ 64.4 million dollars. The purpose of this research, therefore, is to assess the implementation of this program by 33 TCs. The evaluation was conducted from documents collected from web pages of MPOG, ATRICON, IRB and the Portal of Brazil Courts of Accounts. The Loan Agreement 1628-OC / BR, Object Compliance Report, Progress Reports of the 1st and 2nd semesters of 2013 (final report, and surveys conducted by the FIA and FGV also were scrutinized. The results indicate that the Promoex was less than expected; the modernization proposals were more focused on solving administrative problems, as well as by the low impact of Promoex over the actions developed by the TCs.

The NIHR Public Health Research Programme: responding to local authority research needs in the United Kingdom.

Science.gov (United States)

Dorling, Hannah; Cook, Andrew; Ollerhead, Liz; Westmore, Matt

2015-12-11

The remit of the National Institute for Health Research Public Health Research (PHR) Programme is to evaluate public health interventions, providing new knowledge on the benefits, costs, acceptability and wider impacts of interventions, set outside of the National Health Service, intended to improve the health of the public and reduce inequalities. This paper illustrates how the PHR Programme is providing new knowledge for public health decision makers, based on the nine key areas for local authority public health action, described by the King's Fund. Many funded PHR projects are evaluating interventions, applied in a range of settings, across the identified key areas for local authority influence. For example, research has been funded on children and young people, and for some of the wider determinants of health, such as housing and travel. Other factors, such as spatial planning, or open and green spaces and leisure, are less represented in the PHR Programme. Further opportunities in research include interventions to improve the health of adolescents, adults in workplaces, and communities. Building evidence for public health interventions at local authority level is important to prioritise and implement effective changes to improve population health.

Contributions of national and global health estimates to monitoring health-related Sustainable Development Goals in Thailand.

Science.gov (United States)

Bundhamcharoen, Kanitta; Limwattananon, Supon; Kusreesakul, Khanitta; Tangcharoensathien, Viroj

2017-01-01

The Millennium Development Goals (MDGs) triggered increased demand for data on child and maternal mortality for monitoring progress. With the advent of the Sustainable Development Goals (SDGs) and growing evidence of an epidemiological transition towards non-communicable diseases, policy makers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons. This paper draws lessons learned from Thailand's burden of disease study (BOD) on capacity development for NHEs, and discusses the contributions and limitation of GHEs in informing policies at country level. Through training and technical support by external partners, capacities are gradually strengthened and institutionalized to enable regular updates of BOD at national and sub-national levels. Initially, the quality of cause of death reporting in the death certificates was inadequate, especially for deaths occurring in the community. Verbal autopsies were conducted, using domestic resources, to determine probable causes of deaths occurring in the community. This helped improve the estimation of years of life lost. Since the achievement of universal health coverage in 2002, the quality of clinical data on morbidities has also considerably improved. There are significant discrepancies between the 2010 Global Burden of Diseases (GBD) estimates for Thailand and the 1999 nationally generated BOD, especially for years of life lost due to HIV/AIDS, and the ranking of priority diseases. National ownership of NHEs and effective interfaces between researchers and decision makers contribute to enhanced country policy responses, while sub-national data are intended to be used by various sub-national-level partners. Though GHEs contribute to benchmarking country achievement compared with global health

Availability of information in Public Health on the Internet: An analysis of national health authorities in the Spanish-speaking Latin American and Caribbean countries.

Science.gov (United States)

Novillo-Ortiz, David; Hernández-Pérez, Tony; Saigí-Rubió, Francesc

2017-04-01

Access to reliable and quality health information and appropriate medical advice can contribute to a dramatic reduction in the mortality figures of countries. The governments of the Americas are faced with the opportunity to continue working on this challenge, and their institutional presence on their websites should play a key role in this task. In a setting where the access to information is essential to both health professionals and citizens, it is relevant to analyze the role of national health authorities. Given that search engines play such a key role in the access to health information, it is important to specifically know - in connection to national health authorities - whether health information offered is easily available to the population, and whether this information is well-ranked in search engines. Quantitative methods were used to gather data on the institutional presence of national health authorities on the web. An exploratory and descriptive research served to analyze and interpret data and information obtained quantitatively from different perspectives, including an analysis by country, and also by leading causes of death. A total of 18 web pages were analyzed. Information on leading causes of death was searched on websites of national health authorities in the week of August 10-14, 2015. The probability of finding information of national health authorities on the 10 leading causes of death in a country, among the top 10 results on Google, is 6.66%. Additionally, ten out the 18 countries under study (55%) do not have information ranked among the top results in Google when searching for the selected terms. Additionally, a total of 33 websites represent the sources of information with the highest visibility for all the search strategies in each country on Google for the ten leading causes of death in a country. Two websites, the National Library of Medicine and Wikipedia, occur as a result with visibility in the total of eighteen countries of the

Measuring success in global health diplomacy: lessons from marketing food to children in India.

Science.gov (United States)

Smith, Richard; Irwin, Rachel

2016-06-16

Global health diplomacy (GHD) focuses on international negotiation; principally between nation states, but increasingly non-state actors However, agreements made at the global level have to be enacted at the national, and in some cases the sub-national level. This presents two related problems: (1) how can success be measured in global health diplomacy and (2) at what point should success be evaluated? This commentary highlights these issues through examining the relationship between India and the WHO Set of Recommendations on the Marketing of Food and Non-alcoholic Beverages to Children, endorsed by Resolution WHA63.14 at the 63rd World Health Assembly in 2010.

"Your body is your business card": Bodily capital and health authority in the fitness industry.

Science.gov (United States)

Hutson, David J

2013-08-01

Although scholars have noted the connection between appearance and assumptions of health, the degree to which these assumptions matter for establishing authority in social interaction remains less clear. Using a theoretical framework involving "bodily capital"--that is, the value generated from appearance, attractiveness, and physical ability--I investigate the role of appearance in the U.S. fitness industry. Drawing on data from interviews with 26 personal trainers and 25 clients between 2010 and 2011, I find that a trainer's fit-appearing physique imbues their interactions with a degree of moral and health authority. This corporeal credibility engenders trust among clients and allows exercise to be understood as a form of health work. The implications for academics and medical practitioners reach beyond the gym setting and extend recent research linking appearance to health, authority, and medical credibility. Copyright © 2013 Elsevier Ltd. All rights reserved.

Integrating authorities and disciplines into the preparedness-planning process: a study of mental health, public health, and emergency management.

Science.gov (United States)

Robertson, Madeline; Pfefferbaum, Betty; Codispoti, Catherine R; Montgomery, Juliann M

2007-01-01

The process of integrating all necessary authorities and disciplines into an organized preparedness plan is complex, and the inclusion of disaster mental health poses specific challenges. The goals of this project were (1) to identify whether state mental health preparedness was included in state public health and emergency management preparedness plans, (2) to document barriers to entry and strategies reportedly used by state authorities in efforts to incorporate reasonable mental health preparedness into existing public health and emergency management preparedness planning, (3) to employ a theory for organizational change to organize and synthesize this information, and (4) to stimulate further discussion and research supporting coordinated preparedness efforts at the state level, particularly those inclusive of mental health. To accomplish these goals we (1) counted the number of state public health preparedness and emergency management plans that either included, mentioned, or omitted a mental health preparedness plan; (2) interviewed key officials from nine representative states for their reports on strategies used in seeking greater inclusion of mental health preparedness in public health and emergency management preparedness planning; and (3) synthesized these results to contribute to the national dialogue on coordinating disaster preparedness, particularly with respect to mental health preparedness. We found that 15 out of 29 publicly available public health preparedness plans (52 percent) included mental health preparedness, and eight of 43 publicly available emergency management plans (18 percent) incorporated mental health. Interviewees reported numerous barriers and strategies, which we cataloged according to a well-accepted eight-step plan for transforming organizations.

CHIS – Letter from French health insurance authorities "Assurance Maladie" and “frontalier” status

CERN Multimedia

2014-01-01

Certain members of the personnel residing in France have recently received a letter, addressed to themselves and/or their spouse, from the French health insurance authorities (Assurance Maladie) on the subject of changes in the health insurance coverage of “frontalier” workers.   It should be recalled that employed members of personnel (MPE) are not affected by the changes made by the French authorities to frontalier  workers' "right to choose" (droit d'option) in matters of health insurance (see the CHIS website for more details), which took effect as of 1 June 2014, as they are not considered to be frontalier workers. Associated members of the personnel (MPA) are not affected either, unless they live in France and are employed by a Swiss institute. For the small number of MPAs in the latter category who might be affected, as well as for family members who do have frontalier status, CERN is still in discussion with the authorities o...

Social media in public health: an analysis of national health authorities and leading causes of death in Spanish-speaking Latin American and Caribbean countries.

Science.gov (United States)

Novillo-Ortiz, David; Hernández-Pérez, Tony

2017-02-03

Information and communications technologies, like social media, have the potential to reduce some barriers in disease prevention and control in the Americas. National health authorities can use these technologies to provide access to reliable and quality health information. A study was conducted to analyze availability of information about the leading causes of death on social media channels of national health authorities in 18 Spanish-speaking Latin American and Caribbean countries. We gathered data of national health authorities's institutional presence in social media. Exploratory-descriptive research was useful for analysis and interpretation of the data collected. An analysis was carried out for 6 months, from April 1 to September 30, 2015. Sixteen of the 18 countries studied have institutional presences on social media. National health authorities have a presence in an average of almost three platforms (2.8%). An average of 1% of the populations with Internet access across the 18 countries in this study follows national health authorities on social media (approximately, an average of 0.3% of the total population of the countries under study). On average, information on 3.2 of the 10 leading causes of death was posted on the national health authorities' Facebook pages, and information on 2.9 of the 10 leading causes of death was posted on their Twitter profiles. Additionally, regarding public health expenditures and the possibility of retrieving information on the leading causes of death, an apparent negative correlation exists in the case of Facebook, r(13) = -.54, P = .03 and a weak negative correlation in the case of Twitter, r(14) = -.26, P = .31, for the countries with presences in those networks. National health authorities can improve their role in participating in conversations on social media regarding the leading causes of death affecting their countries. Taking into account Internet accessibility levels in the countries under study

National and subnational mortality effects of metabolic risk factors and smoking in Iran: a comparative risk assessment

Directory of Open Access Journals (Sweden)

Farzadfar Farshad

2011-10-01

Full Text Available Abstract Background Mortality from cardiovascular and other chronic diseases has increased in Iran. Our aim was to estimate the effects of smoking and high systolic blood pressure (SBP, fasting plasma glucose (FPG, total cholesterol (TC, and high body mass index (BMI on mortality and life expectancy, nationally and subnationally, using representative data and comparable methods. Methods We used data from the Non-Communicable Disease Surveillance Survey to estimate means and standard deviations for the metabolic risk factors, nationally and by region. Lung cancer mortality was used to measure cumulative exposure to smoking. We used data from the death registration system to estimate age-, sex-, and disease-specific numbers of deaths in 2005, adjusted for incompleteness using demographic methods. We used systematic reviews and meta-analyses of epidemiologic studies to obtain the effect of risk factors on disease-specific mortality. We estimated deaths and life expectancy loss attributable to risk factors using the comparative risk assessment framework. Results In 2005, high SBP was responsible for 41,000 (95% uncertainty interval: 38,000, 44,000 deaths in men and 39,000 (36,000, 42,000 deaths in women in Iran. High FPG, BMI, and TC were responsible for about one-third to one-half of deaths attributable to SBP in men and/or women. Smoking was responsible for 9,000 deaths among men and 2,000 among women. If SBP were reduced to optimal levels, life expectancy at birth would increase by 3.2 years (2.6, 3.9 and 4.1 years (3.2, 4.9 in men and women, respectively; the life expectancy gains ranged from 1.1 to 1.8 years for TC, BMI, and FPG. SBP was also responsible for the largest number of deaths in every region, with age-standardized attributable mortality ranging from 257 to 333 deaths per 100,000 adults in different regions. Discussion Management of blood pressure through diet, lifestyle, and pharmacological interventions should be a priority in Iran

Annual report of the Public Health Authority of the Slovak Republic in 2005

International Nuclear Information System (INIS)

2006-01-01

A brief account of activities carried out by the Public Health Authority of the Slovak Republic (UVZ SR) in 2005 is presented. These activities are reported under the headings: (1) Structural organization of the UVZ SR; (2) Section Hygiene Living and Working Conditions; (3) Division of Health Protection Against Radiation; (4) Epidemiology Section; (5) Division of Medical Microbiology; (6) Section Protection, Promotion and Development of Health; (7) Department of objectification factors welfare.

Health consequences of road accidents: insights from local health authority registries.

Science.gov (United States)

Bertoncello, C; Furlan, P; Baldovin, T; Marcolongo, A; Casale, P; Cocchio, S; Buja, A; Baldo, V

2013-01-01

Road accidents are a major public health problem that affect all age groups but their impact is most striking among the young. The aim of this study is to quantify the burden of road traffic injuries, their mortality and direct in-patient economic costs and to identify the age classes at highest risk for severe road traffic injuries, through analysis of data collected by information systems of an Italian Local Health Authority. The study was conducted in a Local Health Authority of Veneto Region. Injured people were selected from Emergency Department (2006-2010). Data were linked to the Hospital Information System for hospital admissions and to the Mortality Registry to check 30-day mortality. The direct costs associated to hospitalizations were estimated through Diagnosis Related Group reimbursement rates. Multivariate analysis was performed using hospitalization and mortality as the dependent variables and gender, age, day of week when accident occurred as the independent variables. Traffic injury, hospitalization and mortality incidence rates were calculated by gender and age per 100,000 residents per year. The road traffic injuries were 9,192, decreasing from 2,112 in 2006 to 1,980 in 2010. Among injured persons 55.3% were male (68.1% among 15-19 age class); 41.7% young people aged 15-34 years (43.9% among male, 39.0% among female). Total hospitalisation rate was 5.9%. Overall mortality rate was 0.3% (0.9% among aged 65 or older). The cost of hospital admission was euro 2,742,505 (hospitalization mean cost euro 5,097). Risk of hospitalization and death was higher in male, in elderly and during week end. Young people aged 15-19 had the highest incidence of visits (2,258.4 per 100,000) and high hospitalisation weekend and mortality rates (respectively 101.5 and 8.5). Analysis at local level, using current data sources, permits to estimate the burden of injuries caused by road-traffic, to describe the characteristics of injured persons and finally to estimate

Influencing public health without authority.

Science.gov (United States)

Suresh, K

2012-01-01

This paper analyzes the present processes, products and needs of post-graduate public health education for the health programming, implementation and oversight responsibilities at field level and suggests some solutions for the institutes to adopt or adapt for improving the quality of their scholars. Large number of institutions has cropped up in India in the recent years to meet the growing demand of public health specialists/practitioners in various national health projects, international development partners, national and international NGOs. Throwing open MPH courses to multi-disciplinary graduate's is a new phenomenon in India and may be a two edged sword. On one hand it is advantageous to produce multi-faceted Public health postgraduates to meet the multi tasking required, on the other hand getting all of them to a common basic understanding, demystifying technical teaching and churning out products that are acceptable to the traditional health system. These Institutions can and must influence public health in the country through producing professionals of MPH/ MD degree with right attitude and skill-mix. Engaging learners in experimentation, experience sharing projects, stepping into health professionals' roles and similar activities lead to development of relatively clear and permanent neural traces in the brain. The MPH institutes may not have all efficient faculties, for which they should try to achieve this by inviting veterans in public health and professionals from corporate health industry for interface with students on a regular basis. The corporate and public health stalwarts have the capacities to transmit the winning skills and knowledge and also inspire them to adopt or adapt in order to achieve the desired goals.

75 FR 18138 - Health Care Eligibility Under the Secretarial Designee Program and Related Special Authorities

Science.gov (United States)

2010-04-09

... Component members not in a present duty status. This authority includes payment for health care services in... 0790-AI52] Health Care Eligibility Under the Secretarial Designee Program and Related Special... establish policies and assign responsibilities for health care eligibility under the Secretarial Designee...

75 FR 72682 - Health Care Eligibility Under the Secretarial Designee Program and Related Special Authorities

Science.gov (United States)

2010-11-26

... members not in a present duty status. This authority includes payment for health care services in private... 0790-AI52 Health Care Eligibility Under the Secretarial Designee Program and Related Special... assigns responsibilities for health care eligibility under the Secretarial Designee Program. It also...

Social capital, ideology, and health in the United States.

Science.gov (United States)

Herian, Mitchel N; Tay, Louis; Hamm, Joseph A; Diener, Ed

2014-03-01

Research from across disciplines has demonstrated that social and political contextual factors at the national and subnational levels can impact the health and health behavior risks of individuals. This paper examines the impact of state-level social capital and ideology on individual-level health outcomes in the U.S. Leveraging the variation that exists across states in the U.S., the results reveal that individuals report better health in states with higher levels of governmental liberalism and in states with higher levels of social capital. Critically, however, the effect of social capital was moderated by liberalism such that social capital was a stronger predictor of health in states with low levels of liberalism. We interpret this finding to mean that social capital within a political unit-as indicated by measures of interpersonal trust-can serve as a substitute for the beneficial impacts that might result from an active governmental structure. Copyright © 2014 Elsevier Ltd. All rights reserved.

Annual report of the Public Health Authority of the Slovak Republic in 2010

International Nuclear Information System (INIS)

2011-01-01

A brief account of activities carried out by the Public Health Authority of the Slovak Republic (UVZ SR) in 2010 is presented. These activities are reported under the headings: (1) General part; (2) Department of legislation and law; (3) Department of control, surveillance and complaints; (4) Department of environmental health; (5) Department of preventive occupational medicine; (6) Department of food hygiene, food safety and cosmetic products; (7) Department of hygiene of children and youth; (8) Department of objectification factors welfare; (9) Department of medical microbiology; (10) Department of epidemiology; (11) Division of health protection against radiation; (12) Department of health promotion; (13) Department of alcohol and tobacco control.

Annual report of the Public Health Authority of the Slovak Republic in 2012

International Nuclear Information System (INIS)

2013-01-01

A brief account of activities carried out by the Public Health Authority of the Slovak Republic (UVZ SR) in 2012 is presented. These activities are reported under the headings: (1) General part; (2) Department of Legislation and Law; (3) Department inspection, supervision and complaints; (4) Department of International Relations; (5) Department of Environmental Health; (6) Department of Preventive Occupational Medicine; (7) Department of food hygiene, food safety and cosmetic products; (8) Department of Hygiene of Children and Youth; (9) Department of objectification factors welfare; (10) Department of Medical Microbiology; (11) Department of Epidemiology; (12) Department of Health Promotion; (13) Department of health protection against radiation; (14) Publications and Lectures.

Annual report of the Public Health Authority of the Slovak Republic for 2007

International Nuclear Information System (INIS)

2008-01-01

A brief account of activities carried out by the Public Health Authority of the Slovak Republic (UVZ SR) in 2006 is presented. These activities are reported under the headings: (1) General section; (2) Department of legislation and law; (3) Department of control, surveillance and complaints; (4) Department of environmental health; (5) Department of preventive occupational medicine; (6) Department of food hygiene, food safety and cosmetic products; (7) Department of hygiene of children and youth; (8) Department of objectification factors welfare; (9) Department of medical microbiology; (10) Department of epidemiology; (11) Department of health protection against radiation; (12) Department of health promotion; (13) Center of tobacco control.

States with stronger health insurance rate review authority experienced lower premiums in the individual market in 2010-13.

Science.gov (United States)

Karaca-Mandic, Pinar; Fulton, Brent D; Hollingshead, Ann; Scheffler, Richard M

2015-08-01

States have varying degrees of review authority over health insurance carriers' rates, including prior approval authority over proposed rates and requirements for loss ratios, the proportion of premium revenues spent on medical claims. The Affordable Care Act (ACA) requires carriers in certain categories of health insurance to provide public justification for rate increases of 10 percent or more. We collected data on how states changed their rate review authority and requirements during 2010-13, the years immediately after enactment of the ACA, and we combined these data with carrier filings. We found that adjusted premiums in the individual market in states that had prior-approval authority combined with loss ratio requirements were lower in 2010-13 ($3,489) than premiums in states with no rate review authority or that had only file-and-use regulations, which gave the states no authority to block rate increases ($3,617). Adjusted premiums declined modestly in prior-approval states with loss ratio requirements, from $3,526 in 2010 to $3,452 in 2013, while premiums increased from $3,422 to $3,683 in states with no rate review authority or file-and-use regulations only. Our findings suggest that states with prior approval authority and loss ratio requirements constrained health insurance premium increases. Project HOPE—The People-to-People Health Foundation, Inc.

78 FR 14303 - Statement of Delegation of Authority; Health Resources and Services Administration and Centers...

Science.gov (United States)

2013-03-05

... Services Administration and Centers for Disease Control and Prevention I hereby delegate to the Administrator, Health Resources and Services Administration (HRSA), and the Director, Centers for Disease Control and Prevention (CDC), with authority to redelegate, the authority vested in the Secretary of the...

GeoCREV: veterinary geographical information system and the development of a practical sub-national spatial data infrastructure

Directory of Open Access Journals (Sweden)

Nicola Ferrè

2011-05-01

Full Text Available This paper illustrates and discusses the key issues of the geographical information system (GIS developed by the Unit of Veterinary Epidemiology of the Veneto region (CREV, defined according to user needs, spatial data (availability, accessibility and applicability, development, technical aspects, inter-institutional relationships, constraints and policies. GeoCREV, the support system for decision-making, was designed to integrate geographic information and veterinary laboratory data with the main aim to develop a sub-national, spatial data infrastructure (SDI for the veterinary services of the Veneto region in north-eastern Italy. Its implementation required (i collection of data and information; (ii building a geodatabase; and (iii development of a WebGIS application. Tools for the management, collection, validation and dissemination of the results (public access and limited access were developed. The modular concept facilitates the updating and development of the system according to user needs and data availability. The GIS management practices that were followed to develop the system are outlined, followed by a detailed discussion of the key elements of the GIS implementation process (data model, technical aspects, inter-institutional relationship, user dimension and institutional framework. Problems encountered in organising the non-spatial data and the future work directions are also described.

GeoCREV: veterinary geographical information system and the development of a practical sub-national spatial data infrastructure.

Science.gov (United States)

Ferrè, Nicola; Mulatti, Paolo; Mazzucato, Matteo; Lorenzetto, Monica; Trolese, Matteo; Pandolfo, Dario; Vio, Piero; Sitta, Guido; Marangon, Stefano

2011-05-01

This paper illustrates and discusses the key issues of the geographical information system (GIS) developed by the Unit of Veterinary Epidemiology of the Veneto region (CREV), defined according to user needs, spatial data (availability, accessibility and applicability), development, technical aspects, inter-institutional relationships, constraints and policies. GeoCREV, the support system for decision-making, was designed to integrate geographic information and veterinary laboratory data with the main aim to develop a sub-national, spatial data infrastructure (SDI) for the veterinary services of the Veneto region in north-eastern Italy. Its implementation required (i) collection of data and information; (ii) building a geodatabase; and (iii) development of a WebGIS application. Tools for the management, collection, validation and dissemination of the results (public access and limited access) were developed. The modular concept facilitates the updating and development of the system according to user needs and data availability. The GIS management practices that were followed to develop the system are outlined, followed by a detailed discussion of the key elements of the GIS implementation process (data model, technical aspects, inter-institutional relationship, user dimension and institutional framework). Problems encountered in organising the non-spatial data and the future work directions are also described.

Political Discourses, Territorial Configuration and Taxation : : Conflicts in Antioquia and Cauca, Colombia (1850-1899)

OpenAIRE

Kerguelén Méndez, Ricardo José

2014-01-01

This dissertation analyzes Colombia's conflictive nineteenth-century state-building process, focusing in the subnational territories of Antioquia and Cauca. It studies the interconnected processes of territorial reconfiguration and decentralization (and recentralization) of state-authority from 1850 to 1899. Throughout these decades, the conflictive relations between the central government and the political elites in the nine subnational territories, and among them, set the stage for uncompro...

Annual activity report of the Public Health Authority of the Slovak Republic for 2007

International Nuclear Information System (INIS)

2008-01-01

A brief account of activities carried out by the Public Health Authority of the Slovak Republic (UVZ SR) in 2007 of regional offices is presented. These activities are reported under the headings: (1) Environment; (2) Preventive occupational medicine; (3) Food Hygiene; (4) Hygiene of children and youth; (5) Epidemiology; (6) Laboratories objectification factors and working environments; (7)Medical microbiology; (8) Health education; (9) Health protection against radiation; (10) Complaints and petitions; (11) Evaluation of punitive measures for 2007.

Where You Live Matters: Localising Environmental Impacts on Health, Nutrition and Poverty in Cambodia Using Small Area Estimation Techniques

Science.gov (United States)

Nilsen, K.; van Soesbergen, A.; Matthews, Z.

2016-12-01

Socioeconomic development depends on local environments. However, the scientific evidence quantifying the impact of environmental factors on health, nutrition and poverty at subnational levels is limited. This is because socioeconomic indicators are derived from sample surveys representative only at aggregate levels compared to environmental variables mostly available in high-resolution grids. Cambodia was selected because of its commitment to development in the context of a rapidly deteriorating environment. Having made considerable progress since 2005, access to health services is limited, a quarter of the population is still poor and 40% rural children are malnourished. Cambodia is also facing considerable environmental challenges including high deforestation rates, land degradation and natural hazards. Addressing existing gaps in the knowledge of environmental impacts on health and livelihoods, this study applies small area estimation (SAE) to quantify health, nutritional and poverty outcomes in the context of local environments. SAE produces reliable subnational estimates of socioeconomic outcomes available only from sample surveys by combining them with information from auxiliary sources (census). A model is used to explain common trades across areas and a random effect structure is applied to explain the observed extra heterogeneity. SAE models predicting health, nutrition and poverty outcomes excluding and including contextual environmental variables on natural hazards vulnerability, forest cover, climate, and agricultural production are compared. Results are mapped at regional and district levels to spatially assess the impacts of environmental variation on the outcomes. Inter and intra-regional inequalities are also estimated to examine the efficacy of health/socioeconomic policy targeting based on geographic location. Preliminary results suggest that localised environmental factors have considerable impacts on the indicators estimated and should

Public health journals' requirements for authors to disclose funding and conflicts of interest: a cross-sectional study.

Science.gov (United States)

Daou, Karim N; Hakoum, Maram B; Khamis, Assem M; Bou-Karroum, Lama; Ali, Ahmed; Habib, Joseph R; Semaan, Aline T; Guyatt, Gordon; Akl, Elie A

2018-04-23

Public health journals need to have clear policies for reporting the funding of studies and authors' personal financial and non-financial conflicts of interest (COI) disclosures. This study aims to assess the policies of public health journals on reporting of study funding and the disclosure of authors' COIs. This is a cross-sectional study of "Public, Environmental & Occupational Health" journals. Teams of two researchers abstracted data in duplicate and independently using REDCap software. Of 173 public health journals, 155 (90%) had a policy for reporting study funding information. Out of these, a majority did not require reporting of the phase of the study for which funding was received (88%), nor the types of funding sources (87%). Of the 173 journals, 163 (94%) had a policy requiring disclosure of authors' COI. However, the majority of these journals did not require financial conflicts of interest disclosures relating to institutions (75%) nor to the author's family members (90%) while 56% required the disclosure of at least one form of non-financial COI. The policies of the majority of public health journals do not require the reporting of important details such as the role of the funder, and non-financial COI. Journals and publishers should consider revising their editorial policies to ensure complete and transparent reporting of funding and COI.

Annual report of the Public Health Authority of the Slovak Republic for 2010

International Nuclear Information System (INIS)

2011-01-01

A brief account of activities carried out by the Public Health Authority of the Slovak Republic (UVZ SR) in 2010 is presented. These activities are reported under the headings: (1) General pat; (2) Legislation section; Section of control, supervision and complaints; (3) Section of environmental hygiene; (4) Section hygiene living and working conditions; (5) Department of food hygiene, food safety and cosmetic products; (6) Department of hygiene of children and youth; (7) Department of objectification factors welfare; (8) Division of medical microbiology; (9) Epidemiology section; (10) Division of health protection against radiation; (11) Department of health promotion; (12) Department of alcohol and tobacco Control.

The influence of health system organizational structure and culture on integration of health services: the example of HIV service monitoring in South Africa.

Science.gov (United States)

Kawonga, Mary; Blaauw, Duane; Fonn, Sharon

2016-11-01

Administrative integration of disease control programmes (DCPs) within the district health system has been a health sector reform priority in South Africa for two decades. The reforms entail district managers assuming authority for the planning and monitoring of DCPs in districts, with DCP managers providing specialist support. There has been little progress in achieving this, and a dearth of research exploring why. Using a case study of HIV programme monitoring and evaluation (M&E), this article explores whether South Africa's health system is configured to support administrative integration. The article draws on data from document reviews and interviews with 54 programme and district managers in two of nine provinces, exploring their respective roles in decision-making regarding HIV M&E system design and in using HIV data for monitoring uptake of HIV interventions in districts. Using Mintzberg's configurations framework, we describe three organizational parameters: (a) extent of centralization (whether district managers play a role in decisions regarding the design of the HIV M&E system); (b) key part of the organization (extent to which sub-national programme managers vs district managers play the central role in HIV monitoring in districts); and (c) coordination mechanisms used (whether highly formalized and rules-based or more output-based to promote agency). We find that the health system can be characterized as Mintzberg's machine bureaucracy. It is centralized and highly formalized with structures, management styles and practices that promote programme managers as lead role players in the monitoring of HIV interventions within districts. This undermines policy objectives of district managers assuming this leadership role. Our study enhances the understanding of organizational factors that may limit the success of administrative integration reforms and suggests interventions that may mitigate this. © The Author 2016. Published by Oxford University Press in

Annual activity report of the Public Health Authority of the Slovak Republic for 2009

International Nuclear Information System (INIS)

2010-01-01

A brief account of activities carried out by the Public Health Authority of the Slovak Republic (UVZ SR) in 2009 is presented. These activities are reported under the headings: (1) General section; (2) Department of legislation and law; (3) Department of control, surveillance and complaints; (4) Department of environmental health; (5) Department of preventive occupational medicine; (6) Department of food hygiene, food safety and cosmetic products; (7) Department of hygiene of children and youth; (8) Department of objectification factors welfare; (9) Department of medical microbiology; (10) Department of epidemiology; (11) Department of health protection against radiation; (12) Department of health promotion; (13) Department of alcohol and tobacco control.

Annual activity report of the Public Health Authority of the Slovak Republic for 2008

International Nuclear Information System (INIS)

2009-01-01

A brief account of activities carried out by the Public Health Authority of the Slovak Republic (UVZ SR) in 2008 is presented. These activities are reported under the headings: (1) General section; (2) Department of legislation and law; (3) Department of control, surveillance and complaints; (4) Department of environmental health; (5) Department of preventive occupational medicine; (6) Department of food hygiene, food safety and cosmetic products; (7) Department of hygiene of children and youth; (8) Department of objectification factors welfare; (9) Department of medical microbiology; (10) Department of epidemiology; (11) Department of health protection against radiation; (12) Department of health promotion; (13) Department of alcohol and tobacco control.

Annual activity report of the Public Health Authority of the Slovak Republic for 2006

International Nuclear Information System (INIS)

2007-01-01

A brief account of activities carried out by the Public Health Authority of the Slovak Republic (UVZ SR) in 2006 is presented. These activities are reported under the headings: (1) General section; (2) Department of legislation and law; (3) Department of control, surveillance and complaints; (4) Department of environmental health; (5) Department of preventive occupational medicine; (6) Department of food hygiene, food safety and cosmetic products; (7) Department of hygiene of children and youth; (8) Department of objectification factors welfare; (9) Department of medical microbiology; (10) Department of epidemiology; (11) Department of health protection against radiation; (12) Department of health promotion; (13) Center of tobacco control; (14) Crisis management unit.

A proposed quantitative credit-rating methodology for South African provincial departments

Directory of Open Access Journals (Sweden)

Erika Fourie

2016-05-01

Full Text Available The development of subnational credit-rating methodologies affords benefits for subnationals, the sovereign and its citizens. Trusted credit ratings facilitate access to financial markets and above-average ratings allow for the negotiation of better collateral and guarantee agreements, as well as for funding of, for example, infrastructure projects at superior (lower interest rates. This paper develops the quantitative section of a credit-rating methodology for South African subnationals. The unique characteristics of South African data, their assembly, and the selection of dependent and independent variables for the linear-regression model chosen, are discussed. The methodology is then applied to the provincial Department of Health using linear regression modelling.

Authority Delegation in Boyerahmad Health Centers through Model to Combine Suggestions System and Delphi Method 2012

Directory of Open Access Journals (Sweden)

M Momeninezhad

2013-11-01

Full Text Available Background & aim: Authority delegation means to transmit part of organization`s manager and leader`s special authorities and executive duties, regardless its root to subordinates and heads of units and related offices to speed up implementing affairs and organizational purposes quickly and on time. The purpose of this study was to inspect authority delegation in health centers of Boyerahmad district through using model to combine suggestions (to identify process and Delphi method (expert`s opinions . Methods: This cross-sectional study was implemented in two stages at first stage, research community was authorities of Boyerahmad health centers (58 persons, their suggestions about requested processes to delegate were gathered by total count through open questionnaires and in second stage, which was Delphi, suggestions gathered from previous stage judged by 30 experts. Data of both stages analyzed by help of Chi-square, correlation coefficient tests. Results: Findings showed that 73.85% of suggestions were able to be delegated, based on expert`s opinion. 40% of suggestions were in domain of official, 36.92% financial and 23.08% hygienic. 88% less than 6 years management background. 20.69% had no academic studies and only 27% were general physicians. Conclusion: By participation of environmental management levels, several processes may be specified and identify cases which are possible to delegate them executively using Delphi (expert`s opinion and this model can be used as a trust worthy method to delegate authority for decentralization. Key words: Participation Management, Health centers, Authority delegation

[Health care innovation from a territorial perspective: a call for a new approach].

Science.gov (United States)

Costa, Laís Silveira; Gadelha, Carlos Augusto Grabois; Maldonado, José

2012-12-01

Innovation plays an increasingly important role in health care, partly because it is responsible for a significant share of national investment in research and development, and partly because of its industrial and service provision base, which provides a conduit to future technology. The relationship between health care and development is also strengthened as a result of the leading role of health care in generating innovation. Nevertheless, Brazil's health care production base is persistently weak, hindering both universal provision of health care services and international competitiveness. This article, based on the theoretical framework of Political Economy and innovation systems, has sought to identify variables in subnational contexts that influence the dynamic of innovation generation in health care. To this end, the theoretical approach used lies on the assumption that innovation is a contextualized social process and that the production base in healthcare will remain weak if new variables involved in the dynamic of innovation are not taken into account.

[Connections between fiscal federalism and the funding of the Brazilian health care policy].

Science.gov (United States)

de Lima, Luciana Dias

2007-01-01

In the Brazilian society's context of meager financial resources for health care, associated with structural features of fiscal federalism and with the current model of funding transfers for the Unified Health System's (SUS), important inequities directly impact political negotiations and the deployment of federal financing alternatives which are not directly linked to the supply and production of health care activities and services by states and municipalities. We observed that health policies, since the second half of the nineties, have developed their own mechanisms that, in the above mentioned context, tend to accommodate different interests and federative conflicts generated by structural factors and by institutional rules. However, the absence of an integrated planning program between the criteria to establish resource redistribution for financing the Unified Health System and the Brazilian Federation's fiscal sharing system, end up reinforcing certain asymmetric patterns and generating new imbalances, making the compensation of inequities difficult in public health spending at the sub-national domain.

Evaluation of health care system reform in Hubei Province, China.

Science.gov (United States)

Sang, Shuping; Wang, Zhenkun; Yu, Chuanhua

2014-02-21

This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based on the "Result Chain" logic model and include the following four domains: Inputs and Processes, Outputs, Outcomes and Impact. Health care system reform was evaluated using the weighted TOPSIS and weighted Rank Sum Ratio methods. Ultimately, the study established a set of indicators including four grade-1 indicators, 16 grade-2 indicators and 76 grade-3 indicators. The effects of the reforms increased year by year from 2009 to 2011 in Hubei Province. The health status of urban and rural populations and the accessibility, equity and quality of health services in Hubei Province were improved after the reforms. This sub-national case can be considered an example of a useful approach to the evaluation of the effects of health care system reform, one that could potentially be applied in other provinces or nationally.

Evidence from the national health account: the case of Dubai.

Science.gov (United States)

Hamidi, Samer

2014-01-01

National health accounts (NHAs) provide useful information to aid in understanding the health care financing system. This article aims to present a profile of health system financing in Dubai using data from the NHA. We also aim to compare the provider structure of financing schemes in Dubai with those of the State of Qatar and selected Organization for Economic Cooperation and Development (OECD) countries. The author analyzed secondary data published in NHAs for Dubai and Qatar, and data collected by the OECD countries and publicly available from the Statistical Office of the European Union (Eurostat), for 25 OECD countries for comparative analysis. All health financing measures used are as defined in the international System of Health Accounts (SHA). In Dubai, only 33% of current health expenditure (CHE) is funded by the government. However, the public sector is the main source of health funding in Qatar and most OECD countries, with an average of 79% and 72%, respectively. Households in Dubai spent about 22% of CHE, equivalent to an average US$187 per capita, ranking the highest among Gulf Cooperation Council (GCC) countries, and compared with 20% of CHE across OECD countries. Hospitals in Dubai accounted for 48% of CHE, which is much higher than Qatar (40%) and the OECD average (36%). The Dubai health care financing system differs substantially from that in OECD countries, as it is more private oriented. The findings point to several potential opportunities for growth and improvement. Policy areas that may be addressed using the information presented in this article are broad and include the following: shift from hospital care to ambulatory and day care, sustainability of health finance, shift the cost of health care to the private sector, introduce cost-containment measures, revise payment systems for health providers, and produce subnational accounts for non-communicable diseases. More investment in the translation of national health account data into policy

Environmental conditions in health care facilities in low- and middle-income countries: Coverage and inequalities.

Science.gov (United States)

Cronk, Ryan; Bartram, Jamie

2018-04-01

Safe environmental conditions and the availability of standard precaution items are important to prevent and treat infection in health care facilities (HCFs) and to achieve Sustainable Development Goal (SDG) targets for health and water, sanitation, and hygiene. Baseline coverage estimates for HCFs have yet to be formed for the SDGs; and there is little evidence describing inequalities in coverage. To address this, we produced the first coverage estimates of environmental conditions and standard precaution items in HCFs in low- and middle-income countries (LMICs); and explored factors associated with low coverage. Data from monitoring reports and peer-reviewed literature were systematically compiled; and information on conditions, service levels, and inequalities tabulated. We used logistic regression to identify factors associated with low coverage. Data for 21 indicators of environmental conditions and standard precaution items were compiled from 78 LMICs which were representative of 129,557 HCFs. 50% of HCFs lack piped water, 33% lack improved sanitation, 39% lack handwashing soap, 39% lack adequate infectious waste disposal, 73% lack sterilization equipment, and 59% lack reliable energy services. Using nationally representative data from six countries, 2% of HCFs provide all four of water, sanitation, hygiene, and waste management services. Statistically significant inequalities in coverage exist between HCFs by: urban-rural setting, managing authority, facility type, and sub-national administrative unit. We identified important, previously undocumented inequalities and environmental health challenges faced by HCFs in LMICs. The information and analyses provide evidence for those engaged in improving HCF conditions to develop evidence-based policies and efficient programs, enhance service delivery systems, and make better use of available resources. Copyright © 2018 The Authors. Published by Elsevier GmbH.. All rights reserved.

75 FR 36099 - Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health...

Science.gov (United States)

2010-06-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health Service Act AGENCY... changes Section 723 of the Public Health Service Act (PHSA) regarding administration of the PCL program...

Nurse Practitioner Independent Practice Authority and Mental Health Service Delivery in U.S. Community Health Centers.

Science.gov (United States)

Yang, Bo Kyum; Trinkoff, Alison M; Zito, Julie Magno; Burcu, Mehmet; Safer, Daniel J; Storr, Carla L; Johantgen, Mary E; Idzik, Shannon

2017-10-01

Little is known about how nurse practitioner independent practice authority (NP-IPA) influences patient care. This study examined the effect of NP-IPA on patterns of mental health-related visits provided by NPs in U.S. community health centers (CHCs). State NP regulatory information was linked to National Ambulatory Medical Care Survey data on NP- and physician-provided visits (N=61,457) in CHCs from 2006 through 2011. The proportion of NP-provided versus physician-provided mental health-related visits in states with NP-IPA was compared with the proportion in states without NP-IPA. The adjusted odds of mental health-related visits in CHCs provided by NPs in states with and without NP-IPA were compared by using multiple logistic regression models while accounting for the complex survey design. Between 2006 and 2011, the odds of NP- versus physician-provided mental health-related visits in CHCs were more than two times greater in states with NP-IPA than in states with no NP-IPA (adjusted odds ratio [OR]= 2.43, 95% confidence interval [CI]=1.12-4.60). In contrast, no significant difference between states with and without NP-IPA was noted in non-mental health-related CHC visits provided by NPs. Among all mental health-related visits, the odds of visits in which psychotropic medications were prescribed by an NP were more than three times higher in states with NP-IPA than in those without NP-IPA (adjusted OR=3.14, CI=1.50-6.54). Compared with physicians, NPs provided proportionally more CHC mental health-related visits in states with NP-IPA than in states without NP-IPA.

Annual report of the Public Health Authority of the Slovak Republic for 2011

International Nuclear Information System (INIS)

2011-04-01

A brief account of activities carried out by the Public Health Authority of the Slovak Republic (UVZ SR) in 2011 is presented. These activities are reported under the headings: (1) General part; (2) Legislation section; (3) Section of control, supervision and complaints; (4) Section of environmental hygiene; (5) Section hygiene living and working conditions; (6) Department of food hygiene, food safety and cosmetic products; (7) Department of hygiene of children and youth; (8) Department of objectification factors welfare; (9) Division of Medical Microbiology; (10) Epidemiology Section; (11) Division of health protection against radiation.

Objectives and actions of Public Health Authorities in external radiological emergency

International Nuclear Information System (INIS)

Herrera V, L.; Aguilar P, M.C.

1991-01-01

Here are discussed actions and objectives that the public health authorities could think about uncontrolled liberation of radioactive materials. The approaches on the more convenient actions to continue are established upon assimilating the Chernobyl experience. We will enumerate problems that, they could arise with the foregone actions in order to diminish the population detriment. In the face of the uncontrolled liberation of radioactive material in the Nuclear power plant of Laguna Verde, Veracruz, classified like external radiological emergency, the objective of these serious authorities reduce the deleterious effect to the health of the inhabitants around the CNLV, due to the radioactive material liberated to the atmosphere. In consequence, it is necessary carry out actions of protection for the population affected directly by the external irradiation, for the contamination deposited on inhabited areas, cultivation zones, shepherding, manufacturing and farms. The early actions or immediate are in order to limit deterministic damages to the population and give attendance to people with radio lesions. And the intermediate or they of recuperation are in order to maintain for under an acceptable value the risk to the population due to radiation stochastic effects. In the recuperation phase the plan of water and foods control should consider: foods destined to the self consume in the affected region for the liberation and foods processed for the sale or exportation. We will discuss the stage in a mediate phase after the evacuation of the population. The general tasks could be: 1. Actions in order to impede the contamination propagation. 2. Sampling of waters and foods, contamination situation and its quantification. And acceptance quality in elaborated foods. 3. Safeguard of the material and polluted areas. 4. Election of the actions to continue in function of the reference levels and the comparison of the risk of several alternatives. (Author)

76 FR 53903 - Delegation of Authorities

Science.gov (United States)

2011-08-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Delegation of Authorities Notice is hereby given that I... Delegations of Authority, last published at 55 FR 9363 (March 13, 1990). Title I--Quality, Affordable Health... the Public Health Service Act. The delegation includes, but does not limit the authority to, directing...

State Public Health Enabling Authorities: Results of a Fundamental Activities Assessment Examining Core and Essential Services

Science.gov (United States)

Hoss, Aila; Menon, Akshara; Corso, Liza

2016-01-01

Context Public health enabling authorities establish the legal foundation for financing, organizing, and delivering public health services. State laws vary in terms of the content, depth, and breadth of these fundamental public health activities. Given this variance, the Institute of Medicine has identified state public health laws as an area that requires further examination. To respond to this call for further examination, the Centers for Disease Control and Prevention’s Public Health Law Program conducted a fundamental activities legal assessment on state public health laws. Objective The goal of the legal assessment was to examine state laws referencing frameworks representing public health department fundamental activities (ie, core and essential services) in an effort to identify, catalog, and describe enabling authorities of state governmental public health systems. Design In 2013, Public Health Law Program staff compiled a list of state statutes and regulations referencing different commonly-recognized public health frameworks of fundamental activities. The legal assessment included state fundamental activities laws available on WestlawNext as of July 2013. The results related to the 10 essential public health services and the 3 core public health functions were confirmed and updated in June 2016. Results Eighteen states reference commonly-recognized frameworks of fundamental activities in their laws. Thirteen states have listed the 10 essential public health services in their laws. Eight of these states have also referenced the 3 core public health functions in their laws. Five states reference only the core public health functions. Conclusions Several states reference fundamental activities in their state laws, particularly through use of the essential services framework. Further work is needed to capture the public health laws and practices of states that may be performing fundamental activities but without reference to a common framework. PMID

State Public Health Enabling Authorities: Results of a Fundamental Activities Assessment Examining Core and Essential Services.

Science.gov (United States)

Hoss, Aila; Menon, Akshara; Corso, Liza

2016-01-01

Public health enabling authorities establish the legal foundation for financing, organizing, and delivering public health services. State laws vary in terms of the content, depth, and breadth of these fundamental public health activities. Given this variance, the Institute of Medicine has identified state public health laws as an area that requires further examination. To respond to this call for further examination, the Centers for Disease Control and Prevention's Public Health Law Program conducted a fundamental activities legal assessment on state public health laws. The goal of the legal assessment was to examine state laws referencing frameworks representing public health department fundamental activities (ie, core and essential services) in an effort to identify, catalog, and describe enabling authorities of state governmental public health systems. In 2013, Public Health Law Program staff compiled a list of state statutes and regulations referencing different commonly-recognized public health frameworks of fundamental activities. The legal assessment included state fundamental activities laws available on WestlawNext as of July 2013. The results related to the 10 essential public health services and the 3 core public health functions were confirmed and updated in June 2016. Eighteen states reference commonly-recognized frameworks of fundamental activities in their laws. Thirteen states have listed the 10 essential public health services in their laws. Eight of these states have also referenced the 3 core public health functions in their laws. Five states reference only the core public health functions. Several states reference fundamental activities in their state laws, particularly through use of the essential services framework. Further work is needed to capture the public health laws and practices of states that may be performing fundamental activities but without reference to a common framework.

Rating the Raters: Legal Exposure of Trustmark Authorities in the Context of Consumer Health Informatics

Science.gov (United States)

2000-01-01

There are three areas of potential legal exposure for an organization such as a trustmark authority involved in e-health quality rating. First, an e-health provider may make a complaint about negative or impliedly negative ratings rendered by the ratings body (false negative). Typically, a negative ratings complaint would rely on defamation or product disparagement causes of action. In some cases such complaints could be defended on the basis of absence of malice (US). Second, the rating body might render a positive rating on e-health data that a third party allegedly relied upon and suffered injury (false positive). While the primary cause of action would be against the e-health data provider, questions may arise as to the possible liability of the trustmark authority. For example, some US liability exposure is possible based on cases involving the potential liability of product warrantors, trade associations, and certifiers or endorsers. Third, a ratings body may face public law liability for its own web misfeasance. Several risk management approaches are possible and would not necessarily be mutually exclusive. These approaches will require careful investigation to assess their risk reduction potential and, in some cases, the introduction of legislation. PMID:11720941

Constraining Government Regulatory Authority: Tobacco Industry Trade Threats and Challenges to Cigarette Package Health Warning Labels

OpenAIRE

Crosbie, Eric

2016-01-01

This dissertation investigates the rising authority of non-state actors vis-à-vis the state by examining how tobacco companies are using trade agreements to constrain governments from implementing progressive public health policies that require placing pictorial health warning labels (HWLs) on cigarette packages. In particular, the dissertation seeks to address two different but related puzzles. First, despite being developed countries and global health leaders, it is unclear why Australia ha...

Local distributions of wealth to describe health inequalities in India: a new approach for analyzing nationally representative household survey data, 1992-2008.

Science.gov (United States)

Bassani, Diego G; Corsi, Daniel J; Gaffey, Michelle F; Barros, Aluisio J D

2014-01-01

Worse health outcomes including higher morbidity and mortality are most often observed among the poorest fractions of a population. In this paper we present and validate national, regional and state-level distributions of national wealth index scores, for urban and rural populations, derived from household asset data collected in six survey rounds in India between 1992-3 and 2007-8. These new indices and their sub-national distributions allow for comparative analyses of a standardized measure of wealth across time and at various levels of population aggregation in India. Indices were derived through principal components analysis (PCA) performed using standardized variables from a correlation matrix to minimize differences in variance. Valid and simple indices were constructed with the minimum number of assets needed to produce scores with enough variability to allow definition of unique decile cut-off points in each urban and rural area of all states. For all indices, the first PCA components explained between 36% and 43% of the variance in household assets. Using sub-national distributions of national wealth index scores, mean height-for-age z-scores increased from the poorest to the richest wealth quintiles for all surveys, and stunting prevalence was higher among the poorest and lower among the wealthiest. Urban and rural decile cut-off values for India, for the six regions and for the 24 major states revealed large variability in wealth by geographical area and level, and rural wealth score gaps exceeded those observed in urban areas. The large variability in sub-national distributions of national wealth index scores indicates the importance of accounting for such variation when constructing wealth indices and deriving score distribution cut-off points. Such an approach allows for proper within-sample economic classification, resulting in scores that are valid indicators of wealth and correlate well with health outcomes, and enables wealth-related analyses at

Local distributions of wealth to describe health inequalities in India: a new approach for analyzing nationally representative household survey data, 1992-2008.

Directory of Open Access Journals (Sweden)

Diego G Bassani

Full Text Available Worse health outcomes including higher morbidity and mortality are most often observed among the poorest fractions of a population. In this paper we present and validate national, regional and state-level distributions of national wealth index scores, for urban and rural populations, derived from household asset data collected in six survey rounds in India between 1992-3 and 2007-8. These new indices and their sub-national distributions allow for comparative analyses of a standardized measure of wealth across time and at various levels of population aggregation in India.Indices were derived through principal components analysis (PCA performed using standardized variables from a correlation matrix to minimize differences in variance. Valid and simple indices were constructed with the minimum number of assets needed to produce scores with enough variability to allow definition of unique decile cut-off points in each urban and rural area of all states.For all indices, the first PCA components explained between 36% and 43% of the variance in household assets. Using sub-national distributions of national wealth index scores, mean height-for-age z-scores increased from the poorest to the richest wealth quintiles for all surveys, and stunting prevalence was higher among the poorest and lower among the wealthiest. Urban and rural decile cut-off values for India, for the six regions and for the 24 major states revealed large variability in wealth by geographical area and level, and rural wealth score gaps exceeded those observed in urban areas.The large variability in sub-national distributions of national wealth index scores indicates the importance of accounting for such variation when constructing wealth indices and deriving score distribution cut-off points. Such an approach allows for proper within-sample economic classification, resulting in scores that are valid indicators of wealth and correlate well with health outcomes, and enables wealth

25 CFR 900.1 - Authority.

Science.gov (United States)

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Authority. 900.1 Section 900.1 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Authority. These regulations are prepared, issued, and maintained jointly by the Secretary of Health and...

Experience gained in Hungary on the role and responsibility of the public health authority in the nuclear power programme

International Nuclear Information System (INIS)

Sztanyik, L.B.

1983-01-01

The public health service of every country has a basic responsibility for maintaining and continuously improving the standard of health of its population. A significant part of this general responsibility, which has grown in importance in recent years, is radiation protection. While substantial economic, social, medical and scientific benefits are derived from various applications of nuclear energy, health authorities must insist on adequate control to protect the population from excessive exposure to radiation. Safety in the nuclear power industry means the assurance that all operational activities are carried out without undue radiation hazard to the general public and to the persons on-site. It is essential, therefore, that national public health authorities give immediate attention to their responsibilities for radiation protection and ensure the development of an adequate system of control as soon as initiation of a nuclear power programme has been decided. The role and responsibility assigned in Hungary to the public health authority by the government, the development of its organizational structure and of its control system and the actions taken to assert radiation protection requirements in the nuclear power programme of the country from the very beginning of its institution till the commissioning of the first 440 MW(e) unit of the nuclear power plant at Paks are reviewed. (author)

Health, Climate Change and Energy Vulnerability: A Retrospective Assessment of Strategic Health Authority Policy and Practice in England

Directory of Open Access Journals (Sweden)

J. Richardson B.Sc., Ph.D., RN., DipDN., CPsychol., PGCE.

2008-01-01

Full Text Available Background A number of policy documents suggest that health services should be taking climate change and sustainability seriously and recommendations have been made to mitigate and adapt to the challenges health care providers will face. Actions include, for example, moving towards locally sourced food supplies, reducing waste, energy consumption and travel, and including sustainability in policies and strategies. A Strategic Health Authority (SHA is part of the National Health Service (NHS in England. They are responsible for developing strategies for the local health services and ensuring high-quality performance. They manage the NHS locally and are a key link between the U.K. Department of Health and the NHS. They also ensure that national priorities are integrated into local plans. Thus they are in a key position to influence policies and practices to mitigate and adapt to the impact of climate change and promote sustainability. Aim The aim of this study was to review publicly available documents produced by Strategic Health Authorities (SHA to assess the extent to which current activity and planning locally takes into consideration climate change and energy vulnerability. Methods A retrospective thematic content analysis of publicly available materials was undertaken by two researchers over a six month period in 2008. These materials were obtained from the websites of the 10 SHAs in England. Materials included annual reports, plans, policies and strategy documents. Results Of the 10 SHAs searched, 4 were found to have an absence of content related to climate change and sustainability. Of the remaining 6 SHAs that did include content related to climate change and energy vulnerability on their websites consistent themes were seen to emerge. These included commitment to a regional sustainability framework in collaboration with other agencies in the pursuit and promotion of sustainable development. Results indicate that many SHAs in England

Organizational capacity for community development in regional health authorities: a conceptual model.

Science.gov (United States)

Germann, Kathy; Wilson, Doug

2004-09-01

The value of community development (CD) practices is well documented in the health promotion literature; it is a foundational strategy outlined in the Ottawa Charter for Health Promotion. Despite the importance of collaborative action with communities to enhance individual and community health and well-being, there exists a major gap between the evidence for CD and the actual extent to which CD is carried out by health organizations. In this paper it is argued that the gap exists because we have failed to turn the evaluative gaze inward-to examine the capacity of health organizations themselves to facilitate CD processes. This study was designed to explicate key elements that contribute to organizational capacity for community development (OC-CD). Twenty-two front-line CD workers and managers responsible for CD initiatives from five regional health authorities in Alberta, Canada, were interviewed. Based on the study findings, a multidimensional model for conceptualizing OC-CD is presented. Central to the model are four inter-related dimensions: (i) organizational commitment to CD, rooted in particular values and beliefs, leadership and shared understanding of CD; (ii) supportive structures and systems, such as job design, flexible planning processes, evaluation mechanisms and collaborative processes; (iii) allocation of resources for CD; and (iv) working relationships and processes that model CD within the health organization. These four dimensions contribute to successful CD practice in numerous ways, but perhaps most importantly by supporting the empowerment and autonomy of the pivotal organizational player in health promotion practice: the front-line worker.

Equity and geography: the case of child mortality in Papua New Guinea.

Directory of Open Access Journals (Sweden)

Anna E Bauze

Full Text Available BACKGROUND: Recent assessments show continued decline in child mortality in Papua New Guinea (PNG, yet complete subnational analyses remain rare. This study aims to estimate under-five mortality in PNG at national and subnational levels to examine the importance of geographical inequities in health outcomes and track progress towards Millennium Development Goal (MDG 4. METHODOLOGY: We performed retrospective data validation of the Demographic and Health Survey (DHS 2006 using 2000 Census data, then applied advanced indirect methods to estimate under-five mortality rates between 1976 and 2000. FINDINGS: The DHS 2006 was found to be unreliable. Hence we used the 2000 Census to estimate under-five mortality rates at national and subnational levels. During the period under study, PNG experienced a slow reduction in national under-five mortality from approximately 103 to 78 deaths per 1,000 live births. Subnational analyses revealed significant disparities between rural and urban populations as well as inter- and intra-regional variations. Some of the provinces that performed the best (worst in terms of under-five mortality included the districts that performed worst (best, with district-level under-five mortality rates correlating strongly with poverty levels and access to services. CONCLUSIONS: The evidence from PNG demonstrates substantial within-province heterogeneity, suggesting that under-five mortality needs to be addressed at subnational levels. This is especially relevant in countries, like PNG, where responsibility for health services is devolved to provinces and districts. This study presents the first comprehensive estimates of under-five mortality at the district level for PNG. The results demonstrate that for countries that rely on few data sources even greater importance must be given to the quality of future population surveys and to the exploration of alternative options of birth and death surveillance.

Equity and geography: the case of child mortality in Papua New Guinea.

Science.gov (United States)

Bauze, Anna E; Tran, Linda N; Nguyen, Kim-Huong; Firth, Sonja; Jimenez-Soto, Eliana; Dwyer-Lindgren, Laura; Hodge, Andrew; Lopez, Alan D

2012-01-01

Recent assessments show continued decline in child mortality in Papua New Guinea (PNG), yet complete subnational analyses remain rare. This study aims to estimate under-five mortality in PNG at national and subnational levels to examine the importance of geographical inequities in health outcomes and track progress towards Millennium Development Goal (MDG) 4. We performed retrospective data validation of the Demographic and Health Survey (DHS) 2006 using 2000 Census data, then applied advanced indirect methods to estimate under-five mortality rates between 1976 and 2000. The DHS 2006 was found to be unreliable. Hence we used the 2000 Census to estimate under-five mortality rates at national and subnational levels. During the period under study, PNG experienced a slow reduction in national under-five mortality from approximately 103 to 78 deaths per 1,000 live births. Subnational analyses revealed significant disparities between rural and urban populations as well as inter- and intra-regional variations. Some of the provinces that performed the best (worst) in terms of under-five mortality included the districts that performed worst (best), with district-level under-five mortality rates correlating strongly with poverty levels and access to services. The evidence from PNG demonstrates substantial within-province heterogeneity, suggesting that under-five mortality needs to be addressed at subnational levels. This is especially relevant in countries, like PNG, where responsibility for health services is devolved to provinces and districts. This study presents the first comprehensive estimates of under-five mortality at the district level for PNG. The results demonstrate that for countries that rely on few data sources even greater importance must be given to the quality of future population surveys and to the exploration of alternative options of birth and death surveillance.

Local Distributions of Wealth to Describe Health Inequalities in India: A New Approach for Analyzing Nationally Representative Household Survey Data, 1992–2008

Science.gov (United States)

Bassani, Diego G.; Corsi, Daniel J.; Gaffey, Michelle F.; Barros, Aluisio J. D.

2014-01-01

Background Worse health outcomes including higher morbidity and mortality are most often observed among the poorest fractions of a population. In this paper we present and validate national, regional and state-level distributions of national wealth index scores, for urban and rural populations, derived from household asset data collected in six survey rounds in India between 1992–3 and 2007–8. These new indices and their sub-national distributions allow for comparative analyses of a standardized measure of wealth across time and at various levels of population aggregation in India. Methods Indices were derived through principal components analysis (PCA) performed using standardized variables from a correlation matrix to minimize differences in variance. Valid and simple indices were constructed with the minimum number of assets needed to produce scores with enough variability to allow definition of unique decile cut-off points in each urban and rural area of all states. Results For all indices, the first PCA components explained between 36% and 43% of the variance in household assets. Using sub-national distributions of national wealth index scores, mean height-for-age z-scores increased from the poorest to the richest wealth quintiles for all surveys, and stunting prevalence was higher among the poorest and lower among the wealthiest. Urban and rural decile cut-off values for India, for the six regions and for the 24 major states revealed large variability in wealth by geographical area and level, and rural wealth score gaps exceeded those observed in urban areas. Conclusions The large variability in sub-national distributions of national wealth index scores indicates the importance of accounting for such variation when constructing wealth indices and deriving score distribution cut-off points. Such an approach allows for proper within-sample economic classification, resulting in scores that are valid indicators of wealth and correlate well with health

Vicente Fretes Cibils

International Development Research Centre (IDRC) Digital Library (Canada)

Inter-American Development Bank

Mexico City, November 2008 ... Interest in sub-national government .... gender equality and social inclusion ... Education, health, interurban roads, housing, police ... decentralization of health and education sectors). Problems: • Limited funds.

Author Details

African Journals Online (AJOL)

Betancourt, Orlando A. Vol 22, No 1 (2016) - Articles Forensic mental health services: Current service provision and planning for a prison mental health service in the Eastern Cape Abstract PDF. ISSN: 2078-6786. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

The relationship between HIV and fertility in the era of antiretroviral therapy in sub-Saharan Africa: evidence from 49 Demographic and Health Surveys.

Science.gov (United States)

Marston, M; Zaba, B; Eaton, J W

2017-12-01

To describe regional differences in the relative fertility of HIV-positive vs. HIV-negative women and changes as antiretroviral treatment (ART) is scaled up, to improve estimates of predicted need for and coverage of prevention of mother-to-child transmission services at national and subnational levels. We analysed 49 nationally representative household surveys in sub-Saharan Africa between 2003 and 2016 to estimate fertility rate ratios of HIV-positive and HIV-negative women by age using exponential regression and test for regional and urban/rural differences. We estimated the association between national ART coverage and the relationship between HIV and fertility. Significant regional differences exist in HIV and fertility relationships, with less HIV-associated subfertility in Southern Africa. Age patterns of relative fertility are similar. HIV impact on fertility is weaker in urban than rural areas. For women below age 30, regional and urban/rural differences are largely explained by differences in age at sexual debut. Higher levels of national ART coverage were associated with slight attenuation of the relationship between HIV and fertility. Regional differences in HIV-associated subfertility and urban-rural differences in age patterns of relative fertility should be accounted for when predicting need for and coverage of PMTCT services at national and subnational level. Although HIV impacts on fertility are somewhat reduced at higher levels of national ART coverage, differences in fertility between HIV positive and negative remain, and fertility of women on ART should not be assumed to be the same as HIV-negative women. There were few data in recent years, when ART has reached high levels, and this relationship should continue to be assessed as further evidence becomes available. © 2017 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

The role of Swedish Radiation Protection Authority in the field of public health; SSI:s roll i folkhaelsoarbetet - redovisning av regeringsuppdrag inom folkhaelsoomraadet

Energy Technology Data Exchange (ETDEWEB)

Cederlund, Torsten; Finck, Robert; Mjoenes, Lars; Moberg, Leif; Soederman, Ann-Louis; Wiklund, Aasa; Yuen Katarina; Oelander Guer, Hanna

2004-09-01

The Swedish Government has requested the Swedish Radiation Protection Authority (SSI) to make an account of the authority's role in the field of public health. Radiation Protection consists largely of preventive actions in order to protect man and the environment against harmful effects of radiation. The SSI thus considers most of the authority's activities to be public health related. The report describes a number of radiation protection areas from a health perspective. The measures taken by the authority in these areas are also described along with planned activities. In some areas the authority also points out additional measures.

Progress towards universal health coverage in BRICS: translating economic growth into better health.

Science.gov (United States)

Rao, Krishna D; Petrosyan, Varduhi; Araujo, Edson Correia; McIntyre, Diane

2014-06-01

Brazil, the Russian Federation, India, China and South Africa--the countries known as BRICS--represent some of the world's fastest growing large economies and nearly 40% of the world's population. Over the last two decades, BRICS have undertaken health-system reforms to make progress towards universal health coverage. This paper discusses three key aspects of these reforms: the role of government in financing health; the underlying motivation behind the reforms; and the value of the lessons learnt for non-BRICS countries. Although national governments have played a prominent role in the reforms, private financing constitutes a major share of health spending in BRICS. There is a reliance on direct expenditures in China and India and a substantial presence of private insurance in Brazil and South Africa. The Brazilian health reforms resulted from a political movement that made health a constitutional right, whereas those in China, India, the Russian Federation and South Africa were an attempt to improve the performance of the public system and reduce inequities in access. The move towards universal health coverage has been slow. In China and India, the reforms have not adequately addressed the issue of out-of-pocket payments. Negotiations between national and subnational entities have often been challenging but Brazil has been able to achieve good coordination between federal and state entities via a constitutional delineation of responsibility. In the Russian Federation, poor coordination has led to the fragmented pooling and inefficient use of resources. In mixed health systems it is essential to harness both public and private sector resources.

Evidence from the national health account: the case of Dubai

Directory of Open Access Journals (Sweden)

Hamidi S

2014-09-01

Full Text Available Samer Hamidi School of Health and Environmental Studies, Hamadan Bin Mohammad Smart University, Dubai, United Arab Emirates Introduction: National health accounts (NHAs provide useful information to aid in understanding the health care financing system. This article aims to present a profile of health system financing in Dubai using data from the NHA. We also aim to compare the provider structure of financing schemes in Dubai with those of the State of Qatar and selected Organization for Economic Cooperation and Development (OECD countries. Methods: The author analyzed secondary data published in NHAs for Dubai and Qatar, and data collected by the OECD countries and publicly available from the Statistical Office of the European Union (Eurostat, for 25 OECD countries for comparative analysis. All health financing measures used are as defined in the international System of Health Accounts (SHA. Results: In Dubai, only 33% of current health expenditure (CHE is funded by the government. However, the public sector is the main source of health funding in Qatar and most OECD countries, with an average of 79% and 72%, respectively. Households in Dubai spent about 22% of CHE, equivalent to an average US$187 per capita, ranking the highest among Gulf Cooperation Council (GCC countries, and compared with 20% of CHE across OECD countries. Hospitals in Dubai accounted for 48% of CHE, which is much higher than Qatar (40% and the OECD average (36%. Conclusion: The Dubai health care financing system differs substantially from that in OECD countries, as it is more private oriented. The findings point to several potential opportunities for growth and improvement. Policy areas that may be addressed using the information presented in this article are broad and include the following: shift from hospital care to ambulatory and day care, sustainability of health finance, shift the cost of health care to the private sector, introduce cost-containment measures, revise

Health system strengthening in the context of CMAM

International Nuclear Information System (INIS)

Israel, Anne-Dominique; Gallagher, Maureen

2014-01-01

The approach to the management of acute malnutrition has changed substantially in recent years. There has been recognition that, despite huge advances over the last 25 years on how Severe Acute Malnutrition (SAM) is treated, coverage remains around 7 to 13%. Universal coverage to SAM management can only be achieved by ensuring availability of and access to treatment at all levels of the health system. SAM needs to be considered as a disease to be integrated and mainstreamed as part of the basic package of health services, which highlights the need to review existing implementation approaches to be increasingly horizontal, process oriented instead of vertical, model oriented. In many countries, programs to treat AM now fall under the responsibility and leadership of the Ministry of Health and its sub-national authorities. This provides an enabling environment for AM management within the health system as it is integrated as an additional component of the basic healthcare package. In considering SAM as a disease, we can learn from existing large global health initiatives (GHI) experiences, developed in the early 2000s, targeting specific diseases. GAVI (for immunization), PEPFAR (for HIV/AIDS) and Global Fund (for HIV, malaria & TB), applied, at their early stages a “disease based/ vertical approach”. This approach revealed its limitations as the countries where these global health initiatives were implemented had fragile health systems, continuously struggling to operate effectively and to deliver accessible standard quality care. The nutrition community, in promoting AM management to be integrated into the basic package of health services has been, these last years, faced with similar challenges and questions as GHIs. There is an increased need to recognize that most of the barriers identified in delivering SAM or MAM management are common to those faced by the health system overall. Therefore, a more global/ general and coordinated effort is required to

Cold-Chain Adaptability During Introduction of Inactivated Polio Vaccine in Bangladesh, 2015.

Science.gov (United States)

Billah, Mallick M; Zaman, K; Estivariz, Concepcion F; Snider, Cynthia J; Anand, Abhijeet; Hampton, Lee M; Bari, Tajul I A; Russell, Kevin L; Chai, Shua J

2017-07-01

Introduction of inactivated polio vaccine creates challenges in maintaining the cold chain for vaccine storage and distribution. We evaluated the cold chain in 23 health facilities and 36 outreach vaccination sessions in 8 districts and cities of Bangladesh, using purposive sampling during August-October 2015. We interviewed immunization and cold-chain staff, assessed equipment, and recorded temperatures during vaccine storage and transportation. All health facilities had functioning refrigerators, and 96% had freezers. Temperature monitors were observed in all refrigerators and freezers but in only 14 of 66 vaccine transporters (21%). Recorders detected temperatures >8°C for >60 minutes in 5 of 23 refrigerators (22%), 3 of 6 cold boxes (50%) transporting vaccines from national to subnational depots, and 8 of 48 vaccine carriers (17%) used in outreach vaccination sites. Temperatures cold boxes (21%) transporting vaccine from subnational depots to health facilities and 14 of 48 vaccine carriers (29%). Bangladesh has substantial cold-chain storage and transportation capacity after inactivated polio vaccine introduction, but temperature fluctuations during vaccine transport could cause vaccine potency loss that could go undetected. Bangladesh and other countries should strive to ensure consistent and sufficient cold-chain storage and monitor the cold chain during vaccine transportation at all levels. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Involvement of the Public Health Authority in emergency planning and preparedness for nuclear facilities in Hungary

International Nuclear Information System (INIS)

Sztanyik, L.B.

1986-01-01

It is required by the Hungarian Atomic Energy Act and its enacting clause of 1980 that facilities established for the application of atomic energy be designed, constructed and operated in such a manner that abnormal operational occurrences can be avoided and unplanned exposures to radiation and radioactive substances can be prevented. The primary responsibility for planning and implementing emergency actions rests with the management of the operating organization. Thus one of the prerequisites of licensing the first nuclear power plant in Hungary was the preparation and submission for approval of an emergency plan by the operating organization. In addition to this, the council of the county where the power plant is located has also been obliged to prepare a complementary emergency plan, in co-operation with other regional and national authorities, for the prevention of consequences from an emergency that may extend beyond the site boundary of the plant. In preparing the complementary plan, the emergency plan of the facility had to be taken into account. Unlike most national authorities involved in nuclear matters, the Public Health Authority is involved in the preparation of plans for every kind of emergency in a nuclear facility, including even those whose consequences can probably be confined to the plant site. The paper discusses in detail the role and responsibility of the Public Health Authority in emergency planning and preparedness for nuclear facilities. (author)

Soil-transmitted helminthiasis in Latin America and the Caribbean: modelling the determinants, prevalence, population at risk and costs of control at sub-national level

Directory of Open Access Journals (Sweden)

Josh Colston

2013-05-01

Full Text Available We present an example of a tool for quantifying the burden, the population in need of intervention and resources need to contribute for the control of soil-transmitted helminth (STH infection at multiple administrative levels for the region of Latin America and the Caribbean (LAC. The tool relies on published STH prevalence data along with data on the distribution of several STH transmission determinants for 12,273 sub-national administrative units in 22 LAC countries taken from national censuses. Data on these determinants was aggregated into a single risk index based on a conceptual framework and the statistical significance of the association between this index and the STH prevalence indicators was tested using simple linear regression. The coefficient and constant from the output of this regression was then put into a regression formula that was applied to the risk index values for all of the administrative units in order to model the estimated prevalence of each STH species. We then combine these estimates with population data, treatment thresholds and unit cost data to calculate total control costs. The model predicts an annual cost for the procurement of preventive chemotherapy of around US$ 1.7 million and a total cost of US$ 47 million for implementing a comprehensive STH control programme targeting an estimated 78.7 million school-aged children according to the WHO guidelines throughout the entirety of the countries included in the study. Considerable savings to this cost could potentially be made by embedding STH control interventions within existing health programmes and systems. A study of this scope is prone to many limitations which restrict the interpretation of the results and the uses to which its findings may be put. We discuss several of these limitations.

Soil-transmitted helminthiasis in Latin America and the Caribbean: modelling the determinants, prevalence, population at risk and costs of control at sub-national level.

Science.gov (United States)

Colston, Josh; Saboyá, Martha

2013-05-01

We present an example of a tool for quantifying the burden, the population in need of intervention and resources need to contribute for the control of soil-transmitted helminth (STH) infection at multiple administrative levels for the region of Latin America and the Caribbean (LAC). The tool relies on published STH prevalence data along with data on the distribution of several STH transmission determinants for 12,273 sub-national administrative units in 22 LAC countries taken from national censuses. Data on these determinants was aggregated into a single risk index based on a conceptual framework and the statistical significance of the association between this index and the STH prevalence indicators was tested using simple linear regression. The coefficient and constant from the output of this regression was then put into a regression formula that was applied to the risk index values for all of the administrative units in order to model the estimated prevalence of each STH species. We then combine these estimates with population data, treatment thresholds and unit cost data to calculate total control costs. The model predicts an annual cost for the procurement of preventive chemotherapy of around US$ 1.7 million and a total cost of US$ 47 million for implementing a comprehensive STH control programme targeting an estimated 78.7 million school-aged children according to the WHO guidelines throughout the entirety of the countries included in the study. Considerable savings to this cost could potentially be made by embedding STH control interventions within existing health programmes and systems. A study of this scope is prone to many limitations which restrict the interpretation of the results and the uses to which its findings may be put. We discuss several of these limitations.

42 CFR 81.1 - Purpose and Authority.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Purpose and Authority. 81.1 Section 81.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 Introduction § 81.1 Purpose and Authority...

Understanding the productive author who published papers in medicine using National Health Insurance Database: A systematic review and meta-analysis.

Science.gov (United States)

Chien, Tsair-Wei; Chang, Yu; Wang, Hsien-Yi

2018-02-01

Many researchers used National Health Insurance database to publish medical papers which are often retrospective, population-based, and cohort studies. However, the author's research domain and academic characteristics are still unclear.By searching the PubMed database (Pubmed.com), we used the keyword of [Taiwan] and [National Health Insurance Research Database], then downloaded 2913 articles published from 1995 to 2017. Social network analysis (SNA), Gini coefficient, and Google Maps were applied to gather these data for visualizing: the most productive author; the pattern of coauthor collaboration teams; and the author's research domain denoted by abstract keywords and Pubmed MESH (medical subject heading) terms.Utilizing the 2913 papers from Taiwan's National Health Insurance database, we chose the top 10 research teams shown on Google Maps and analyzed one author (Dr. Kao) who published 149 papers in the database in 2015. In the past 15 years, we found Dr. Kao had 2987 connections with other coauthors from 13 research teams. The cooccurrence abstract keywords with the highest frequency are cohort study and National Health Insurance Research Database. The most coexistent MESH terms are tomography, X-ray computed, and positron-emission tomography. The strength of the author research distinct domain is very low (Gini < 0.40).SNA incorporated with Google Maps and Gini coefficient provides insight into the relationships between entities. The results obtained in this study can be applied for a comprehensive understanding of other productive authors in the field of academics.

Market--what market? A review of Health Authority purchasing in the NHS internal market.

Science.gov (United States)

West, P A

1998-05-01

This paper argues that the British NHS Reforms (the 'Reforms') set out in Working for Patients [1] largely failed to create a market, to achieve the changes that market forces might have been expected to achieve or to meet the objectives set for the NHS in Working for Patients. It draws on the available literature and the author's experience of work with the NHS during the 6 years after Working for Patients. It is hampered, as are all such reviews of the UK Reforms, by the lack of a detailed and systematic research appraisal of the internal market. Many small changes, resulting from market mechanisms, may have occurred throughout the NHS without being publicized or well documented. But overall, there is little convincing evidence that the Reforms have achieved their goals or met the objectives of the politicians who initiated them. The argument here is necessarily limited by the space available (but see [2] for a detailed analysis of the NHS Reforms). The initial sections of the paper examine the characteristics of markets and market power and the extent to which the NHS Reforms created a market, with health authorities and fund-holders as its buyers. The paper concentrates in particular on health authorities. Later sections then examine the extent to which the Reforms met the objectives set out in Working for Patients.

Mapping for maternal and newborn health: the distributions of women of childbearing age, pregnancies and births.

Science.gov (United States)

Tatem, Andrew J; Campbell, James; Guerra-Arias, Maria; de Bernis, Luc; Moran, Allisyn; Matthews, Zoë

2014-01-04

The health and survival of women and their new-born babies in low income countries has been a key priority in public health since the 1990s. However, basic planning data, such as numbers of pregnancies and births, remain difficult to obtain and information is also lacking on geographic access to key services, such as facilities with skilled health workers. For maternal and newborn health and survival, planning for safer births and healthier newborns could be improved by more accurate estimations of the distributions of women of childbearing age. Moreover, subnational estimates of projected future numbers of pregnancies are needed for more effective strategies on human resources and infrastructure, while there is a need to link information on pregnancies to better information on health facilities in districts and regions so that coverage of services can be assessed. This paper outlines demographic mapping methods based on freely available data for the production of high resolution datasets depicting estimates of numbers of people, women of childbearing age, live births and pregnancies, and distribution of comprehensive EmONC facilities in four large high burden countries: Afghanistan, Bangladesh, Ethiopia and Tanzania. Satellite derived maps of settlements and land cover were constructed and used to redistribute areal census counts to produce detailed maps of the distributions of women of childbearing age. Household survey data, UN statistics and other sources on growth rates, age specific fertility rates, live births, stillbirths and abortions were then integrated to convert the population distribution datasets to gridded estimates of births and pregnancies. These estimates, which can be produced for current, past or future years based on standard demographic projections, can provide the basis for strategic intelligence, planning services, and provide denominators for subnational indicators to track progress. The datasets produced are part of national midwifery

Principles and framework for eHealth strategy development.

Science.gov (United States)

Scott, Richard E; Mars, Maurice

2013-07-30

Significant investment in eHealth solutions is being made in nearly every country of the world. How do we know that these investments and the foregone opportunity costs are the correct ones? Absent, poor, or vague eHealth strategy is a significant barrier to effective investment in, and implementation of, sustainable eHealth solutions and establishment of an eHealth favorable policy environment. Strategy is the driving force, the first essential ingredient, that can place countries in charge of their own eHealth destiny and inform them of the policy necessary to achieve it. In the last 2 years, there has been renewed interest in eHealth strategy from the World Health Organization (WHO), International Telecommunications Union (ITU), Pan American Health Organization (PAHO), the African Union, and the Commonwealth; yet overall, the literature lacks clear guidance to inform countries why and how to develop their own complementary but locally specific eHealth strategy. To address this gap, this paper further develops an eHealth Strategy Development Framework, basing it upon a conceptual framework and relevant theories of strategy and complex system analysis available from the literature. We present here the rationale, theories, and final eHealth strategy development framework by which a systematic and methodical approach can be applied by institutions, subnational regions, and countries to create holistic, needs- and evidence-based, and defensible eHealth strategy and to ensure wise investment in eHealth.

Measuring Iran's success in achieving Millennium Development Goal 4: a systematic analysis of under-5 mortality at national and subnational levels from 1990 to 2015

Directory of Open Access Journals (Sweden)

Younes Mohammadi, PhD

2017-05-01

provinces achieved MDG 4 and SDG 3 (target 2 goals by 2015. However, at the subnational level in some provinces, there is substantial inequity. Local policy makers should use effective strategies to accelerate the reduction of child mortality for these provinces by 2030. Possible recommendations for such strategies include enhancing the level of education and health literacy among women, tackling sex discrimination, and improving incomes for families. Funding: Iran Ministry of Health and Education.

Gender, job authority, and depression.

Science.gov (United States)

Pudrovska, Tetyana; Karraker, Amelia

2014-12-01

Using the 1957-2004 data from the Wisconsin Longitudinal Study, we explore the effect of job authority in 1993 (at age 54) on the change in depressive symptoms between 1993 and 2004 (age 65) among white men and women. Within-gender comparisons indicate that women with job authority (defined as control over others' work) exhibit more depressive symptoms than women without job authority, whereas men in authority positions are overall less depressed than men without job authority. Between-gender comparisons reveal that although women have higher depression than men, women's disadvantage in depression is significantly greater among individuals with job authority than without job authority. We argue that macro- and meso-processes of gender stratification create a workplace in which exercising job authority exposes women to interpersonal stressors that undermine health benefits of job authority. Our study highlights how the cultural meanings of masculinities and femininities attenuate or amplify health-promoting resources of socioeconomic advantage. © American Sociological Association 2014.

Incidence and prevalence of head lice in a district health authority area.

Science.gov (United States)

Harris, J; Crawshaw, J G; Millership, S

2003-09-01

There are very few recent studies of the incidence and prevalence of head lice in the UK. A population-based questionnaire survey was carried out in a district health authority area. Two hundred and four of 235 primary schools (87%) agreed to participate. A total of 21,556 of 43,889 (49%) questionnaires were returned by parents. Overall 438 children had head lice at the time of the survey, giving a prevalence of 2.03%; 8,059 had had lice at some time in the last year giving an annual incidence of 37.4%.

Implementation of Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Health Authority by the Agency for Toxic Substances and Disease Registry

International Nuclear Information System (INIS)

Siegel, M.R.

1990-01-01

The Superfund Amendments and Reauthorization Act (SARA) of 1986 greatly expanded the health authority of the Comprehensive Environmental Response, Compensation, and Liability Act. One of the federal agencies most affected by SARA is the Agency for Toxic Substances and Disease Registry (ATSDR) of the U.S. Public Health Service. Among other responsibilities, ATSDR was mandated to conduct health assessments within strict time frames for each site on or proposed for the U.S. Environmental Protection Agency's National Priorities List. The author will review ATSDR's efforts to address this new statutory mandate, especially for federal facilities, and will focus on different conceptual frameworks for implementing the health assessment program

The role of Swedish Radiation Protection Authority in the field of public health 2008; SSI:s roll i folkhaelsoarbetet 2008 - redovisning av regeringsuppdrag inom folkhaelsoomraadet

Energy Technology Data Exchange (ETDEWEB)

Hyrke, Lena; Almen, Anja; Blixt, Anders; Brewitz, Erica; Mjoenes, Lars; Moberg, Leif; Skeppstroem, Kirlna; Wester, Ulf

2008-04-15

The Swedish Government has requested that the Swedish Radiation Protection Authority (SSI) to make an account of the authority's role in the field of public health. Radiation Protection consists largely of preventive actions in order to protect man and the environment against harmful effects of radiation. The SSI thus considers most of the authority's activities to be public health related. The report describes a number of radiation protection areas from a health perspective. The measures taken by the authority in these areas are also described along with planned activities. In some areas the authority also points out additional measures

AUTHOR GUIDELINES

Directory of Open Access Journals (Sweden)

Chief Editor

2014-12-01

Full Text Available AUTHOR GUIDELINESIndian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/loginOnline SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.SectionsEditorial:On issues of current public health needAbout 1000 – 1200 wordsReferences: 5 – 10 (PubMed - Citation preferredInvited Commentary:Brief, provocative, opinionated communicationsOn issues of current public health needMain Text: 750-1000 words excluding referencesReferences: 5 – 10 (PubMed - Citation preferredOriginal Article:Articles from Original ResearchStructured abstract: 250 wordsMain Text: 2500 - 3000 words, IMRD formatKey Words: 5 - 8References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4*Certificate of clearance from respective Institutional Ethical Committee (IECReview Article:On subject of public health relevanceAbstract: 250 wordsMain Text: 2500 - 3000 wordsKey Words: 3 - 4References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4Short Communication / Article:Short report of a research project / outbreakMain Text : 1000 – 1200 wordsReferences: 10 – 15 (PubMed - Citation preferredTable / Figure: 01*Certificate of clearance from respective Institutional Ethical Committee (IECReport from the field

Health in All Policies (HiAP) framework for country action.

Science.gov (United States)

2014-06-01

This document serves as a 'starter's kit' for applying Health in All Policies (HiAP) in decision-making and implementation at national and subnational levels. It can be easily adapted for use in different country contexts and at the regional and global levels. WHAT IS HIAP?: HiAP is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies and avoids harmful health impacts in order to improve population health and health equity. As a concept, it reflects the principles of: legitimacy, accountability, transparency and access to information, participation, sustainability and collaboration across sectors and levels of government. Health and health equity are values in their own right and are also important prerequisites for achieving many other societal goals. Many of the determinants of health and health inequities in populations have social, environmental and economic origins that extend beyond the direct influence of the health sector and health policies. Thus, public policies in all sectors and at different levels of governance can have a significant impact on population health and health equity. The Framework sets out six key components that should be addressed in order to put the HiAP approach into action: (1) establish the need and priorities for HiAP, (2) frame planned action, (3) identify supportive structures and processes, (4) facilitate assessment and engagement, (5) ensure monitoring, evaluation and reporting, (6) build capacity. These components are not fixed in order or priority. Rather, individual countries will adopt and adjust the components in ways that are most relevant for their specific governance, economic and social contexts. Although governments as a whole bear the ultimate responsibility for the health of their citizens, health authorities at all levels are key actors in promoting HiAP. They should therefore actively seek opportunities to collaborate with and

Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia: challenges, needs and potential strategies.

Science.gov (United States)

Petersen, Inge; Marais, Debbie; Abdulmalik, Jibril; Ahuja, Shalini; Alem, Atalay; Chisholm, Dan; Egbe, Catherine; Gureje, Oye; Hanlon, Charlotte; Lund, Crick; Shidhaye, Rahul; Jordans, Mark; Kigozi, Fred; Mugisha, James; Upadhaya, Nawaraj; Thornicroft, Graham

2017-06-01

Poor governance has been identified as a barrier to effective integration of mental health care in low- and middle-income countries. Governance includes providing the necessary policy and legislative framework to promote and protect the mental health of a population, as well as health system design and quality assurance to ensure optimal policy implementation. The aim of this study was to identify key governance challenges, needs and potential strategies that could facilitate adequate integration of mental health into primary health care settings in low- and middle-income countries. Key informant qualitative interviews were held with 141 participants across six countries participating in the Emerging mental health systems in low- and middle-income countries (Emerald) research program: Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda. Data were transcribed (and where necessary, translated into English) and analysed thematically using framework analysis, first at the country level, then synthesized at a cross-country level. While all the countries fared well with respect to strategic vision in the form of the development of national mental health policies, key governance strategies identified to address challenges included: strengthening capacity of managers at sub-national levels to develop and implement integrated plans; strengthening key aspects of the essential health system building blocks to promote responsiveness, efficiency and effectiveness; developing workable mechanisms for inter-sectoral collaboration, as well as community and service user engagement; and developing innovative approaches to improving mental health literacy and stigma reduction. Inadequate financing emerged as the biggest challenge for good governance. In addition to the need for overall good governance of a health care system, this study identifies a number of specific strategies to improve governance for integrated mental health care in low- and middle-income countries. © The

[Hygiene in Urological Surgeries - Results of the Health Authority's Visit to all Urological Surgeries in Braunschweig].

Science.gov (United States)

Buhr-Riehm, B; Lenz, T

2015-07-01

Following a patient complaint, the Health Department carried out a hygiene inspection of a urological practice in Braunschweig in February 2013. The topic of the complaint was that a patient assumed having acquired a resistant pathogen in the practice. In the subsequent visit, significant hygiene defects were found, particularly with regard to the processing of medical devices. This led to a decision to commit all urological practices in Braunschweig to hygiene inspections as part of a priority project. In retrospect, the hygiene surveys were justified. Deficiencies included inadequate preparation of medical products, procedures in practice inconsistent with hygiene plans, poor knowledge of hygiene procedures among assistant staff and doctors, lack of expertise of assistant staff and lack of hygiene risk awareness by doctors. Positive experiences were: open communication in a good atmosphere with the Practice managers, willingness to change, good cooperation between the Health Authority and the Labor Inspectorate and Physicians' Association. The claimed deficits were corrected by spring 2014 by the practice operators. The consulting expertise of the health authorities was made use of continuously. © Georg Thieme Verlag KG Stuttgart · New York.

Health Equity Assessment Toolkit (HEAT: software for exploring and comparing health inequalities in countries

Directory of Open Access Journals (Sweden)

Ahmad Reza Hosseinpoor

2016-10-01

Full Text Available Abstract Background It is widely recognised that the pursuit of sustainable development cannot be accomplished without addressing inequality, or observed differences between subgroups of a population. Monitoring health inequalities allows for the identification of health topics where major group differences exist, dimensions of inequality that must be prioritised to effect improvements in multiple health domains, and also population subgroups that are multiply disadvantaged. While availability of data to monitor health inequalities is gradually improving, there is a commensurate need to increase, within countries, the technical capacity for analysis of these data and interpretation of results for decision-making. Prior efforts to build capacity have yielded demand for a toolkit with the computational ability to display disaggregated data and summary measures of inequality in an interactive and customisable fashion that would facilitate interpretation and reporting of health inequality in a given country. Methods To answer this demand, the Health Equity Assessment Toolkit (HEAT, was developed between 2014 and 2016. The software, which contains the World Health Organization’s Health Equity Monitor database, allows the assessment of inequalities within a country using over 30 reproductive, maternal, newborn and child health indicators and five dimensions of inequality (economic status, education, place of residence, subnational region and child’s sex, where applicable. Results/Conclusion HEAT was beta-tested in 2015 as part of ongoing capacity building workshops on health inequality monitoring. This is the first and only application of its kind; further developments are proposed to introduce an upload data feature, translate it into different languages and increase interactivity of the software. This article will present the main features and functionalities of HEAT and discuss its relevance and use for health inequality monitoring.

Author Disambiguation in PubMed: Evidence on the Precision and Recall of Author-ity among NIH-Funded Scientists.

Science.gov (United States)

Lerchenmueller, Marc J; Sorenson, Olav

2016-01-01

We examined the usefulness (precision) and completeness (recall) of the Author-ity author disambiguation for PubMed articles by associating articles with scientists funded by the National Institutes of Health (NIH). In doing so, we exploited established unique identifiers-Principal Investigator (PI) IDs-that the NIH assigns to funded scientists. Analyzing a set of 36,987 NIH scientists who received their first R01 grant between 1985 and 2009, we identified 355,921 articles appearing in PubMed that would allow us to evaluate the precision and recall of the Author-ity disambiguation. We found that Author-ity identified the NIH scientists with 99.51% precision across the articles. It had a corresponding recall of 99.64%. Precision and recall, moreover, appeared stable across common and uncommon last names, across ethnic backgrounds, and across levels of scientist productivity.

78 FR 21606 - Delegation of Authority

Science.gov (United States)

2013-04-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Delegation of Authority Notice is hereby given that in furtherance of the delegation of authority to the Assistant Secretary for Health on September 28, 1979, by the... such work by private non- profit entities, respectively. All previous delegations and redelegations...

Author Details

African Journals Online (AJOL)

: effects on infant and young child health and feeding practices. Abstract PDF. ISSN: 2078-6204. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

Requirements of health policy and services journals for authors to disclose financial and non-financial conflicts of interest: a cross-sectional study.

Science.gov (United States)

Khamis, Assem M; Hakoum, Maram B; Bou-Karroum, Lama; Habib, Joseph R; Ali, Ahmed; Guyatt, Gordon; El-Jardali, Fadi; Akl, Elie A

2017-09-19

The requirements of the health policy and services journals for authors to report their financial and non-financial conflicts of interest (COI) are unclear. The present article aims to assess the requirements of health policy and services journals for authors to disclose their financial and non-financial COIs. This is a cross-sectional study of journals listed by the Web of Science under the category of 'Health Policy and Services'. We reviewed the 'Instructions for Authors' on the journals' websites and then simulated the submission of a manuscript to obtain any additional relevant information made available during that step. We abstracted data in duplicate and independently using a standardised form. Out of 72 eligible journals, 67 (93%) had a COI policy. A minority of policies described how the disclosed COIs of authors would impact the editorial process (34%). None of the policies had clear-cut criteria for rejection based on the content of the disclosure. Approximately a fifth of policies (21%) explicitly stated that inaccurate or incomplete disclosures might lead to manuscript rejection or retraction. No policy described whether the journal would verify the accuracy or completeness of authors' disclosed COIs. Most journals' policies (93%) required the disclosure of at least one form of financial COI. While the majority asked for specification of source of payment (71%), a minority asked for the amount (18%). Overall, 81% of policies explicitly required disclosure of non-financial COIs. A majority of health policy and services journal policies required the disclosure of authors' financial and non-financial COIs, but few required details on disclosed COIs. Health policy journals should provide specific definitions and instructions for disclosing non-financial COIs. A framework providing clear typology and operational definitions of the different types of COIs will facilitate both their disclosure by authors and reviewers and their assessment and management by

78 FR 50057 - Delegation of Authorities

Science.gov (United States)

2013-08-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Delegation of Authorities Notice... to the effective date of this delegation of authorities. Nothing in this delegation of authorities is... delegation of authorities excludes the authority to issue regulations and to submit reports to Congress...

Oil for health in sub-Saharan Africa: health systems in a 'resource curse' environment.

Science.gov (United States)

Calain, Philippe

2008-10-21

In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomized by oil extraction in sub-Saharan Africa. Based on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan), I propose a framework for analysing the effects of the resource curse on the structure of health systems at sub-national levels. Qualitative attributes are emphasised. The role of the corporate sector, the influence of conflicts, and the value of classical mitigation measures (such as health impact assessments) are further examined. Health systems in a resource curse environment are classically fractured into tripartite components, including governmental health agencies, non-profit non-governmental organisations, and the corporate extractive sector. The three components entertain a range of contractual relationships generally based on operational considerations which are withdrawn from social or community values. Characterisation of agencies in this system should also include: values, operating principles, legitimacy and operational spaces. From this approach, it appears that community health is at the same time marginalized and instrumentalized toward economic and corporate interests in resource curse settings. From a public health point of view, the resource curse represents a fundamental failure of dominant development theories, rather than a delay in creating the proper economy and governance environment for social progress. The scope of research on the resource curse should be broadened to include more accurate or comprehensive indicators of destitution (including health components) and more open perspectives on causal mechanisms.

Oil for health in sub-Saharan Africa: health systems in a 'resource curse' environment

Directory of Open Access Journals (Sweden)

Calain Philippe

2008-10-01

Full Text Available Abstract Background In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomised by oil extraction in sub-Saharan Africa. Methods Based on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan, I propose a framework for analysing the effects of the resource curse on the structure of health systems at sub-national levels. Qualitative attributes are emphasised. The role of the corporate sector, the influence of conflicts, and the value of classical mitigation measures (such as health impact assessments are further examined. Results Health systems in a resource curse environment are classically fractured into tripartite components, including governmental health agencies, non-profit non-governmental organisations, and the corporate extractive sector. The three components entertain a range of contractual relationships generally based on operational considerations which are withdrawn from social or community values. Characterisation of agencies in this system should also include: values, operating principles, legitimacy and operational spaces. From this approach, it appears that community health is at the same time marginalised and instrumentalised toward economic and corporate interests in resource curse settings. Conclusion From a public health point of view, the resource curse represents a fundamental failure of dominant development theories, rather than a delay in creating the proper economy and governance environment for social progress. The scope of research on the resource curse should be broadened to include more accurate or comprehensive indicators of destitution (including health components and more open perspectives on causal mechanisms.

Promoting universal financial protection: constraints and enabling factors in scaling-up coverage with social health insurance in Nigeria.

Science.gov (United States)

Onoka, Chima A; Onwujekwe, Obinna E; Uzochukwu, Benjamin S; Ezumah, Nkoli N

2013-06-13

The National Health Insurance Scheme (NHIS) in Nigeria was launched in 2005 as part of efforts by the federal government to achieve universal coverage using financial risk protection mechanisms. However, only 4% of the population, and mainly federal government employees, are currently covered by health insurance and this is primarily through the Formal Sector Social Health Insurance Programme (FSSHIP) of the NHIS. This study aimed to understand why different state (sub-national) governments decided whether or not to adopt the FSSHIP for their employees. This study used a comparative case study approach. Data were collected through document reviews and 48 in-depth interviews with policy makers, programme managers, health providers, and civil servant leaders. Although the programme's benefits seemed acceptable to state policy makers and the intended beneficiaries (employees), the feasibility of employer contributions, concerns about transparency in the NHIS and the role of states in the FSSHIP, the roles of policy champions such as state governors and resistance by employees to making contributions, all influenced the decision of state governments on adoption. Overall, the power of state governments over state-level health reforms, attributed to the prevailing system of government that allows states to deliberate on certain national-level policies, enhanced by the NHIS legislation that made adoption voluntary, enabled states to adopt or not to adopt the program. The study demonstrates and supports observations that even when the content of a programme is generally acceptable, context, actor roles, and the wider implications of programme design on actor interests can explain decision on policy adoption. Policy implementers involved in scaling-up the NHIS programme need to consider the prevailing contextual factors, and effectively engage policy champions to overcome known challenges in order to encourage adoption by sub-national governments. Policy makers and

Transformation management of primary health care services in two selected local authorities in Gauteng

Directory of Open Access Journals (Sweden)

W Sibaya

2000-09-01

Full Text Available The transformation of health services in South Africa today is governed by the political, policy and legislative frameworks. This article focuses on the transformation of a primary health care service within a local authority in Gauteng. The purpose with this article is to explore and describe the perceptions (expectations and fears of selected managers employed in this primary health care service. The results are utilised to compile a strategy (framework for transformation management and leadership within the primary health care service. A qualitative research design was utilised and the data was collected by means of individual interviews with selected managers in the service, followed by a content analysis. The expectations and fears of managers focus mainly on personnel matters, community participation/satisfaction, salaries and parity, inadequate stocks/supplies and medication, the deterioration of quality service delivery and the need for training and empowerment. These results are divided into structure, process and outcome dimensions and are embodied in the conceptual framework for the transformation and leadership strategy. It is recommended that standards for transformation management be formulated and that the quality of transformation management be evaluated accordingly.

Deregulation and natural gas trade relationships: lessons from the Alberta-California experience

International Nuclear Information System (INIS)

Wilson, Patrick Impero

1997-01-01

In 1978 the US government moved to deregulate the American natural gas industry. The market changes that resulted from this initial step took time to ripple their way out to regional and subnational gas trading relationships. This ripple effect required subnational governments (state and provincial regulators) to rethink their gas regulatory policies. This article examines the restructuring of the Alberta-California gas trade. It explores how changes in US policy forced California and Alberta regulators to recast their policies. It concludes with several lessons that can be drawn from this case about the complex challenge of restructuring international gas trading relationships. (author)

Developing purchasing strategy: a case study of a District Health Authority using soft systems methodology.

Science.gov (United States)

Brown, A D

1997-02-01

This paper examines the attempt by a District Health Authority (DHA) to create structures (called Purchasing Strategy Groups or PSGs) to facilitate the effective development of its purchasing strategy. The paper is based on a case study design conducted using Soft Systems Methodology (SSM). The research contribution the paper makes is twofold. First, it analyses some of the fundamental management-related difficulties that a DHA can experience when attempting to come to terms with its role and responsibilities in the 1990s. Second, it provides a discussion and evaluation of the utility of SSM for qualitative research in the National Health Service (NHS) in the UK.

Urban poverty and utilization of maternal and child health care services in India.

Science.gov (United States)

Prakash, Ravi; Kumar, Abhishek

2013-07-01

Drawing upon data from the third round of the National Family Health Survey (NFHS-3) conducted in India during 2005-06, this study compares the utilization of selected maternal and child health care services between the urban poor and non-poor in India and across selected Indian states. A wealth index was created, separately for urban areas, using Principal Component Analysis to identify the urban poor. The findings suggest that the indicators of maternal and child health care are worse among the urban poor than in their non-poor counterparts. For instance, the levels of antenatal care, safe delivery and childhood vaccinations are much lower among the urban poor than non-poor, especially in socioeconomically disadvantageous states. Among all the maternal and child health care indicators, the non-poor/poor difference is most pronounced for delivery care in the country and across the states. Other than poverty status, utilization of antenatal services by mothers increases the chances of safe delivery and child immunization at both national and sub-national levels. The poverty status of the household emerged as a significant barrier to utilization of health care services in urban India.

An overiew of non medical prescribing across one strategic health authority: a questionnaire survey

Directory of Open Access Journals (Sweden)

Courtenay Molly

2012-06-01

Full Text Available Abstract Background Over 50,000 non-medical healthcare professionals across the United Kingdom now have prescribing capabilities. However, there is no evidence available with regards to the extent to which non-medical prescribing (NMP has been implemented within organisations across a strategic health authority (SHA. The aim of the study was to provide an overview of NMP across one SHA. Methods NMP leads across one SHA were asked to supply the email addresses of NMPs within their organisation. One thousand five hundred and eighty five NMPs were contacted and invited to complete an on-line descriptive questionnaire survey, 883 (55.7% participants responded. Data was collected between November 2010 and February 2011. Results The majority of NMPs were based in primary care and worked in a team of 2 or more. Nurse independent supplementary prescribers were the largest group (590 or 68.6% compared to community practitioner prescribers (198 or 22.4%, pharmacist independent supplementary prescribers (35 or 4%, and allied health professionals and optometrist independent and/or supplementary prescribers (8 or 0.9%. Nearly all (over 90% of nurse independent supplementary prescribers prescribed medicines. Approximately a third of pharmacist independent supplementary prescribers, allied health professionals, and community practitioner prescribers did not prescribe. Clinical governance procedures were largely in place, although fewer procedures were reported by community practitioner prescribers. General practice nurses prescribed the most items. Factors affecting prescribing practice were: employer, the level of experience prior to becoming a non-medical prescriber, existence of governance procedures and support for the prescribing role (p  Conclusion NMP in this strategic health authority reflects national development of this relatively new role in that the majority of non-medical prescribers were nurses based in primary care, with fewer pharmacist and

An overiew of non medical prescribing across one strategic health authority: a questionnaire survey.

Science.gov (United States)

Courtenay, Molly; Carey, Nicola; Stenner, Karen

2012-06-01

Over 50,000 non-medical healthcare professionals across the United Kingdom now have prescribing capabilities. However, there is no evidence available with regards to the extent to which non-medical prescribing (NMP) has been implemented within organisations across a strategic health authority (SHA). The aim of the study was to provide an overview of NMP across one SHA. NMP leads across one SHA were asked to supply the email addresses of NMPs within their organisation. One thousand five hundred and eighty five NMPs were contacted and invited to complete an on-line descriptive questionnaire survey, 883 (55.7%) participants responded. Data was collected between November 2010 and February 2011. The majority of NMPs were based in primary care and worked in a team of 2 or more. Nurse independent supplementary prescribers were the largest group (590 or 68.6%) compared to community practitioner prescribers (198 or 22.4%), pharmacist independent supplementary prescribers (35 or 4%), and allied health professionals and optometrist independent and/or supplementary prescribers (8 or 0.9%). Nearly all (over 90%) of nurse independent supplementary prescribers prescribed medicines. Approximately a third of pharmacist independent supplementary prescribers, allied health professionals, and community practitioner prescribers did not prescribe. Clinical governance procedures were largely in place, although fewer procedures were reported by community practitioner prescribers. General practice nurses prescribed the most items. Factors affecting prescribing practice were: employer, the level of experience prior to becoming a non-medical prescriber, existence of governance procedures and support for the prescribing role (p < 0.001). NMP in this strategic health authority reflects national development of this relatively new role in that the majority of non-medical prescribers were nurses based in primary care, with fewer pharmacist and allied health professional prescribers. This

77 FR 72350 - Delegation of Authorities

Science.gov (United States)

2012-12-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Delegation of Authorities Notice is hereby given that I... ensure that CMS' provider enrollment process continues without interruption. This delegation of authority... effective date of this delegation of authority. These authorities may be re-delegated. This delegation of...

76 FR 9353 - Statement of Delegation of Authority

Science.gov (United States)

2011-02-17

... involved the exercise of these authorities prior to the effective date of this delegation. This delegation... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Statement of Delegation of Authority Notice is hereby given that I have delegated to the Administrator, Health Resources...

Author Details

African Journals Online (AJOL)

Adams, C. Vol 19, No 2 (2013) - Articles Alpha Theta Meditation: Phenomenological, neurophysiologic, mindfulness, mood, health and sport implications. Abstract. ISSN: 1117-4315. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

76 FR 12978 - Statement of Delegation of Authority

Science.gov (United States)

2011-03-09

... HRSA and CDC officials, which involve the exercise of these authorities prior to the effective date of... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Statement of Delegation of Authority Notice is hereby given that I have delegated to the Administrator, Health Resources...

Leadership and governance of community health worker programmes at scale: a cross case analysis of provincial implementation in South Africa.

Science.gov (United States)

Schneider, Helen; Nxumalo, Nonhlanhla

2017-09-15

National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy. A cross case analysis of leadership and governance roles, drawing on three case studies of adoption and implementation of the WBOTs strategy at provincial level (Western Cape, North West and Gauteng) was conducted. The primary case studies mapped system components and assessed implementation processes and contexts. They involved teams of researchers and over 200 interviews with stakeholders from senior to frontline, document reviews and analyses of routine data. The secondary, cross case analysis specifically focused on the issues and challenges facing, and strategies adopted by provincial and district policy makers and managers, as they engaged with the new national mandate. From this key sub-national leadership and governance roles were formulated. Four key roles are identified and discussed: 1. Negotiating a fit between national mandates and provincial and district histories and strategies of community based services 2. Defining new organisational and accountability relationships between CHWs, local health services, communities and NGOs 3. Revising and developing new aligned and integrated planning, human resource, financing and information systems 4. Leading change by building new collective visions, mobilising political, including budgetary, support and designing implementation strategies. This analysis, from real-life systems, adds to understanding of the processes

Childhood leukaemia in the West Berkshire and Basingstoke and North Hampshire District Health Authorities in relation to nuclear establishments in the vicinity

International Nuclear Information System (INIS)

Roman, Eve; Beral, Valerie; Carpenter, Lucy; Watson, Ann; Barton, Carol; Ryder, Hilary; Aston, D.L.

1987-01-01

These data indicate that in the two district health authorities studied there was an excess incidence of childhood leukaemia during 1972-85 in the vicinity of the nuclear establishments. In the West Berkshire and Basingstoke and North Hampshire District Health Authorities an average of 60 000 children aged 0-14 lived within a 10 km radius of a nuclear establishment each year. The normal expectation of leukaemia in these children was two cases a year, whereas the recorded incidence was three cases per year, representing one extra case of leukaemia each year among these 60 000 children. (author)

Spatial variations and determinants of infant and under-five mortality in Bangladesh.

Science.gov (United States)

Gruebner, Oliver; Khan, Mmh; Burkart, Katrin; Lautenbach, Sven; Lakes, Tobia; Krämer, Alexander; Subramanian, S V; Galea, Sandro

2017-09-01

Reducing child mortality is a Sustainable Development Goal yet to be achieved by many low-income countries. We applied a subnational and spatial approach based on publicly available datasets and identified permanent insolvency, urbanicity, and malaria endemicity as factors associated with child mortality. We further detected spatial clusters in the east of Bangladesh and noted Sylhet and Jamalpur as those districts that need immediate attention to reduce child mortality. Our approach is transferable to other regions in comparable settings worldwide and may guide future studies to identify subnational regions in need for public health attention. Our study adds to our understanding where we may intervene to more effectively improve health, particularly among disadvantaged populations. Copyright © 2017 Elsevier Ltd. All rights reserved.

78 FR 18594 - Delegation of Authorities

Science.gov (United States)

2013-03-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Delegation of Authorities Notice is hereby given that I... Delegations of Authority, last published at 55 FR 9363 (March 13, 1990). Affordable Care Act Title I--Quality... Programs. This delegation of authorities excludes the authority to issue regulations and to submit reports...

Author Details

African Journals Online (AJOL)

Ololo, Shimeles. Vol 19, No 1 (2009) - Articles Indigenous Community Insurance (Iddirs) as an Alternative Health Care Financing in Jimma City, Southwest Ethiopia Abstract PDF. ISSN: 1029-1857. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

Author Details

African Journals Online (AJOL)

Adeniran, A. Vol 20, No 2 (2017) - Articles Organosomatic indices, haematological and histological assessment as biomarkers of health status in feral and cultured Clarias gariepinus. Abstract PDF. ISSN: 1119-5096. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

Author Details

African Journals Online (AJOL)

Otubanjo, O. D.. Vol 7, No 1 (2017) - Articles Radiological and related chemical health impact assessments of uranium in pipe borne water from some waterworks in Lagos metropolis, Nigeria Abstract PDF. ISSN: 1596-0862. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

Author Details

African Journals Online (AJOL)

Sogbesan, O. A.. Vol 7, No 1 (2017) - Articles Radiological and related chemical health impact assessments of uranium in pipe borne water from some waterworks in Lagos metropolis, Nigeria Abstract PDF. ISSN: 1596-0862. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

Author Details

African Journals Online (AJOL)

Alausa, S. K.. Vol 7, No 1 (2017) - Articles Radiological and related chemical health impact assessments of uranium in pipe borne water from some waterworks in Lagos metropolis, Nigeria Abstract PDF. ISSN: 1596-0862. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

Author Details

African Journals Online (AJOL)

Bolaji, Iyanda Adisa. Vol 5 (2016) - Articles Health Implications of Internet Addiction among In-School Adolescents in Ogbomoso North Local Government Area of Oyo State Abstract. ISSN: 2026-6081. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

Author Details

African Journals Online (AJOL)

Olabode, OA. Vol 2, No 2 (2006) - Articles Listeria monocytogenes: the nature, public health aspects and retrospective situations of an emerging infectious pathogen in Nigerian Abstract. ISSN: 0794-4721. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about ...

Responsibility without legal authority? Tackling alcohol-related health harms through licensing and planning policy in local government.

Science.gov (United States)

Martineau, F P; Graff, H; Mitchell, C; Lock, K

2014-09-01

The power to influence many social determinants of health lies within local government sectors that are outside public health's traditional remit. We analyse the challenges of achieving health gains through local government alcohol control policies, where legal and professional practice frameworks appear to conflict with public health action. Current legislation governing local alcohol control in England and Wales is reviewed and analysed for barriers and opportunities to implement effective population-level health interventions. Case studies of local government alcohol control practices are described. Addressing alcohol-related health harms is constrained by the absence of a specific legal health licensing objective and differences between public health and legal assessments of the relevance of health evidence to a specific place. Local governments can, however, implement health-relevant policies by developing local evidence for alcohol-related health harms; addressing cumulative impact in licensing policy statements and through other non-legislative approaches such as health and non-health sector partnerships. Innovative local initiatives-for example, minimum unit pricing licensing conditions-can serve as test cases for wider national implementation. By combining the powers available to the many local government sectors involved in alcohol control, alcohol-related health and social harms can be tackled through existing local mechanisms. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health.

Author Details

African Journals Online (AJOL)

Addai-Asante, Johnson. Vol 12, No 1-2 (2015) - Articles Enrolment on Health Insurance Scheme in Ghana: Evidence from Mfantseman Municipality Abstract PDF. ISSN: 0855-6768. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

Author Details

African Journals Online (AJOL)

Ramroop, S. Vol 7, No 1 (2009) - Articles Application of Negative Binomial Regression for Assessing Public Awareness of the Health Effects of Nicotine and Cigarettes Abstract PDF. ISSN: 1728-774X. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

Author Details

African Journals Online (AJOL)

Atiemo, SM. Vol 12, No 2 (2010) - Articles Determination of Heavy Metals and Human Health Risk Assessment of Road Dust on the Tema Motorway and Tetteh Quarshie Interchange in Accra, Ghana Abstract. ISSN: 0855-3823. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

Author Details

African Journals Online (AJOL)

Asuquo, EF. Vol 9, No 1&2 (2010) - Articles Organizational climate and nurses' job satisfaction in Cross River State, Health Institutions, Nigeria Abstract PDF. ISSN: 1596-2911. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

Author Details

African Journals Online (AJOL)

Owoyemi, AO. Vol 14, No 1 (2007) - Articles Review of public health implications of cell phone radiation and other sources of non-ionizing radiation and ionizing radiation. Abstract. ISSN: 1117-4153. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

Author Details

African Journals Online (AJOL)

Knoesen, Brent C. Vol 23, No 4 (2017): Supplement 1 - Articles Recording of nonverbal communication during focus group discussions in health research. Abstract. ISSN: 1117-4315. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

Author Details

African Journals Online (AJOL)

Ginika, KC. Vol 18, No 3 (2012) - Articles Self-reported health profile of athletes in Ibadan, South-western Nigeria: Indications for conformity with pre-participation screening. Abstract. ISSN: 1117-4315. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

Author Details

African Journals Online (AJOL)

Nwachukwu, FG. Vol 8, No 3 (2014) - Articles An Assessment of the Psychological Aspects of Health Communication among Port Harcourt City Residents Abstract PDF. ISSN: 2070-0083. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

Operational research to inform a sub-national surveillance intervention for malaria elimination in Solomon Islands

Directory of Open Access Journals (Sweden)

Atkinson Jo-An

2012-03-01

Full Text Available Abstract Background Successful reduction of malaria transmission to very low levels has made Isabel Province, Solomon Islands, a target for early elimination by 2014. High malaria transmission in neighbouring provinces and the potential for local asymptomatic infections to cause malaria resurgence highlights the need for sub-national tailoring of surveillance interventions. This study contributes to a situational analysis of malaria in Isabel Province to inform an appropriate surveillance intervention. Methods A mixed method study was carried out in Isabel Province in late 2009 and early 2010. The quantitative component was a population-based prevalence survey of 8,554 people from 129 villages, which were selected using a spatially stratified sampling approach to achieve uniform geographical coverage of populated areas. Diagnosis was initially based on Giemsa-stained blood slides followed by molecular analysis using polymerase chain reaction (PCR. Local perceptions and practices related to management of fever and treatment-seeking that would impact a surveillance intervention were also explored using qualitative research methods. Results Approximately 33% (8,554/26,221 of the population of Isabel Province participated in the survey. Only one subject was found to be infected with Plasmodium falciparum (Pf (96 parasites/μL using Giemsa-stained blood films, giving a prevalence of 0.01%. PCR analysis detected a further 13 cases, giving an estimated malaria prevalence of 0.51%. There was a wide geographical distribution of infected subjects. None reported having travelled outside Isabel Province in the previous three months suggesting low-level indigenous malaria transmission. The qualitative findings provide warning signs that the current community vigilance approach to surveillance will not be sufficient to achieve elimination. In addition, fever severity is being used by individuals as an indicator for malaria and a trigger for timely treatment

Author Details

African Journals Online (AJOL)

Chukwu, EE. Vol 42, No 4 (2015) - Articles Knowledge, Attitude and Practice of School Health among Primary School Teachers in Ogun State, Nigeria Abstract PDF. ISSN: 0302-4660. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

Author Details

African Journals Online (AJOL)

Ofevwe, GE. Vol 22, No 1-2 (2010) - Articles Evaluation of the performance of primary schools in Oredo Local Government Area of Edo State in the school health programme. Abstract PDF. ISSN: 0794-7410. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More ...

Author Details

African Journals Online (AJOL)

Qi, Qing. Vol 29, No 2 (2017) - Articles Psychological health among Chinese college students: a rural/urban comparison. Abstract. ISSN: 1728-0583. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use ...

Author Details

African Journals Online (AJOL)

Kirsten, GJC. Vol 35, No 3 (2015) - Articles The nature of workplace bullying experienced by teachers and the biopsychosocial health effects. Abstract PDF. ISSN: 2076-3433. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms ...

Author Details

African Journals Online (AJOL)

Misra, M. Vol 103, No 11 (2013) - Articles Hookah pipe smoking among health sciences students. Abstract PDF. ISSN: 0256-95749. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL ...

Author Details

African Journals Online (AJOL)

Wong, K.L.. Vol 10, No 1S (2018): Special Issue - Articles Key performance indicators for measuring sustainability in health care industry in Malaysia Abstract PDF. ISSN: 1112-9867. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

Author Details

African Journals Online (AJOL)

Leichliter, JS. Vol 8, No 2 (2011) - Articles 'Clinics aren't meant for men': Sexual health care access and seeking behaviours among men in Gauteng province, South Africa Abstract PDF. ISSN: 1813-4424. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about ...

Author Details

African Journals Online (AJOL)

Fungo, B. Vol 7, No 1 (2010) - Articles Traditional medicine as an alternative form of health care system: A preliminary case study of Nangabo sub-county, central Uganda Abstract PDF. ISSN: 0189-6016. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about ...

Author Details

African Journals Online (AJOL)

Ogo, IN. Vol 15, No 1 (2004) - Articles Listeria monocytogenes and other Listeria species in poul try faeces applied as manure on farm lands: Environmental health and food safety. Abstract PDF. ISSN: 01891731. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More ...

The French National Authority for Health (HAS) Guidelines for Conducting Budget Impact Analyses (BIA).

Science.gov (United States)

Ghabri, Salah; Autin, Erwan; Poullié, Anne-Isabelle; Josselin, Jean Michel

2018-04-01

Budget impact analysis (BIA) provides short- and medium-term estimates on changes in budgets and health outcomes resulting from the adoption of new health interventions. The purpose of this study is to present the newly developed French National Authority for Health (HAS) guidelines on budget impact analysis as follows: process, literature review, recommendations and comparisons with other guidelines. The development process of the HAS guidelines included a literature review (search dates: January 2000 to June 2016), a retrospective investigation of BIA previously submitted to HAS, a public consultation, international expert reviews and approval from the HAS Board and the Economic and Public Health Evaluation Committee of HAS. Documents identified in the literature review included 12 national guidelines, 5 recommendations for good practices developed by national and international society of health economics and 14 methodological publications including recommendations for conducting BIA. Based on its research findings, HAS developed its first BIA guidelines, which include recommendations on the following topics: BIA definition, perspective, populations, time horizon, compared scenarios, budget impact models, costing, discounting, choice of clinical data, reporting of results and uncertainty exploration. It is expected that the HAS BIA guidelines will enhance the usefulness, quality and transparency of BIA submitted by drug manufacturers to HAS. BIA is becoming an essential part of a comprehensive economic assessment of healthcare interventions in France, which also includes cost-effectiveness analysis and equity of access to healthcare.

48 CFR 305.502 - Authority.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Authority. 305.502 Section 305.502 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES COMPETITION AND ACQUISITION PLANNING PUBLICIZING CONTRACT ACTIONS Paid Advertisements 305.502 Authority. The Contracting Officer may...

75 FR 63480 - Delegation of Authorities

Science.gov (United States)

2010-10-15

... exercise of the authorities delegated herein prior to the effective date of this delegation. This delegation of authorities granted herein is effective immediately. Authority: 44 U.S.C. 3101. Dated... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Centers for Medicare & Medicaid...

Bioethical responsibilities of the health authority in health care and biomedical research

Directory of Open Access Journals (Sweden)

Rodrigo A. Salinas

2015-01-01

Full Text Available The reflection on bioethical contents of health policies and their effects on the demands for social justice has been a preferred concern of those who have driven the health reforms that were behind the creation of the National Health Service and, more recently, the regime of health guarantees. In the course of the years, the concern for the vindication of individual rights in the context of health care and research has joined to citizen demands for equitable access to health actions. For this purpose, in 2006 and 2012, specific laws addressing these matters were enacted and in the last year, regulations that make them operative emerged and are being implemented. The wording of the articles of both laws, in the effort to rescue individual rights, raises an imbalance in some respects, with regard to the social impact of their implementation. In certain subjects, its provisions run counter to existing codes of professional ethics in the country and in others; its implementation allows the privatization of the process of ethical review of pharmacological research, which was restricted to public health services. The absence of starting up of the National Bioethics Commission, pending since 2006, has prevented the creation of a pluralistic spaTce for deliberation on these issues and others as provided by law.

Author Details

African Journals Online (AJOL)

Runsewe-Abiodun, TI. Vol 9, No 1 (2015) - Articles Trends in perinatal health indices in the Amajuba District, KwaZulu-Natal, South Africa, 1990 - 2012. Abstract PDF. ISSN: 1999-7671. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

Author Details

African Journals Online (AJOL)

Omuemu, V. Vol 15, No 2 (2013) - Articles Hand hygiene practices among doctors in a tertiary health facility in southern Nigeria Abstract. ISSN: 2276-7096. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of ...

Author Details

African Journals Online (AJOL)

Ajiboyed, PO. Vol 11, No 3 (2008) - Articles Predictors of psychiatric readmissions to the psychiatric unit of a tertiary health facility in a Nigerian city - a 5-year study. Abstract PDF. ISSN: 1994-8220. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

Author Details

African Journals Online (AJOL)

Abdel – Rasoul, GM. Vol 2, No 1 (2009) - Articles Auditory and Respiratory Health Disorders Among Workers in an Iron and Steel Factory Abstract. ISSN: 1687-8671. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

Author Details

African Journals Online (AJOL)

Fono-Tamo, R.S.. Vol 11, No 2 (2016) - Articles Physico-thermal characteristics and health risk evaluation of randomly selected brake pads in the Nigerian market. Abstract. ISSN: 0795-5111. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

Author Details

African Journals Online (AJOL)

Matzopoulos, R. Vol 5, No 2 (2012) - Articles Conflict of interest: A tenacious ethical dilemma in public health policy, not only in clinical practice/research. Abstract PDF. ISSN: 1999-7639. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

Author Details

African Journals Online (AJOL)

Berry, D. Vol 76, No 1 (1989) - Articles Home births in the Mosvold health ward of KwaZulu. Abstract PDF. ISSN: 0256-95749. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News.

Author Details

African Journals Online (AJOL)

Buchman, E. Vol 76, No 1 (1989) - Articles Home births in the Mosvold health ward of KwaZulu. Abstract PDF. ISSN: 0256-95749. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL ...

76 FR 22396 - Delegation of Authority

Science.gov (United States)

2011-04-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Delegation of Authority Notice is... Department's policy on regulations and the existing delegation of authority to approve and issue regulations... effective date of this delegation. This delegation is effective upon signature. (Authority: Section 6 of the...

Under-5 mortality in 2851 Chinese counties, 1996-2012: a subnational assessment of achieving MDG 4 goals in China.

Science.gov (United States)

Wang, Yanping; Li, Xiaohong; Zhou, Maigeng; Luo, Shusheng; Liang, Juan; Liddell, Chelsea A; Coates, Matthew M; Gao, Yanqiu; Wang, Linhong; He, Chunhua; Kang, Chuyun; Liu, Shiwei; Dai, Li; Schumacher, Austin E; Fraser, Maya S; Wolock, Timothy M; Pain, Amanda; Levitz, Carly E; Singh, Lavanya; Coggeshall, Megan; Lind, Margaret; Li, Yichong; Li, Qi; Deng, Kui; Mu, Yi; Deng, Changfei; Yi, Ling; Liu, Zheng; Ma, Xia; Li, Hongtian; Mu, Dezhi; Zhu, Jun; Murray, Christopher J L; Wang, Haidong

2016-01-16

In the past two decades, the under-5 mortality rate in China has fallen substantially, but progress with regards to the Millennium Development Goal (MDG) 4 at the subnational level has not been quantified. We aimed to estimate under-5 mortality rates in mainland China for the years 1970 to 2012. We estimated the under-5 mortality rate for 31 provinces in mainland China between 1970 and 2013 with data from censuses, surveys, surveillance sites, and disease surveillance points. We estimated under-5 mortality rates for 2851 counties in China from 1996 to 2012 with the reported child mortality numbers from the Annual Report System on Maternal and Child Health. We used a small area mortality estimation model, spatiotemporal smoothing, and Gaussian process regression to synthesise data and generate consistent provincial and county-level estimates. We compared progress at the county level with what was expected on the basis of income and educational attainment using an econometric model. We computed Gini coefficients to study the inequality of under-5 mortality rates across counties. In 2012, the lowest provincial level under-5 mortality rate in China was about five per 1000 livebirths, lower than in Canada, New Zealand, and the USA. The highest provincial level under-5 mortality rate in China was higher than that of Bangladesh. 29 provinces achieved a decrease in under-5 mortality rates twice as fast as the MDG 4 target rate; only two provinces will not achieve MDG 4 by 2015. Although some counties in China have under-5 mortality rates similar to those in the most developed nations in 2012, some have similar rates to those recorded in Burkina Faso and Cameroon. Despite wide differences, the inter-county Gini coefficient has been decreasing. Improvement in maternal education and the economic boom have contributed to the fall in child mortality; more than 60% of the counties in China had rates of decline in under-5 mortality rates significantly faster than expected. Fast

76 FR 25355 - Delegation of Authority

Science.gov (United States)

2011-05-04

... subordinates, which involve the exercise of this authority prior to the effective date of this delegation. This delegation is effective upon date of signature. Authority: 44 U.S.C. 3101. Dated: April 22, 2011. Kathleen... DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) Office of the Secretary Delegation of Authority...

Search Results | Page 827 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Identification of sub-national effects as a new form of resource curse is a vital ... Introduction: Indonesian government launched Jampersal program or Maternity Insurance in ... affordable and excellent health care, including for mental health services. ... Indonesia is one of the countries which have increasing of prevalence of ...

The case for full practice authority.

Science.gov (United States)

Holmes, Olivia; Kinsey-Weathers, Shanieka

2016-03-01

The Institute of Medicine (IOM) recommended in its 2010 report on the future of nursing that advanced practice registered nurses (APRNs) should factor prominently in providing care to the millions of Americans who access healthcare services under the Affordable Care Act (ACA). The IOM also recommended that APRNs practice to the full extent of their education and training.However, many states have laws in place that limit full practice authority for APRNs, specifically NPs, in providing basic health services such as primary care. These laws place restrictions on independent practice and Medicaid and Medicare reimbursement, which prevent nurses from “responding effectively to rapidly changing health care settings and an evolving health care system.” Less than half of the United States has adopted full practice authority licensure and practice laws (see APRN practice authority at a glance). This article discusses how the primary care needs of millions of Americans can be met by granting full practice authority to APRNs nationwide and provides evidence to support the high level of care these practitioners can provide independently.

Second-hand smoke: a neglected public health challenge.

Science.gov (United States)

Singh, Rana J; Lal, Pranay G

2011-01-01

Exposure to secondhand smoke (SHS) causes an estimated 5% of the global burden of disease, slightly higher than the burden from direct use of tobacco. This review highlights the urgent need to address this ignored public health issue by presenting the evidence and impact of SHS on those exposed using global studies including those from the South-East Asia Region. The burden of morbidity from SHS exposure is higher in low-income countries in Southeast Asia region compared to the rest of the world. SHS exposure affects those most vulnerable, especially women and children. While several countries in the region have enacted legislation which offer protection to those exposed to SHS, most measures are partial and inadequate. As a result, implementation and compliance at national and sub-national level within the countries of the Southeast Asia region is variable. Governments must ensure that legislation mandates comprehensive smoke-free environments in order to provide public health benefit which offers universal protection to everyone and everywhere. Where comprehensive legislation exists, stringent implementation and enforcement, along with awareness building, education and monitoring through regular compliance studies must be done to sustain smokefree status of public places within jurisdictions.

Developing a workbook to support the contextualisation of global health systems guidance: a case study identifying steps and critical factors for success in this process at WHO.

Science.gov (United States)

Alvarez, Elizabeth; Lavis, John N; Brouwers, Melissa; Schwartz, Lisa

2018-03-02

Global guidance can help countries strengthen their health systems to deliver effective interventions to their populations. However, to have an impact, guidance needs to be contextualised or adapted to local settings; this process includes consideration of health system arrangements and political system factors. To date, methods to support contextualisation do not exist. In response, a workbook was designed to provide specific methods and strategies to enable the contextualisation of WHO's 'Optimizing health worker roles to improve maternal and newborn health' (OptimizeMNH) guidance at the national or subnational level. The objective of this study was to describe the process of developing the workbook and identify key steps of the development process, barriers that arose and facilitators that helped overcome some of these barriers. A qualitative single case study design was carried out. Interviews, documents and a reflexive journal were used. Constant comparison and an edit-style of organisation were used during data analysis to develop concepts, themes, subthemes and relationships among them. Thirteen interviews were conducted and 52 documents were reviewed. Three main steps were identified in the process of developing the workbook for health systems guidance contextualisation, namely (1) determining the need for and gaining approval to develop the workbook, (2) developing the workbook (taking on the task, creating the structure of the workbook, operationalising its components, undergoing approval processes and editing it), and (3) implementing the workbook both at the WHO level and at the national/subnational level. Five barriers and/or facilitators emerged relevant to each step, namely (1) having well-placed and credible champions, (2) creating and capitalising on opportunities, (3) finding the right language to engage various actors and obtain buy-in, (4) obtaining and maintaining meaningful buy-in, and (5) ensuring access to resources. Understanding the key

Improving imperfect data from health management information systems in Africa using space-time geostatistics.

Directory of Open Access Journals (Sweden)

Peter W Gething

2006-06-01

Full Text Available Reliable and timely information on disease-specific treatment burdens within a health system is critical for the planning and monitoring of service provision. Health management information systems (HMIS exist to address this need at national scales across Africa but are failing to deliver adequate data because of widespread underreporting by health facilities. Faced with this inadequacy, vital public health decisions often rely on crudely adjusted regional and national estimates of treatment burdens.This study has taken the example of presumed malaria in outpatients within the largely incomplete Kenyan HMIS database and has defined a geostatistical modelling framework that can predict values for all data that are missing through space and time. The resulting complete set can then be used to define treatment burdens for presumed malaria at any level of spatial and temporal aggregation. Validation of the model has shown that these burdens are quantified to an acceptable level of accuracy at the district, provincial, and national scale.The modelling framework presented here provides, to our knowledge for the first time, reliable information from imperfect HMIS data to support evidence-based decision-making at national and sub-national levels.

Spatial accessibility to basic public health services in South Sudan

Directory of Open Access Journals (Sweden)

Peter M. Macharia

2017-05-01

Full Text Available At independence in 2011, South Sudan’s health sector was almost non-existent. The first national health strategic plan aimed to achieve an integrated health facility network that would mean that 70% of the population were within 5 km of a health service provider. Publically available data on functioning and closed health facilities, population distribution, road networks, land use and elevation were used to compute the fraction of the population within 1 hour walking distance of the nearest public health facility offering curative services. This metric was summarised for each of the 78 counties in South Sudan and compared with simpler metrics of the proportion of the population within 5 km of a health facility. In 2016, it is estimated that there were 1747 public health facilities, out of which 294 were non-functional in part due to the on-going civil conflict. Access to a service provider was poor with only 25.7% of the population living within one-hour walking time to a facility and 28.6% of the population within 5 km. These metrics, when applied sub-nationally, identified the same high priority, most vulnerable counties. Simple metrics based upon population distribution and location of facilities might be as valuable as more complex models of health access, where attribute data on travel routes are imperfect or incomplete and sparse. Disparities exist in South Sudan among counties and those with the poorest health access should be targeted for priority expansion of clinical services.

Search Results | Page 40 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Results 391 - 400 of 8518 ... Monitoring subnational violence in Asia ... West and Central African Partnership for Maternal, Newborn, Child, and Adolescent Health Research ... their way through Mexico are victims of sexual violence, according to ...

Search Results | Page 39 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Results 381 - 390 of 8494 ... Monitoring subnational violence in Asia ... West and Central African Partnership for Maternal, Newborn, Child, and Adolescent Health Research ... their way through Mexico are victims of sexual violence, according to ...

Search Results | Page 43 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Results 421 - 430 of 8531 ... Monitoring subnational violence in Asia ... West and Central African Partnership for Maternal, Newborn, Child, and Adolescent Health Research ... their way through Mexico are victims of sexual violence, according to ...

Search Results | Page 42 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Results 411 - 420 of 8523 ... Monitoring subnational violence in Asia ... West and Central African Partnership for Maternal, Newborn, Child, and Adolescent Health Research ... their way through Mexico are victims of sexual violence, according to ...

[Institutional violence, medical authority, and power relations in maternity hospitals from the perspective of health workers].

Science.gov (United States)

Aguiar, Janaina Marques de; d'Oliveira, Ana Flávia Pires Lucas; Schraiber, Lilia Blima

2013-11-01

The current article discusses institutional violence in maternity hospitals from the health workers' perspective, based on data from a study in the city of São Paulo, Brazil. Eighteen health workers from the public and private sectors were interviewed, including obstetricians, nurses, and nurse technicians. A semi-structured interview was used with questions on professional experience and the definition of violence. The analysis revealed that these health workers acknowledged the existence of discriminatory and disrespectful practices against women during prenatal care, childbirth, and the postpartum. Examples of such practices cited by interviewees included the use of pejorative slang as a form of "humor", threats, reprimands, and negligence in the management of pain. Such practices are not generally viewed by health workers as violent, but rather as the exercise of professional authority in what is considered a "difficult" context. The institutional violence is thus trivialized, disguised as purportedly good practice (i.e., "for the patient's own good"), and rendered invisible in the daily routine of care provided by maternity services.

42 CFR 447.506 - Authorized generic drugs.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Authorized generic drugs. 447.506 Section 447.506... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payment for Drugs § 447.506 Authorized generic drugs. (a) Authorized generic drug defined. For the purposes of this subpart, an authorized generic drug...

Structural Determinants and Children's Oral Health: A Cross-National Study.

Science.gov (United States)

Baker, S R; Foster Page, L; Thomson, W M; Broomhead, T; Bekes, K; Benson, P E; Aguilar-Diaz, F; Do, L; Hirsch, C; Marshman, Z; McGrath, C; Mohamed, A; Robinson, P G; Traebert, J; Turton, B; Gibson, B J

2018-03-01

Much research on children's oral health has focused on proximal determinants at the expense of distal (upstream) factors. Yet, such upstream factors-the so-called structural determinants of health-play a crucial role. Children's lives, and in turn their health, are shaped by politics, economic forces, and social and public policies. The aim of this study was to examine the relationship between children's clinical (number of decayed, missing, and filled teeth) and self-reported oral health (oral health-related quality of life) and 4 key structural determinants (governance, macroeconomic policy, public policy, and social policy) as outlined in the World Health Organization's Commission for Social Determinants of Health framework. Secondary data analyses were carried out using subnational epidemiological samples of 8- to 15-y-olds in 11 countries ( N = 6,648): Australia (372), New Zealand (three samples; 352, 202, 429), Brunei (423), Cambodia (423), Hong Kong (542), Malaysia (439), Thailand (261, 506), United Kingdom (88, 374), Germany (1498), Mexico (335), and Brazil (404). The results indicated that the type of political regime, amount of governance (e.g., rule of law, accountability), gross domestic product per capita, employment ratio, income inequality, type of welfare regime, human development index, government expenditure on health, and out-of-pocket (private) health expenditure by citizens were all associated with children's oral health. The structural determinants accounted for between 5% and 21% of the variance in children's oral health quality-of-life scores. These findings bring attention to the upstream or structural determinants as an understudied area but one that could reap huge rewards for public health dentistry research and the oral health inequalities policy agenda.

20-Year Subject and Author Index, Volume 1, 1997-Volume 20, 1996; Subject and Author Index, Volume 21, 1997.

Science.gov (United States)

Weiler, Robert M.; Pealer, Lisa N.

1997-01-01

This index provides readers interested in health behavior, health education, and health promotion ordered access to materials published in Health Values and the American Journal of Health Behavior, 1977-1997. The index includes 115 subject headings and 5 department headings, classifying 918 entries by 1,319 authors and coauthors. (SM)

Weight-Related Health Behaviors and Body Mass: Associations between Young Adults and Their Parents, Moderated by Parental Authority

Science.gov (United States)

Niemeier, Brandi S.; Hektner, Joel M.

2012-01-01

Background: Parents' behaviors could contribute to the development of their children's weight-related health behaviors. Purpose: Relationships of young adults' (N = 151) and their parents' weight-related behaviors were examined along with parental authority styles. Methods: Questionnaires were completed by young adults and their parents.…

Religious influences on human capital variations in imperial Russia

Directory of Open Access Journals (Sweden)

Tomila Lankina

2012-01-01

Full Text Available Historical legacies, particularly imperial tutelage and religion, have featured prominently in recent scholarship on political regime variations in post-communist settings, challenging earlier temporally proximate explanations. The overlap between tutelage, geography, and religion has complicated the uncovering of the spatially uneven effects of the various legacies. The author addresses this challenge by conducting sub-national analysis of religious influences within one imperial domain, Russia. In particular, the paper traces how European settlement in imperial Russia has had a bearing on human development in the imperial periphery. The causal mechanism that the paper proposes to account for this influence is the Western communities’ impact on literacy, which is in turn linked in the analysis to the Western Christian, particularly Protestant, roots, of settler populations. The author makes this case by constructing an original dataset based on sub-national data from the hitherto underutilised first imperial census of 1897.

Regression Analysis to Identify Factors Associated with Household Salt Iodine Content at the Sub-National Level in Bangladesh, India, Ghana and Senegal

Science.gov (United States)

Knowles, Jacky; Kupka, Roland; Dumble, Sam; Garrett, Greg S.; Pandav, Chandrakant S.; Yadav, Kapil; Nahar, Baitun; Touré, Ndeye Khady; Amoaful, Esi Foriwa; Gorstein, Jonathan

2018-01-01

Regression analyses of data from stratified, cluster sample, household iodine surveys in Bangladesh, India, Ghana and Senegal were conducted to identify factors associated with household access to adequately iodised salt. For all countries, in single variable analyses, household salt iodine was significantly different (p < 0.05) between strata (geographic areas with representative data, defined by survey design), and significantly higher (p < 0.05) among households: with better living standard scores, where the respondent knew about iodised salt and/or looked for iodised salt at purchase, using salt bought in a sealed package, or using refined grain salt. Other country-level associations were also found. Multiple variable analyses showed a significant association between salt iodine and strata (p < 0.001) in India, Ghana and Senegal and that salt grain type was significantly associated with estimated iodine content in all countries (p < 0.001). Salt iodine relative to the reference (coarse salt) ranged from 1.3 (95% CI 1.2, 1.5) times higher for fine salt in Senegal to 3.6 (95% CI 2.6, 4.9) times higher for washed and 6.5 (95% CI 4.9, 8.8) times higher for refined salt in India. Sub-national data are required to monitor equity of access to adequately iodised salt. Improving household access to refined iodised salt in sealed packaging, would improve iodine intake from household salt in all four countries in this analysis, particularly in areas where there is significant small-scale salt production. PMID:29671774

Certificate-Based Encryption with Keyword Search: Enabling Secure Authorization in Electronic Health Record

Directory of Open Access Journals (Sweden)

Clémentine Gritti

2016-11-01

Full Text Available In an e-Health scenario, we study how the practitioners are authorized when they are requesting access to medical documents containing sensitive information. Consider the following scenario. A clinician wants to access and retrieve a patient’s Electronic Health Record (EHR, and this means that the clinician must acquire sufficient access right to access this document. As the EHR is within a collection of many other patients, the clinician would need to specify some requirements (such as a keyword which match the patient’s record, as well as having a valid access right. The complication begins when we do not want the server to learn anything from this query (as the server might be outsourced to other place. To encompass this situation, we define a new cryptographic primitive called Certificate-Based Encryption with Keyword Search (CBEKS, which will be suitable in this scenario. We also specify the corresponding security models, namely computational consistency, indistinguishability against chosen keyword and ciphertext attacks, indistinguishability against keyword-guessing attacks and collusion resistance. We provide a CBEKS construction that is proven secure in the standard model with respect to the aforementioned security models.

76 FR 62068 - Delegation of Authorities

Science.gov (United States)

2011-10-06

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Delegation of Authorities Notice is hereby given that I... information. This delegation shall be exercised in accordance with the Department's applicable policies... effective date of this delegation. This delegation of authorities is effective upon date of signature...

Mobile phone-based syndromic surveillance system, Papua New Guinea.

Science.gov (United States)

Rosewell, Alexander; Ropa, Berry; Randall, Heather; Dagina, Rosheila; Hurim, Samuel; Bieb, Sibauk; Datta, Siddhartha; Ramamurthy, Sundar; Mola, Glen; Zwi, Anthony B; Ray, Pradeep; MacIntyre, C Raina

2013-11-01

The health care system in Papua New Guinea is fragile, and surveillance systems infrequently meet international standards. To strengthen outbreak identification, health authorities piloted a mobile phone-based syndromic surveillance system and used established frameworks to evaluate whether the system was meeting objectives. Stakeholder experience was investigated by using standardized questionnaires and focus groups. Nine sites reported data that included 7 outbreaks and 92 cases of acute watery diarrhea. The new system was more timely (2.4 vs. 84 days), complete (70% vs. 40%), and sensitive (95% vs. 26%) than existing systems. The system was simple, stable, useful, and acceptable; however, feedback and subnational involvement were weak. A simple syndromic surveillance system implemented in a fragile state enabled more timely, complete, and sensitive data reporting for disease risk assessment. Feedback and provincial involvement require improvement. Use of mobile phone technology might improve the timeliness and efficiency of public health surveillance.

Clustering and inertia: structural integration of home care in Swedish elderly care

Directory of Open Access Journals (Sweden)

Nils Olof Hedman

2007-09-01

Full Text Available Purpose: To study the design and distribution of different organizational solutions regarding the responsibility for and provision of home care for elderly in Swedish municipalities. Method: Directors of the social welfare services in all Swedish municipalities received a questionnaire about old-age care organization, especially home care services and related activities. Rate of response was 73% (211/289. Results: Three different organizational models of home care were identified. The models represented different degrees of integration of home care, i.e. health and social aspects of home care were to varying degrees integrated in the same organization. The county councils (i.e. large sub-national political-administrative units tended to contain clusters of municipalities (smaller sub-national units with the same organizational characteristics. Thus, municipalities' home care organization followed a county council pattern. In spite of a general tendency for Swedish municipalities to reorganize their activities, only 1% of them had changed their home care services organization in relation to the county council since the reform. Conclusion: The decentralist intention of the reform—to give actors at the sub-national levels freedom to integrate home care according to varying local circumstances—has resulted in a sub-national inter-organizational network structure at the county council, rather than municipal, level, which is highly inert and difficult to change.

77 FR 37412 - Delegation of Authority

Science.gov (United States)

2012-06-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Community Living Delegation of Authority Effective immediately, I hereby delegate to the individual serving as the Administrator for the... of the Social Security Act, 42 U.S.C. 1397k. This authority may be redelegated. This delegation...

A Cross-Sectional Analysis of Acute Hepatitis B Virus Reported to the Vancouver Coastal Health Authority from 2000 to 2003

Directory of Open Access Journals (Sweden)

Yvette Leung

2006-01-01

Full Text Available BACKGROUND: Acute hepatitis B virus (HBV transmission remains a significant public health problem despite effective vaccination and prophylaxis strategies. Vancouver, British Columbia, has a large ethnic community from endemic areas, which may further impact on the epidemiology of acute HBV. A cross-sectional study of factors associated with acute HBV cases reported to the Vancouver Coastal Health Authority (Vancouver, British Columbia from 2000 to 2003 is reported.

Montesquieu and Judicial Review of Proportionality in Administrative Law : Rethinking the Separation of Powers in the Neoliberal Era

NARCIS (Netherlands)

L. van den Berge (Lukas)

2017-01-01

textabstractThe present era has seen an unprecedented fragmentation of the public sphere, a breakup of public imperium into separate pieces, not only left in the hands of supranational or subnational authorities, but also entrusted to private actors. With the abandonment of previously undisputed

48 CFR 1615.070 - Negotiation authority.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Negotiation authority. 1615.070 Section 1615.070 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT FEDERAL EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION 1615.070 Negotiation authority. Th...

Co-operation Between Different Authorities on Radiation and Health Protection Related to the Measures in Andreeva Bay

International Nuclear Information System (INIS)

Sneve, Malgorzata K.

2003-01-01

The Norwegian Radiation Protection Authority (NRPA) has been involved in the implementation of the Norwegian Plan of Action run by the Norwegian Government to ensure appropriate environmental protection and nuclear safety in the decommissioning of nuclear installations in the Northwest Russia. One objective is to ensure that the procedures used for the decommissioning of nuclear installations and radioactive waste management are appropriate and consistent with relevant policies and guidelines adopted by Russian regulatory bodies and international agencies. NRPA is an advisor for the Norwegian Ministry of Foreign Affairs on radiation protection and nuclear safety issues and ensures good co-operation with Russian authorities on the common goals. The Russian Federation state regulatory process imposes strict requirements on operators to demonstrate adequate safety, environmental and human health protection. Practically, however, there is little experience in Russia of how to assess coherently and combine all different issues within an overall process that leads to informed decision making. Regulatory requirements and related assessments tend to focus either on safety (prevention of accidents), protection of human health (in normal operations and in the event of accidents) or protection of the environment as distinct from human health, not on the whole problem. The Regulatory Support Project has been carried out by NRPA and different Russian regulatory bodies like Gosatomnadzor, Medbioextreme and others with support also from regulatory bodies in other countries. The major goal of the Regulatory Support Project is to support Russian regulatory bodies when developing guidelines and requirements for the planning, licensing and implementation of the industry projects. Another goal is that related industrial projects in Northwest Russia are managed in such a way as to efficiently secure an acceptable level of protection of human health and the environment, consistent with

Public authority responses to marine stinger public health risks: a scenario analysis of the Irukandji health threat in controlled spaces at public beaches in Australia.

Science.gov (United States)

Crowley-Cyr, Lynda

2012-12-01

This scenario analysis was undertaken to anticipate the likelihood of public authority liability for negligence arising from harm associated with the relatively new phenomenon of the Irukandji marine stinger health threat in Australia. The tort of negligence is about allocating liability for wrongs typically committed by one person or entity against another. The author questions whether a person who enters a marine stinger enclosure at one of Australia's patrolled and flagged beaches and suffers serious injury from an Irukandji sting can seek compensation or damages in negligence against government. It is argued that as the law currently stands, an injured bather without adequate warning could successfully sue a local authority for creating a false perception of safety and therefore inducing risky behaviour. Changes in ecology and climate variability are relevant considerations. This is a novel issue not previously dealt with in Australian courts.

200 Area Deactivation Project Facilities Authorization Envelope Document

International Nuclear Information System (INIS)

DODD, E.N.

2000-01-01

Project facilities as required by HNF-PRO-2701, Authorization Envelope and Authorization Agreement. The Authorization Agreements (AA's) do not identify the specific set of environmental safety and health requirements that are applicable to the facility. Therefore, the facility Authorization Envelopes are defined here to identify the applicable requirements. This document identifies the authorization envelopes for the 200 Area Deactivation

The effects of global health initiatives on country health systems: a review of the evidence from HIV/AIDS control.

Science.gov (United States)

Biesma, Regien G; Brugha, Ruairí; Harmer, Andrew; Walsh, Aisling; Spicer, Neil; Walt, Gill

2009-07-01

This paper reviews country-level evidence about the impact of global health initiatives (GHIs), which have had profound effects on recipient country health systems in middle and low income countries. We have selected three initiatives that account for an estimated two-thirds of external funding earmarked for HIV/AIDS control in resource-poor countries: the Global Fund to Fight AIDS, TB and Malaria, the World Bank Multi-country AIDS Program (MAP) and the US President's Emergency Plan for AIDS Relief (PEPFAR). This paper draws on 31 original country-specific and cross-country articles and reports, based on country-level fieldwork conducted between 2002 and 2007. Positive effects have included a rapid scale-up in HIV/AIDS service delivery, greater stakeholder participation, and channelling of funds to non-governmental stakeholders, mainly NGOs and faith-based bodies. Negative effects include distortion of recipient countries' national policies, notably through distracting governments from coordinated efforts to strengthen health systems and re-verticalization of planning, management and monitoring and evaluation systems. Sub-national and district studies are needed to assess the degree to which GHIs are learning to align with and build the capacities of countries to respond to HIV/AIDS; whether marginalized populations access and benefit from GHI-funded programmes; and about the cost-effectiveness and long-term sustainability of the HIV and AIDS programmes funded by the GHIs. Three multi-country sets of evaluations, which will be reporting in 2009, will answer some of these questions.

Regression Analysis to Identify Factors Associated with Household Salt Iodine Content at the Sub-National Level in Bangladesh, India, Ghana and Senegal

Directory of Open Access Journals (Sweden)

Jacky Knowles

2018-04-01

Full Text Available Regression analyses of data from stratified, cluster sample, household iodine surveys in Bangladesh, India, Ghana and Senegal were conducted to identify factors associated with household access to adequately iodised salt. For all countries, in single variable analyses, household salt iodine was significantly different (p < 0.05 between strata (geographic areas with representative data, defined by survey design, and significantly higher (p < 0.05 among households: with better living standard scores, where the respondent knew about iodised salt and/or looked for iodised salt at purchase, using salt bought in a sealed package, or using refined grain salt. Other country-level associations were also found. Multiple variable analyses showed a significant association between salt iodine and strata (p < 0.001 in India, Ghana and Senegal and that salt grain type was significantly associated with estimated iodine content in all countries (p < 0.001. Salt iodine relative to the reference (coarse salt ranged from 1.3 (95% CI 1.2, 1.5 times higher for fine salt in Senegal to 3.6 (95% CI 2.6, 4.9 times higher for washed and 6.5 (95% CI 4.9, 8.8 times higher for refined salt in India. Sub-national data are required to monitor equity of access to adequately iodised salt. Improving household access to refined iodised salt in sealed packaging, would improve iodine intake from household salt in all four countries in this analysis, particularly in areas where there is significant small-scale salt production.

76 FR 64953 - Statement of Organization, Functions and Delegations of Authority

Science.gov (United States)

2011-10-19

... re-delegations of authority made to HRSA officials and employees of affected organizational... Organization, Functions and Delegations of Authority This notice amends Part R of the Statement of Organization, Functions and Delegations of Authority of the Department of Health and Human Services (HHS), Health...

Johnson Space Center Health and Medical Technical Authority

Science.gov (United States)

Fogarty, Jennifer A.

2010-01-01

1.HMTA responsibilities: a) Assure program/project compliance with Agency health and medical requirements at identified key decision points. b) Certify that programs/projects comply with Agency health and medical requirements prior to spaceflight missions. c) Assure technical excellence. 2. Designation of applicable NASA Centers for HMTA implementation and Chief Medical Officer (CMO) appointment. 3. Center CMO responsible for HMTA implementation for programs and projects at the center. JSC HMTA captured in "JSC HMTA Implementation Plan". 4. Establishes specifics of dissenting opinion process consistent with NASA procedural requirements.

78 FR 64520 - Statement of Organization, Functions, and Delegations of Authority

Science.gov (United States)

2013-10-29

... Statement: All delegations and redelegations of authority to officers and employees of NIH that were in..., Functions, and Delegations of Authority Part N, National Institutes of Health (NIH), of the Statement of Organization, Functions, and Delegations of Authority for the Department of Health and Human Services (40 FR...

[Description of the process of preparation and response of local health authorities facing the introduction of the Chikungunya virus in Colombia, 2014].

Science.gov (United States)

Alarcón-Cruz, Ángela P; Prieto-Suárez, Edgar

2016-06-01

Objective To describe the process of preparation and response of local health authorities in key public health issues while facing the introduction stage of an unusual virus: Chikungunya in Colombia in 2014. Methods A cross-sectional study was conducted using a survey that was developed for this study and sent to Public Health coordinators and to the person in charge of vector borne-diseases in the country's territorial entities. Results 23 out of the 35 territories at risk from the transmission of Chikungunya agreed to answer the survey. A global review of the survey scores for each evaluated section shows better performances in the areas of knowledge management, comprehensive patient care, epidemiological intelligence, and health promotion. According to the results of this study, the epidemiological surveillance system during the Chikungunya epidemic had a low acceptability and flexibility, possibly contributing to the underreporting of cases. Conclusions In general, knowledge and implementation by local authorities of the Integrated Health Strategy- EGI (Estrategia de Gestión Integral, by its Spanish acronym)- for vector-borne diseases was evident from the themes evaluated in this study. However, it is necessary to reinforce the communication of risks, laboratory, and outbreak and contingencies management areas faced during the introduction of new viruses.

Presence and use of legislative guidelines for the distribution of decentralized decision making authority in the jimma zone health system, southwest ethiopia.

Science.gov (United States)

Woldie, Mirkuzie; Jirra, Challi; Azene, Girma

2011-08-01

Decentralization ultimately involves the execution of most health care activities at lower levels of the health system. However, when poorly implemented, decentralization can create confusion about roles and responsibilities. Therefore, the objective of this study was to assess the presence and use of legislative guidelines depicting the distribution of decentralized authority for decision making in the Jimma Zone health system, Southwest Ethiopia. A cross sectional study employing both qualitative and quantitative methods was undertaken from 16(th) January to 15(th) March 2007 in Jimma Zone. Health managers at relevant departments of the Federal Ministry of Health, Oromia Regional Health Bureau (RHB), Jimma Zonal Health Department, 13 Woreda Health Offices of Jimma Zone and the health centers and health posts in these districts were included in the study. Data was collected using interview guides and self administered structured questionnaires prepared for each level of the health system. Tape-recorded qualitative data was transcribed and analyzed using thematic framework approach while SPSS for windows version 12.0.1 was used to analyze the quantitative data obtained. According to the regional guidelines, ensuring achievement of regional health service targets is the responsibility of the RHB. This was clear to 97 (97.9%) of the health managers included in this study. However, almost equivalent proportion of the respondents, 95 (95.9%) agreed that the FMOH should be responsible for this. Similarly, 71 (73.9%) of the health managers knew that approval of health budgets and efforts for local resource generation is the responsibility of the Woreda Administrative Council while the remaining 27.1% were uncertain or disagreed about this regional direction. Such confusions were observed in almost every functional area. Moreover, legislative guidelines were not available in most of the district health offices and health facilities. Legislative guidelines depicting the

9 CFR 147.51 - Authorized laboratory minimum requirements.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Authorized laboratory minimum requirements. 147.51 Section 147.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... Authorized Laboratories and Approved Tests § 147.51 Authorized laboratory minimum requirements. These minimum...

76 FR 72713 - Statement of Delegation of Authority

Science.gov (United States)

2011-11-25

... involve the exercise of these authorities prior to the effective date of this delegation. This delegation... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Centers for..., Health Resources and Services Administration (HRSA), and the Director, Centers for Disease Control and...

Implementing personalisation for people with mental health problems: a comparative case study of four local authorities in England.

Science.gov (United States)

Larsen, John; Ainsworth, Emily; Harrop, Clare; Patterson, Sue; Hamilton, Sarah; Szymczynska, Paulina; Tew, Jerry; Manthorpe, Jill; Pinfold, Vanessa

2013-04-01

Enhancing choice and control for people using services is a mental health and social-care service priority in England. Personalisation is a new policy and practice for delivery of social-care services where eligible adults are allocated a personal budget to spend to meet their agreed support needs. To describe approaches to introducing personal budgets to people with severe and enduring mental health needs, and to identify facilitators or barriers encountered. Within four English local authority (LA) areas, purposively selected to provide maximum variation, semi-structured interviews were undertaken with 58 participants from LAs, NHS trusts and third-sector organisations. An Interpretive Framework analysis considered within- and across-site insights. Issues arising from the implementation of personalisation for people with mental health needs are presented under two general themes: "responsibility and power" and "vision and leadership". Key challenges identified were complexities of working across NHS and LAs, the importance of effective leadership and engagement with service user representatives. Implementing personal budgets in mental health requires effective engagement of health and social-care systems. Change processes need strong leadership, clear vision and personal commitment, with ownership by all key stakeholders, including front-line practitioners.

Mobile Phone–based Syndromic Surveillance System, Papua New Guinea

Science.gov (United States)

Ropa, Berry; Randall, Heather; Dagina, Rosheila; Hurim, Samuel; Bieb, Sibauk; Datta, Siddhartha; Ramamurthy, Sundar; Mola, Glen; Zwi, Anthony B.; Ray, Pradeep; MacIntyre, C. Raina

2013-01-01

The health care system in Papua New Guinea is fragile, and surveillance systems infrequently meet international standards. To strengthen outbreak identification, health authorities piloted a mobile phone–based syndromic surveillance system and used established frameworks to evaluate whether the system was meeting objectives. Stakeholder experience was investigated by using standardized questionnaires and focus groups. Nine sites reported data that included 7 outbreaks and 92 cases of acute watery diarrhea. The new system was more timely (2.4 vs. 84 days), complete (70% vs. 40%), and sensitive (95% vs. 26%) than existing systems. The system was simple, stable, useful, and acceptable; however, feedback and subnational involvement were weak. A simple syndromic surveillance system implemented in a fragile state enabled more timely, complete, and sensitive data reporting for disease risk assessment. Feedback and provincial involvement require improvement. Use of mobile phone technology might improve the timeliness and efficiency of public health surveillance. PMID:24188144

Search Results | Page 43 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Results 421 - 430 of 8531 ... Monitoring subnational violence in Asia ... Partnership for Maternal, Newborn, Child, and Adolescent Health Research ... on their way through Mexico are victims of sexual violence, according to reports from Amnesty International. Project. -. Violence Prevention, Access to Justice, and Economic ...

Existence and functionality of emergency obstetric care services at district level in Kenya

DEFF Research Database (Denmark)

Echoka, Elizabeth; Kombe, Yeri; Dubourg, Dominique

2013-01-01

The knowledge on emergency obstetric care (EmOC) is limited in Kenya, where only partial data from sub-national studies exist. The EmOC process indicators have also not been integrated into routine health management information system to monitor progress in safe motherhood interventions both...

76 FR 13646 - Statement of Delegation of Authority

Science.gov (United States)

2011-03-14

... Delegation of Authority Notice is hereby given that I have delegated to the Administrator, Health Resources and Services Administration (HRSA), authority vested in the Secretary under Title XX, Section 2008(b... Act, as it pertains to the functions assigned to HRSA. This authority may be redelegated. HRSA will...

Measuring inequalities in the distribution of the Fiji Health Workforce.

Science.gov (United States)

Wiseman, Virginia; Lagarde, Mylene; Batura, Neha; Lin, Sophia; Irava, Wayne; Roberts, Graham

2017-06-30

Despite the centrality of health personnel to the health of the population, the planning, production and management of human resources for health remains underdeveloped in many low- and middle-income countries (LMICs). In addition to the general shortage of health workers, there are significant inequalities in the distribution of health workers within LMICs. This is especially true for countries like Fiji, which face major challenges in distributing its health workforce across many inhabited islands. In this study, we describe and measure health worker distributional inequalities in Fiji, using data from the 2007 Population Census, and Ministry of Health records of crude death rates and health workforce personnel. We adopt methods from the economics literature including the Lorenz Curve/Gini Coefficient and Theil Index to measure the extent and drivers of inequality in the distribution of health workers at the sub-national level in Fiji for three categories of health workers: doctors, nurses, and all health workers (doctors, nurses, dentists and health support staff). Population size and crude death rates are used as proxies for health care needs. There are greater inequalities in the densities of health workers at the provincial level, compared to the divisional level in Fiji - six of the 15 provinces fall short of the recommended threshold of 2.3 health workers per 1,000 people. The estimated decile ratios, Gini co-efficient and Thiel index point to inequalities at the provincial level in Fiji, mainly with respect to the distribution of doctors; however these inequalities are relatively small. While populations with lower mortality tend to have a slightly greater share of health workers, the overall distribution of health workers on the basis of need is more equitable in Fiji than for many other LMICs. The overall shortage of health workers could be addressed by creating new cadres of health workers; employing increasing numbers of foreign doctors, including

Download this PDF file

African Journals Online (AJOL)

MLR

availability of the opportunity for dual constitutionalism, the co-existence of federal and sub-national ... 1109; Jonathan Marshfield,. 'Models of Sub-national Constitutionalism' (2011) 115 Penn State Law Review, 1151; .... us that we need to trace, track, and have an understanding of sub-national constitutions. This act of ...

5 CFR 179.102 - Delegation of authority.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Delegation of authority. 179.102 Section... COLLECTION STANDARDS General Provisions and Administration § 179.102 Delegation of authority. (a) The Chief... Disability Fund, the Employees' Life Insurance Fund, the Retired Federal Employees Health Benefits Act (74...

Creation of Malaysia’s Royal Belum State Park: A Case Study of Conservation in a Developing Country

OpenAIRE

Schwabe, KA; Carson, RT; DeShazo, JR; Potts, MD; Reese, AN; Vincent, JR

2015-01-01

© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav. The incentives for resource extraction and development make the conservation of biodiversity challenging within tropical forestlands. The 2007 establishment of the Royal Belum State Park in the Malaysian state of Perak offers lessons for creating protected areas in tropical countries where subnational governments are major forestland owners. This article elucidates the social and political forces that influe...

Towards a global alcohol policy: alcohol, public health and the role of WHO.

Science.gov (United States)

Jernigan, D. H.; Monteiro, M.; Room, R.; Saxena, S.

2000-01-01

In 1983 the World Health Assembly declared alcohol-related problems to be among the world's major health concerns. Since then, alcohol consumption has risen in developing countries, where it takes a heavy toll. Alcohol-related problems are at epidemic levels in the successor states of the Soviet Union and are responsible for 3.5% of disability-adjusted life years (DALYs) lost globally. Substantial evidence exists of the relationship between the levels and patterns of alcohol consumption on the one hand and the incidence of alcohol-related problems on the other. Over the past 20 years, research has demonstrated the effectiveness of public policies involving, for example, taxation and restrictions on alcohol availability, in reducing alcohol-related problems. In the wake of rapid economic globalization, many of these policies at national and subnational levels have been eroded, often with the support of international financial and development organizations. Development agencies and international trade agreements have treated alcohol as a normal commodity, overlooking the adverse consequences of its consumption on productivity and health. WHO is in a strong position to take the lead in developing a global alcohol policy aimed at reducing alcohol-related problems, providing scientific and statistical support, capacity-building, disseminating effective strategies and collaborating with other international organizations. Such leadership can play a significant part in diminishing the health and social problems associated with alcohol use. PMID:10885168

Position paper for health authorities: archived clinical pathology data-treasure to revalue and appropriate.

Science.gov (United States)

Nwose, E U; Richards, R S; Butkowski, E; Cann, Nathan

2010-12-01

Archived clinical pathology data (ACPD) is recognized as useful for research. Given our privileged de-identified ACPD from South West Pathology Service (SWPS), attempt is made to estimate what it would cost any researcher without such privilege to generate the same data. The Ethics Committee of the Area Health Service approved a request for Dr. Uba Nwose to use de-identified ACPD acquired by the SWPS for clinical laboratory-based translational biomedical science research. 10-years (1999-2008) have been pooled to constitute the database. Data include blood sugar, cholesterol, D-dime, ESR, glucose tolerance, haematocrit, HbA 1 c, homocysteine, serum creatinine, total protein and vitamins [C & E] amongst others. For this report, the bulk-billed-cost of tests were estimated based on number and unit price of each test performed. AU$ 17,507,136.85 is the cost paid by Medicare in the period. This amount is a conservative estimate that could be spent to generate such 10-years data in the absence of ACPD. The health/pathology service has not given any financial research grant. However, the support-in-kind is worth more than celebrated competitive research grants. It calls for revaluatrion by academic, research and scientific institutions the use ofACPD. For the countries where such provision is non-existent, this report provides a 'Position Paper' to present to the directorates or institutes of health authorities to appropriate the value of ACPD and approve of their use as a research treasure and resource management tool.

76 FR 31337 - Public Health Service Act (PHS); Delegation of Authority

Science.gov (United States)

2011-05-31

... Service Act (PHS); Delegation of Authority Notice is hereby given that pursuant to Section 3306(14) of the... authorities described in section 3306(14)(B) of the PHS Act. This delegation is in addition to those duties..., pursuant to the delegation in the previous paragraph. These authorities shall be exercised under the...

Off-site intervention plan of the public health authorities for emergencies at the Caorso nuclear power plant

International Nuclear Information System (INIS)

Fabbri, S.; Sogni, R.; Boeri, G.; Cencetti, S.; Melandri, G.; Paterlini, L.

1986-01-01

The Caorso nuclear power plant, which is near Piacenza and has an 875 MW boiling water reactor, has been generating electricity on a regular basis since 1978. The off-site intervention plan of the public health authorities, based on an analysis of hypothetical accidents, was approved in 1977 and subsequently revised. A study of the radiological consequences of these accidents for man and the environment indicates that the highest doses likely to be received by inhalation of 131 I would be no more than a few rem, whereas the levels of soil contamination, even at a distance of 40 km, could exceed 1 μCi/m 2 . The main problems caused by such accidents are therefore related to environmental contamination. Under the intervention plan, the provincial prefect is responsible for co-ordinating the work of all the civil, military and medical authorities. Teams from ENEL, the fire service and the local health services (USL) monitor the concentration of 131 I in the air and the exposure level, and take samples within a radius of 10 km around the site. The police and army control road traffic and are responsible, if necessary, for the evacuation of the population. A radiometry co-ordination centre (CCRI) is set up to process the readings made by the teams and provides the prefect with the technical information he requires to take decisions The local medical services (USL) run the centre where the population is assembled and monitor superficial contamination, apply initial decontamination measures, and provide medical assistance in general. The Piacenza USL also takes action by sending out its mobile radiometry laboratory, using its measurement equipment and providing logistic support to the CCRI. It is also to play a major role in informing the population in the event of an alarm. (author)

THE NATIONAL AUTHORITY FOR ANIMAL HEALTH AND FOOD SAFETY, THE MAIN BODY INVOLVED IN FOOD SAFETY IN ROMANIA

Directory of Open Access Journals (Sweden)

PETRUTA-ELENA ISPAS

2012-05-01

Full Text Available This paper is intended to present the role, functions and responsibilities of the National Authority for Animal Health and Food Safety as the main body involved in food safety in Romania. It will be also exposed the Regulation 178/2002 of the European Parliament and the Council, the general food ”law” in Europe, and Law 150/2004, which transposed into Romanian legislation Regulation 178/2002.

THE AFFORDABLE CARE ACT AND INCENTIVIZED HEALTH WELLNESS PROGRAMS--A TALE OF FEDERALISM AND SHIFTING ADMINISTRATIVE BURDEN.

Science.gov (United States)

Sirpal, Sanjeev

2014-01-01

The Patient Protection and Affordable Care Act creates new incentives and builds on existing wellness program policies to promote employer wellness programs and encourage opportunities to support healthier workplaces. The proposed rules are promulgated by the Department of Health and Human Services (HHS), the Department of Labor, and the Treasury Department, and seek to encourage appropriately designed, consumer-protective wellness programs in group health coverage. This legislative landscape raises significant federalism concerns insofar as it largely shifts the responsibility for administration of health incentive programs to the states. Little attention has been paid to the shifting "administrative burden" that would thereby ensue. This paper will address the distribution of power in the American federal system vis-à-vis subnational counterparts in the wake of rampant, recent health care reform efforts. This paper will therefore explore the willingness of the national government to delegate policymaking responsibility to state governments in the context of an important aspect of healthcare reform. This, in turn, can be used to assess the distribution of powers between governmental levels--a subject that has received little systematic inquiry to date. Finally, this paper will explore the degree of administrative burden shifting that may likely occur as a result of these changes in health reform and what potential impacts it may have on individual health.

The Human Resources for Health Effort Index: a tool to assess and inform Strategic Health Workforce Investments.

Science.gov (United States)

Fort, Alfredo L; Deussom, Rachel; Burlew, Randi; Gilroy, Kate; Nelson, David

2017-07-19

Despite its importance, the field of human resources for health (HRH) has lagged in developing methods to measure its status and progress in low- and middle-income countries suffering a workforce crisis. Measures of professional health worker densities and distribution are purely numerical, unreliable, and do not represent the full spectrum of workers providing health services. To provide more information on the multi-dimensional characteristics of human resources for health, in 2013-2014, the global USAID-funded CapacityPlus project, led by IntraHealth International, developed and tested a 79-item HRH Effort Index modeled after the widely used Family Planning Effort Index. The index includes seven recognized HRH dimensions: Leadership and Advocacy; Policy and Governance; Finance; Education and Training; Recruitment, Distribution, and Retention; Human Resources Management; and Monitoring, Evaluation, and Information Systems. Each item is scored from 1 to 10 and scores are averaged with equal weights for each dimension and overall. The questionnaire is applied to knowledgeable informants from public, nongovernmental organization, and private sectors in each country. A pilot test among 49 respondents in Kenya and Nigeria provided useful information to improve, combine, and streamline questions. CapacityPlus applied the revised 50-item questionnaire in 2015 in Burkina Faso, Dominican Republic, Ghana, and Mali, among 92 respondents. Additionally, the index was applied subnationally in the Dominican Republic (16 respondents) and in a consensus-building meeting in Mali (43 respondents) after the national application. The results revealed a range of scores between 3.7 and 6.2 across dimensions, for overall scores between 4.8 and 5.5. Dimensions with lower scores included Recruitment, Distribution, and Retention, while Leadership and Advocacy had higher scores. The tool proved to be well understood and provided key qualitative information on the health workforce to assist

Mobility and health sector development in China and India.

Science.gov (United States)

Holdaway, Jennifer; Levitt, Peggy; Fang, Jing; Rajaram, Narasimhan

2015-04-01

China and India are both attempting to create comprehensive healthcare systems in the context of rapid but uneven economic growth and rapidly changing burdens of disease. While in each country the referencing of international policies and work experience abroad have been part of this process, research has yet to examine the kind of knowledge that is exchanged or the various actors involved in knowledge circulation. Based on a study of two sub-national contexts, this article focuses on the role Chinese and Indian health professionals who have studied and worked overseas play in introducing ideas and practices about healthcare provision and health education. We found that experience abroad influenced individuals, institutions, and each society differently and with some contradictory effects. International experience clearly contributed to personal growth and led individuals to support the adoption of new institutional practices, such as more egalitarian relations between doctors and patients and between students and teachers. However, the content of what individuals learned overseas and the mechanisms through which this knowledge was introduced back into homeland settings often reinforced rather than ameliorated institutional hierarchies and social inequalities. While the scope of this research was limited, we suggest that more explicit analysis of the role professional migrants play in transferring ideas and practices within the health sector would be valuable for policymakers and funders seeking to support a more productive interaction between local and global knowledge. Copyright © 2015 Elsevier Ltd. All rights reserved.

FFTF Authorization Agreement

International Nuclear Information System (INIS)

DAUTEL, W.A.

2000-01-01

The purpose of the Authorization Agreement is to serve as a mechanism whereby the U.S. Department of Energy, Richland Operations Office (RL) and Fluor Hanford (FH) jointly clarify and agree to key conditions for conducting work safely and efficiently in the Fast Flux Test Facility (FFTF). Work must be accomplished in a manner that achieves high levels of quality while protecting the environment and the safety and health of workers and the public, and complying with applicable contractual and regulatory requirements. It is the intent of this Agreement to address those items of significant importance in establishing and supporting the FFTF Authorization Envelope, but this Agreement in no way alters the terms and conditions of the Project Hanford Management Contract (PHMC), Contract Number DE-AC06-96RL13200

MACROECONOMIC IMPACT OF DECENTRALIZATION

Directory of Open Access Journals (Sweden)

Emilia Cornelia STOICA

2014-05-01

Full Text Available The concept of decentralization has a variety of expressions, but the meaning generally accepted refers to the transfer of authority and responsibility of the public functions from central government to sub-national public entities or even to the private sector. Decentralization process is complex, affecting many aspects of social and economic life and public management, and its design and implementation cover several stages, depending on the cyclical and structural developments of the country. From an economic perspective, decentralization is seen as a means of primary importance in terms of improving the effectiveness and efficiency of public services and macroeconomic stability due to the redistribution of public finances while in a much closer logic of the government policy objectives. But the decentralization process behaves as well some risks, because it involves the implementation of appropriate mechanisms for the establishment of income and expenditure programming at the subnational level, which, if is not correlated with macroeconomic policy imperatives can lead to major imbalances, both financially as in termes of economic and social life. Equally, ensuring the balance of the budget at the local level is imperative to fulfill, this goal imposing a legal framework and specific procedures to size transfers of public funds, targeted or untargeted. Also, public and local authorities have to adopt appropriate laws and regulations such that sub-national public entities can access loans - such as bank loans or debentures from domestic or external market - in terms of a strict monitoring national financial stability. In all aspects of decentralization - political, administrative, financial -, public authorities should develop and implement the most effective mechanisms to coordinate macroeconomic objectives and both sectoral and local interests and establish clear responsibilities - exclusive or shared - for all parties involved in the

School and Nation: Identity Politics and Educational Media in an Age of Diversity

Science.gov (United States)

Carrier, Peter, Ed.

2013-01-01

At a time when the power of schools and both state and federal education authorities to guide young people's sense of belonging is being challenged by multilingualism, by the claims of supra- and subnational regions and minorities, by memories of national catastrophes and crimes, and by out-of-school educational media, this collection of essays…

OCCURRENCE OF LISTERIA MONOCYTOGENES IN READY TO EAT FOOD SAMPLES COLLECTED BY LOMBARDY REGION HEALTH AUTHORITIES IN 2009-2010

Directory of Open Access Journals (Sweden)

E. Oliverio

2012-08-01

Full Text Available The study provides data on the prevalence of Listeria monocytogenes in ready-to-eat food samples collected by Lombardy region health authorities and analyzed by Department of Food Microbiology, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna. From the total of 503 food samples analyzed, the pathogen was detected in 85 (16,9%. In particular it was highlighted in 8/152 (5,3% meat products, in 5/245 (2% dairy products and in 42/106 (39,6% fishery products. Given the considerable public health implications, the study confirms that a well-planned program of listeriosis surveillance should be enforced to suitably estimate the burden of disease and to prevent foodborne outbreaks.

Annual report of the Public Health Authority of the Slovak Republic in 2010; Vyrocna sprava Uradu verejneho zdravotnictva Slovenskej republiky za rok 2010

Energy Technology Data Exchange (ETDEWEB)

NONE

2011-07-01

A brief account of activities carried out by the Public Health Authority of the Slovak Republic (UVZ SR) in 2010 is presented. These activities are reported under the headings: (1) General part; (2) Department of legislation and law; (3) Department of control, surveillance and complaints; (4) Department of environmental health; (5) Department of preventive occupational medicine; (6) Department of food hygiene, food safety and cosmetic products; (7) Department of hygiene of children and youth; (8) Department of objectification factors welfare; (9) Department of medical microbiology; (10) Department of epidemiology; (11) Division of health protection against radiation; (12) Department of health promotion; (13) Department of alcohol and tobacco control.

Budgeting based on need: a model to determine sub-national allocation of resources for health services in Indonesia.

Science.gov (United States)

Ensor, Tim; Firdaus, Hafidz; Dunlop, David; Manu, Alex; Mukti, Ali Ghufron; Ayu Puspandari, Diah; von Roenne, Franz; Indradjaya, Stephanus; Suseno, Untung; Vaughan, Patrick

2012-08-29

Allocating national resources to regions based on need is a key policy issue in most health systems. Many systems utilise proxy measures of need as the basis for allocation formulae. Increasingly these are underpinned by complex statistical methods to separate need from supplier induced utilisation. Assessment of need is then used to allocate existing global budgets to geographic areas. Many low and middle income countries are beginning to use formula methods for funding however these attempts are often hampered by a lack of information on utilisation, relative needs and whether the budgets allocated bear any relationship to cost. An alternative is to develop bottom-up estimates of the cost of providing for local need. This method is viable where public funding is focused on a relatively small number of targeted services. We describe a bottom-up approach to developing a formula for the allocation of resources. The method is illustrated in the context of the state minimum service package mandated to be provided by the Indonesian public health system. A standardised costing methodology was developed that is sensitive to the main expected drivers of local cost variation including demographic structure, epidemiology and location. Essential package costing is often undertaken at a country level. It is less usual to utilise the methods across different parts of a country in a way that takes account of variation in population needs and location. Costing was based on best clinical practice in Indonesia and province specific data on distribution and costs of facilities. The resulting model was used to estimate essential package costs in a representative district in each province of the country. Substantial differences in the costs of providing basic services ranging from USD 15 in urban Yogyakarta to USD 48 in sparsely populated North Maluku. These costs are driven largely by the structure of the population, particularly numbers of births, infants and children and also key

Budgeting based on need: a model to determine sub-national allocation of resources for health services in Indonesia

Directory of Open Access Journals (Sweden)

Ensor Tim

2012-08-01

Full Text Available Abstract Background Allocating national resources to regions based on need is a key policy issue in most health systems. Many systems utilise proxy measures of need as the basis for allocation formulae. Increasingly these are underpinned by complex statistical methods to separate need from supplier induced utilisation. Assessment of need is then used to allocate existing global budgets to geographic areas. Many low and middle income countries are beginning to use formula methods for funding however these attempts are often hampered by a lack of information on utilisation, relative needs and whether the budgets allocated bear any relationship to cost. An alternative is to develop bottom-up estimates of the cost of providing for local need. This method is viable where public funding is focused on a relatively small number of targeted services. We describe a bottom-up approach to developing a formula for the allocation of resources. The method is illustrated in the context of the state minimum service package mandated to be provided by the Indonesian public health system. Methods A standardised costing methodology was developed that is sensitive to the main expected drivers of local cost variation including demographic structure, epidemiology and location. Essential package costing is often undertaken at a country level. It is less usual to utilise the methods across different parts of a country in a way that takes account of variation in population needs and location. Costing was based on best clinical practice in Indonesia and province specific data on distribution and costs of facilities. The resulting model was used to estimate essential package costs in a representative district in each province of the country. Findings Substantial differences in the costs of providing basic services ranging from USD 15 in urban Yogyakarta to USD 48 in sparsely populated North Maluku. These costs are driven largely by the structure of the population

Local smoke-free policy development in Santa Fe, Argentina.

Science.gov (United States)

Sebrié, Ernesto M; Glantz, Stanton A

2010-04-01

To describe the process of approval and implementation of a comprehensive smoke-free law in the province of Santa Fe, Argentina, between 2005 and 2009. Review of the Santa Fe smoke-free legislation, articles published in local newspapers and documentation on two lawsuits filed against the law, and interviews with key individuals in Santa Fe. Efforts to implement smoke-free policies in Santa Fe began during the 1990s without success, and resumed in 2005 when the provincial Legislature approved the first 100% smoke-free subnational law in Argentina. There was no strong opposition during the discussions within the legislature. As in other parts of the world, pro-tobacco industry interests attempted to block the implementation of the law using well known strategies. These efforts included a controversy media campaign set up, the creation of a hospitality industry association and a virtual smokers' rights group, the introduction of a counterproposal seeking modification of the law, the challenge of the law in the Supreme Court, and the proposal of a weak national bill that would 'conflict' with the subnational law. Tobacco control advocates sought media attention as a strategy to protect the law. Santa Fe is the first subnational jurisdiction in Latin America to have enacted a comprehensive smoke-free policy following the recommendations of the World Health Organization (WHO) Framework Convention on Tobacco Control. After 3 years of implementation, pro-tobacco industry forces failed to undermine the law. Other subnational jurisdictions in Argentina, as well as in Mexico and Brazil are following the Santa Fe example.

A Health Equity Problem for Low Income Children: Diet Flexibility Requires Physician Authorization.

Science.gov (United States)

Stookey, Jodi D

2015-09-01

USDA programs, such as the Child and Adult Care Food Program (CACFP), School Breakfast Program (SBP), and/or National School Lunch Program (NSLP), enable child care centers and schools to provide free and reduced price meals, daily, to millions of low income children. Despite intention to equalize opportunity for every child to have a healthy diet, USDA program rules may be contributing to child obesity disparities and health inequity. USDA program rules require child care centers and schools to provide meals that include a specified number of servings of particular types of foods and beverages. The rules are designed for the average, healthy weight child to maintain weight and growth. They are not designed for the underweight child to gain weight, obese child to normalize weight, or pre-diabetic child to avoid incident diabetes. The rules allow for only one meal pattern and volume, as opposed to a flexible spectrum of meal patterns and portion sizes. Parents of children who participate in the CACFP, SBP, and/or NSLP do not have control over the amount or composition of the subsidized meals. Parents of overweight, obese, or diabetic children who participate in the subsidized meal programs can request dietary change, special meals or accommodations to address their child's health status, but child care providers and schools are not required to comply with the request unless a licensed physician signs a "Medical statement to request special meals and/or accommodations". Although physicians are the only group authorized to change the foods, beverages, and portion sizes served daily to low income children, they are not doing so. Over the past three years, despite an overweight and obesity prevalence of 30% in San Francisco child care centers serving low income children, zero medical statements were filed to request special meals or accommodations to alter daily meals in order to prevent obesity, treat obesity, or prevent postprandial hyperglycemia. Low income children

[Detection of a Disease Cluster by the Health Authorities of Stendal District due to Campylobacter jejuni in a Nursery After the Consumption of Raw Milk].

Science.gov (United States)

Hermann, N; Schubert, I

2015-07-01

A notification from a laboratory concerning the detection of Campylobacter jejuni in a 6-year-old boy initiated the investigation carried out by the health authorities from Stendal district, in order to explain the morbidity rate caused by the germ. The day after the boy's pediatrician informed about a visit to a farm, which was confirmed by the head of the nursery. She told the health authorities about the consumption of raw milk during their visit at the farm.The following days more children fell sick. Within 10 days the total number of diseased children was 21. The health authorities asked for stool samples of the diseased children, nursery nurses and the head of the farm since raw milk presents a potential cause of infection. The health authorities together with the Saxony-Anhalt State Office for Consumer Protection conducted a retrospective cohort study. The aim was to explain the association between the exposure from raw milk consumption and the occurrence of the disease from C. jejuni. Based on a questionnaire data about the food and milk intake at the nursery and at home and about the trip to the farm were collected. 91% of the children's cohort and 86% of the adults' cohort were captured.The exposed group at risk showed a higher risk of falling ill than the group, which was not exposed. The risk factor raw milk explained the difference. Furthermore, the analysis of milk samples taken by the district veterinary office from 2 cows and from the farm's tank was able to detect the germs. The correlation of the illness, the consumption of raw milk, the detection of C. jejuni in the samples taken from the children and the samples taken from the cows was evident. Based on the case the health authorities recommended that heads of nurseries as well as heads of dairy farming in the district of Stendal needed to be advised on raw milk. Nurseries are still allowed to take trips to farms. However, raw animal derivates including milk must not be consumed. © Georg Thieme

How federal health-care policies interface with urban and rural areas: a comparison of three systems.

Science.gov (United States)

Baracskay, Daniel

2012-01-01

Global public health policies span national borders and affect multitudes of people. The spread of infectious disease has neither political nor economic boundaries, and when elevated to a status of pandemic proportions, immediate action is required. In federal systems of government, the national level leads the policy formation and implementation process, but also collaborates with supranational organisations as part of the global health network. Likewise, the national level of government cooperates with sub-national governments located in both urban and rural areas. Rural areas, particularly in less developed countries, tend to have higher poverty rates and lack the benefits of proper medical facilities, communication modes and technology to prevent the spread of disease. From the perspective of epidemiological surveillance and intervention, this article will examine federal health policies in three federal systems: Australia, Malaysia and the USA. Using the theoretical foundations of collaborative federalism, this article specifically examines how collaborative arrangements and interactions among governmental and non-governmental actors help to address the inherent discrepancies that exist between policy implementation and reactions to outbreaks in urban and rural areas. This is considered in the context of the recent H1N1 influenza pandemic, which spread significantly across the globe in 2009 and is now in what has been termed the 'post-pandemic era'.

45 CFR 99.21 - Authority of presiding officer.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Authority of presiding officer. 99.21 Section 99.21 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROCEDURE FOR HEARINGS FOR THE CHILD CARE AND DEVELOPMENT FUND Hearing Procedures § 99.21 Authority of presiding officer...

77 FR 48525 - Statement of Organization, Functions and Delegations of Authority

Science.gov (United States)

2012-08-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Statement of... Clinician Recruitment and Service (BCRS), who reports directly to the Administrator, Health Resources and..., Functions and Delegations of Authority of the Department of Health and Human Services (HHS), Health...

Performance Assessment of the Juaboso District Office of the National Health Insurance Authority.

Science.gov (United States)

Effah, Paul; Appiah, Kingsley Opoku; Abor, Patience Aseweh

2016-09-01

To assess the performance of the National Health Insurance Authority (NHIA) in Ghana. Using a thorough case study of the Juaboso District Office of the NHIA, this study assessed the community coverage rate, the annual expenditure and income, and the trend of claims payment for the period 2009 to 2012 as well as factors influencing the level of patronage of the National Health Insurance Scheme. A self-administered structured questionnaire was used to gather data from the management of the scheme. Secondary data were also gathered from the scheme's audited financial statements. Informal discussions were held with the premium collectors and clients to throw more light on revenue generation challenges. The study found an increasing trend in the coverage rate on a yearly basis. Over the study period, the rate moved from 30.6 to 60.1, representing an increase of 96.7%. This shows that in terms of coverage rate, the Juaboso District Office of the NHIA is performing very well. The study also found that revenue has increased but the percentage rate of increase has decreased, compared with the coverage percentage rate. Expenditure has been on the rise, increasing by as much as 20.7% in 2011. Again, the study revealed a consistent year-on-year increase in the claims payment, consistent with the national trend. Constant clinical auditing of claims payments is required to ensure accountability. This would lead to transparency with regard to performance assessment of the claims. The findings have important implications for the effective management of the NHIA. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

76 FR 13618 - Delegation of Authority; Centers for Medicare & Medicaid Services

Science.gov (United States)

2011-03-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Delegation of Authority; Centers... Organization, Functions, and Delegations of Authority, last published at 55 FR 9363 (March 13, 1990). Part A... of Inspector General. This delegation of authority supersedes the authorities delegated under Part A...

75 FR 12559 - Statement of Organization, Functions and Delegations of Authority

Science.gov (United States)

2010-03-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Statement of..., Functions and Delegations of Authority of the Department of Health and Human Services (HHS), Health... the Health Care Quality Improvement Act of 1986 and Section 5 of the Medicare and Medicaid Patient and...

Importance of hemodialysis-related outcomes: comparison of ratings by a self-help group, clinicians, and health technology assessment authors with those by a large reference group of patients

Directory of Open Access Journals (Sweden)

Janssen IM

2016-12-01

Full Text Available Inger M Janssen,1 Fueloep Scheibler,2 Ansgar Gerhardus3,4 1Department of Epidemiology and International Public Health, University of Bielefeld, Bielefeld, 2Department of Non-Drug Interventions, Institute for Quality and Efficiency in Health Care, Cologne, 3Department for Health Services Research, Institute for Public Health and Nursing Research, University of Bremen, 4Health Sciences Bremen, University of Bremen, Bremen, Germany Background: The selection of important outcomes is a crucial decision for clinical research and health technology assessment (HTA, and there is ongoing debate about which stakeholders should be involved. Hemodialysis is a complex treatment for chronic kidney disease (CKD and affects many outcomes. Apart from obvious outcomes, such as mortality, morbidity and health-related quality of life (HRQoL, others such as, concerning daily living or health care provision, may also be important. The aim of our study was to analyze to what extent the preferences for patient-relevant outcomes differed between various stakeholders. We compared preferences of stakeholders normally or occasionally involved in outcome prioritization (patients from a self-help group, clinicians and HTA authors with those of a large reference group of patients. Participants and methods: The reference group consisted of 4,518 CKD patients investigated previously. We additionally recruited CKD patients via a regional self-help group, nephrologists via an online search and HTA authors via an expert database or personal contacts. All groups assessed the relative importance of the 23 outcomes by means of a discrete visual analog scale. We used descriptive statistics to rank outcomes and compare the results between groups. Results: We received completed questionnaires from 49 self-help group patients, 19 nephrologists and 18 HTA authors. Only the following 3 outcomes were ranked within the top 7 outcomes by all 4 groups: safety, HRQoL and emotional state. The

A proposed quantitative credit-rating methodology for South African provincial departments

OpenAIRE

Erika Fourie; Tanja Verster; Gary Wayne van Vuuren

2016-01-01

The development of subnational credit-rating methodologies affords benefits for subnationals, the sovereign and its citizens. Trusted credit ratings facilitate access to financial markets and above-average ratings allow for the negotiation of better collateral and guarantee agreements, as well as for funding of, for example, infrastructure projects at superior (lower) interest rates. This paper develops the quantitative section of a credit-rating methodology for South African subnationals. Th...

77 FR 61761 - Delegation of Authority

Science.gov (United States)

2012-10-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Community Living Delegation of... the Administrator, or his or her subordinates, involving the exercise of these authorities prior to the effective date of this delegation. This delegation is effective upon date of signature. Dated...

Developing and sustaining leadership in public health nursing: findings from one British Columbia health authority.

Science.gov (United States)

Mills, Leslie; Wong, Sabrina T; Bhagat, Radhika; Quail, Donna; Triolet, Kathy; Weber, Tannis

2012-12-01

To develop clinical leadership among front-line public health nurses (PHNs). This paper describes a quality improvement process to develop clinical leadership among front-line PHNs. Three activities were undertaken by a working group consisting mainly of front-line staff: engaging PHNs in an online change-readiness questionnaire, administering a survey to clients who had ever used public health services delivered by one Vancouver Community Infant, Child and Youth (ICY) program team and conducting three group interviews with public health providers. The group interviews asked about PHN practice. They were analyzed using thematic content analysis. This quality improvement project suggests that PHNs (n=70) strongly believed in opportunities for system improvement. Client surveys (n=429) and community partner surveys (n=79) revealed the importance of the PHN role. Group interview data yielded three themes: PHNs were the "hub" of community care; PHNs lacked a common language to describe their work; PHNs envisioned their future practice encompassing their full scope of competencies. PHNs developed the "ICY Public Health Nursing Model," which articulates 14 public health interventions and identifies the scope of their work. Developing and sustaining clinical leadership in front-line PHNs was accomplished through these various quality assurance activities. Copyright © 2013 Longwoods Publishing.

Author's capabilities in author indexing

International Nuclear Information System (INIS)

Ooi, Shoichi

1988-01-01

The purpose of this paper is to provide a author capability of current author indexing practices in journal literature indexing practices in 'Journal of Nuclear Science and Technology of Japan'. This Journal employed keywords freely assigned by author and not taken from INIS Thesaurus or other vocabulary list. Author examined 413 literatures, comparing keywords assigned by the literatures' authors with descriptor's (ATOMINDEX) assigned by an experienced professional indexer. The results of the comparisons showed that the average set of terms assigned by author included about 70% of all the terms assigned to the same literature by the professional indexer. Authors eventually would contribute, for the most effective point to create reference to information is at the time of its generation. Consequently, it may be possible to transfer them easily to descriptors in every secondary information system. (author)

Evaluation of a pilot intervention to redesign the decentralised vaccine supply chain system in Nigeria.

Science.gov (United States)

Molemodile, Shola; Wotogbe, Maruchi; Abimbola, Seye

2017-05-01

Responsibility for immunisation in Nigeria is decentralised to sub-national governments. So far, they have failed to achieve optimal coverage for their populations. We evaluated a pilot intervention implemented between 2013 and 2014 to redesign a vaccine supply chain management system in Kano, Nigeria. The intervention included financing immunisation services from a designated pool of government and donor funds, a visibility tool to track vaccine stock, and a private vendor engaged to deliver vaccines directly to health facilities. The number of local government areas within the state with adequate vaccine stock increased from 21% to 98% after 10 months. To understand how the intervention achieved this outcome, we analysed immunisation coverage for the period and interviewed 18 respondents across different levels of government. We found that the intervention worked by improving ownership and accountability for immunisation by sub-national governments and their capacity for generating resources and management (of data and the supply chain). While the intervention focused on improving immunisation coverage, we identified gaps in the demand for services. Efforts to improve immunisation coverage and vaccine supply systems should streamline decentralised structures, empower sub-national governments with financial and technical capacity, and promote strategies to improve the demand and use of services.

The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey

Directory of Open Access Journals (Sweden)

Heidi J. Larson, PhD

2016-10-01

Conclusions: Regular monitoring of vaccine attitudes – coupled with monitoring of local immunization rates – at the national and sub-national levels can identify populations with declining confidence and acceptance. These populations should be prioritized to further investigate the drivers of negative sentiment and to inform appropriate interventions to prevent adverse public health outcomes.

77 FR 71004 - Patents and Inventions; Delegation of Authority

Science.gov (United States)

2012-11-28

... any actions taken that involve the exercise of the authorities delegated herein prior to the effective... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Patents and... separate delegation. The exercise of this authority must be in accordance with applicable laws, regulations...

Prior Authorization of PMDs Demonstration - Status Update

Data.gov (United States)

U.S. Department of Health & Human Services — CMS implemented a Prior Authorization process for scooters and power wheelchairs for people with Fee-For-Service Medicare who reside in seven states with high...

Socioeconomic inequalities and mortality trends in BRICS, 1990-2010.

Science.gov (United States)

Mújica, Oscar J; Vázquez, Enrique; Duarte, Elisabeth C; Cortez-Escalante, Juan J; Molina, Joaquin; Barbosa da Silva Junior, Jarbas

2014-06-01

To explore the presence and magnitude of--and change in--socioeconomic and health inequalities between and within Brazil, the Russian Federation, India, China and South Africa--the countries known as BRICS--between 1990 and 2010. Comparable data on socioeconomic and health indicators, at both country and primary subnational levels, were obtained from publicly available sources. Health inequalities between and within countries were identified and summarized by using standard gap and gradient metrics. Four of the BRICS countries showed increases in both income level and income inequality between 1990 and 2010. The exception was Brazil, where income inequality decreased over the same period. Between-country inequalities in level of education and access to sanitation remained mostly unchanged but the largest between-country difference in mean life expectancy increased, from 9 years in 1990 to 20 years in 2010. Throughout the study period, there was disproportionality in the burden of disease between BRICS. However, the national infant mortality rate fell substantially over the study period in all five countries. In Brazil and China, the magnitude of subnational income-related inequalities in infant mortality, both absolute and relative, also decreased substantially. Despite the economic prosperity and general improvements in health seen since 1990, profound inequalities in health persist both within and between BRICS. However, the substantial reductions observed--within Brazil and China--in the inequalities in income-related levels of infant mortality are encouraging.

76 FR 65519 - Statement of Organization, Functions, and Delegations of Authority

Science.gov (United States)

2011-10-21

... Innovation. Delegation of Authority All delegations and re-delegations of authority to officers and employees... Statement of Organization, Functions, and Delegations of Authority Part M of the Substance Abuse and Mental Health Services Administration (SAMHSA) Statement of Organization, Functions, and Delegations of...

78 FR 6111 - Statement of Organization, Functions, and Delegations of Authority

Science.gov (United States)

2013-01-29

... delegations and redelegations of authority made to officials and employees of affected organizational...] Statement of Organization, Functions, and Delegations of Authority AGENCY: Food and Drug Administration, HHS... Organization, Functions, and Delegations of Authority for the Department of Health and Human Services (35 FR...

75 FR 42762 - Statement of Organization, Functions, and Delegations of Authority

Science.gov (United States)

2010-07-22

... Planning, Research and Evaluation, which involved the exercise of this authority prior to the effective... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Statement of... authority pertaining to authorities delegated herein. (d) Effective Date. This delegation is effective on...

How Are New Vaccines Prioritized in Low-Income Countries? A Case Study of Human Papilloma Virus Vaccine and Pneumococcal Conjugate Vaccine in Uganda.

Science.gov (United States)

Wallace, Lauren; Kapirir, Lydia

2017-04-08

To date, research on priority-setting for new vaccines has not adequately explored the influence of the global, national and sub-national levels of decision-making or contextual issues such as political pressure and stakeholder influence and power. Using Kapiriri and Martin's conceptual framework, this paper evaluates priority setting for new vaccines in Uganda at national and sub-national levels, and considers how global priorities can influence country priorities. This study focuses on 2 specific vaccines, the human papilloma virus (HPV) vaccine and the pneumococcal conjugate vaccine (PCV). This was a qualitative study that involved reviewing relevant Ugandan policy documents and media reports, as well as 54 key informant interviews at the global level and national and sub-national levels in Uganda. Kapiriri and Martin's conceptual framework was used to evaluate the prioritization process. Priority setting for PCV and HPV was conducted by the Ministry of Health (MoH), which is considered to be a legitimate institution. While respondents described the priority setting process for PCV process as transparent, participatory, and guided by explicit relevant criteria and evidence, the prioritization of HPV was thought to have been less transparent and less participatory. Respondents reported that neither process was based on an explicit priority setting framework nor did it involve adequate representation from the districts (program implementers) or publicity. The priority setting process for both PCV and HPV was negatively affected by the larger political and economic context, which contributed to weak institutional capacity as well as power imbalances between development assistance partners and the MoH. Priority setting in Uganda would be improved by strengthening institutional capacity and leadership and ensuring a transparent and participatory processes in which key stakeholders such as program implementers (the districts) and beneficiaries (the public) are

76 FR 6795 - Statement of Organization, Functions, and Delegations of Authority; Office of the National...

Science.gov (United States)

2011-02-08

... Technology, all delegations and redelegations of authority made to officials and employees of affected..., Functions, and Delegations of Authority; Office of the National Coordinator for Health Information... Organization, Functions, and Delegations of Authority for the Department of Health and Human Services, Chapter...

Veneto Region, Italy. Health system review.

Science.gov (United States)

Toniolo, Franco; Mantoan, Domenico; Maresso, Anna

2012-01-01

The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. This HiT is one of the first to be written on a subnational level of government and focuses on the Veneto Region of northern Italy. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Veneto Region is one of Italy's richest regions and the health of its resident population compares favourably with other regions in Italy. Life expectancy for both men and women, now at 79.1 and 85.2 years, respectively, is slightly higher than the national average, while mortality rates are comparable to national ones. The major causes of death are tumours and cardiovascular diseases. Under Italy's National Health Service, the organization and provision of health care is a regional responsibility and regions must provide a nationally defined (with regional input) basic health benefit package to all of their citizens; extra services may be provided if budgets allow. Health care is mainly financed by earmarked central and regional taxes, with regions receiving their allocated share of resources from the National Health Fund. Historically, health budget deficits have been a major problem in most Italian regions, but since the early 2000s the introduction of efficiency measures and tighter procedures on financial management have contributed to a significant decrease in the Veneto Regions health budget deficit.The health system is governed by the Veneto Region government (Giunta) via the Departments of Health and Social Services, which receive technical support from a single General Management Secretariat. Health care is

Social cost of carbon pricing of power sector CO2: accounting for leakage and other social implications from subnational policies

Science.gov (United States)

Bistline, John E.; Rose, Steven K.

2018-01-01

In environments where climate policy has partial coverage or unequal participation, carbon dioxide (CO2) emissions or economic activity may shift to locations and sectors where emissions are unregulated. This is referred to as leakage. Leakage can offset or augment emissions reductions associated with a policy, which has important environmental and economic implications. Although leakage has been studied at national levels, analysis of leakage for subnational policies is limited. This is despite greater market integration and many existing state and regional environmental regulations in the US. This study explores leakage potential, net emissions changes, and other social implications in the US energy system with regionally differentiated pricing of power sector CO2 emissions. We undertake an economic analysis using EPRI’s US-REGEN model, where power sector CO2 emissions are priced in individual US regions with a range of social cost of carbon (SCC) values. SCC estimates are being considered by policy-makers for valuing potential societal damages from CO2 emissions. In this study, we evaluate the emissions implications within the SCC pricing region, within the power sector outside the SCC region, and outside the power sector (i.e. in the rest of the energy system). Results indicate that CO2 leakage is possible within and outside the electric sector, ranging from negative 70% to over 80% in our scenarios, with primarily positive leakage outcomes. Typically ignored in policy analysis, leakage would affect CO2 reduction benefits. We also observe other potential societal effects within and across regions, such as higher electricity prices, changes in power sector investments, and overall consumption losses. Efforts to reduce leakage, such as constraining power imports into the SCC pricing region likely reduce leakage, but could also result in lower net emissions reductions, as well as larger price increases. Thus, it is important to look beyond leakage and consider a

75 FR 49942 - Statement of Organization, Functions, and Delegations of Authority

Science.gov (United States)

2010-08-16

... Authority All delegations and re-delegations of authority to officers and employees of SAMHSA which were in... Statement of Organization, Functions, and Delegations of Authority Part M of the Substance Abuse and Mental Health Services Administration (SAMHSA) Statement of Organization, Functions, and Delegations of...

Efficiency of private and public primary health facilities accredited by the National Health Insurance Authority in Ghana

NARCIS (Netherlands)

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Akazili, James; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F.

2015-01-01

Background: Despite improvements in a number of health outcome indicators partly due to the National Health Insurance Scheme (NHIS), Ghana is unlikely to attain all its health-related millennium development goals before the end of 2015. Inefficient use of available limited resources has been cited

Measures of Maternal Socioeconomic Status in Yemen and Association with Maternal and Child Health Outcomes.

Science.gov (United States)

Alosaimi, Abdullah N; Luoto, Riitta; Al Serouri, Abdul Wahed; Nwaru, Bright I; Mouniri, Halima

2016-02-01

Reliable measurement of socioeconomic status (SES) in health research requires extensive resources and can be challenging in low-income countries. We aimed to develop a set of maternal SES indices and investigate their associations with maternal and child health outcomes in rural Yemen. We applied factor analysis based on principal component analysis extraction to construct the SES indices by capturing household attributes for 7295 women of reproductive age. Data were collected from a sub-national household survey conducted in six rural districts in four Yemeni provinces in 2008-2009. Logistic regression models were fitted to estimate the associations between the SES indices and maternal mortality, spontaneous abortion, stillbirth, neonatal and infant mortality. Three SES indices (wealth, educational and housing quality) were extracted, which together explained 54 % of the total variation in SES. Factor scores were derived and categorized into tertiles. After adjusting for potential confounding factors, higher tertiles of all the indices were inversely associated with spontaneous abortion. Higher tertiles of wealth and educational indices were inversely associated with stillbirth, neonatal and infant mortality. None of the SES indices was strongly associated with maternal mortality. By subjecting a number of household attributes to factor analysis, we derived three SES indices (wealth, educational, and housing quality) that are useful for maternal and child health research in rural Yemen. The indices were worthwhile in predicting a number of maternal and child health outcomes. In low-income settings, failure to account for the multidimensionality of SES may underestimate the influence of SES on maternal and child health.

Traditional health practitioners and the authority to issue medical ...

African Journals Online (AJOL)

to face in selecting the credible practitioners from the bogus ones for registration ... for registration. It is clear that the definition of a traditional health ... medical certificate and its validity can bring about came sharply to the fore in Kievits Kroon ...

Protecting resources for primary health care under fiscal federalism: options for resource allocation.

Science.gov (United States)

Okorafor, Okore A; Thomas, Stephen

2007-11-01

The introduction of fiscal federalism or decentralization of functions to lower levels of government is a reform not done primarily with health sector concerns. A major concern for the health sector is that devolution of expenditure responsibilities to sub-national levels of government can adversely affect the equitable distribution of financial resources across local jurisdictions. Since the adoption of fiscal federalism in South Africa, progress towards achieving a more equitable distribution of public sector health resources (financial) has slowed down considerably. This study attempts to identify appropriate resource allocation mechanisms under the current South African fiscal federal system that could be employed to promote equity in primary health care (PHC) allocations across provinces and districts. The study uses data from interviews with government officials involved in the budgeting and resource allocation process for PHC, literature on fiscal federalism and literature on international experience to inform analysis and recommendations. The results from the study identify historical incremental budgeting, weak managerial capacity at lower levels of government, poor accounting of PHC expenditure, and lack of protection for PHC funds as constraints to the realization of a more equitable distribution of PHC allocations. Based on interview data, no one resource allocation mechanism received unanimous support from stakeholders. However, the study highlights the particularly high level of autonomy enjoyed by provincial governments with regards to decision making for allocations to health and PHC services as the major constraint to achieving a more equitable distribution of PHC resources. The national government needs to have more involvement in decision making for resource allocation to PHC services if significant progress towards equity is to be achieved.

What's buzzing on your feed? Health authorities' use of Facebook to combat Zika in Singapore.

Science.gov (United States)

Vijaykumar, Santosh; Meurzec, Rianne Wally; Jayasundar, Karthikayen; Pagliari, Claudia; Fernandopulle, Yohan

2017-11-01

In 2016, Singapore grappled with one of the largest Zika outbreaks in Southeast Asia. This study examines the use of Facebook for Zika-related outreach by the Ministry of Health (MOH) and the National Environmental Agency (NEA) from March 1, 2015, to September 1, 2016, and public response to this effort. Despite nearly equivalent outreach, MOH's Facebook posts received more likes (µ = 3.49) and shares (µ = 30.11), whereas NEA's posts received more comments (µ = 4.55), with NEA posting mostly on prevention (N = 30) and MOH on situational updates (N = 24). Thematic analyses identified prevention-related posts as garnering the most likes (N = 1277), while update-related posts were most shared (N = 1059) and commented upon (N = 220). Outreach ceased briefly for 2 months after Singapore's first imported case of Zika, but increased following the outbreak of locally transmitted cases in August 2016. Public engagement was significantly higher during Zika compared with prior haze and dengue outbreaks. The results indicate the value of Facebook as a tool for rapid outreach during infectious disease outbreaks, and as a "listening" platform for those managing the situation. We discuss implications for public health communication research and policy. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis.

Science.gov (United States)

Achoki, Tom; Hovels, Anke; Masiye, Felix; Lesego, Abaleng; Leufkens, Hubert; Kinfu, Yohannes

2017-01-05

Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the delivery of maternal and child health services in the country. The study focused on all 72 health districts of Zambia. We compiled a district-level database comprising health outcomes (measured by the probability of survival to 5 years of age), health outputs (measured by coverage of key health interventions) and a set of health system inputs, namely, financial resources and human resources for health, for the year 2010. We used data envelopment analysis to assess the performance of subnational units across Zambia with respect to technical and SE, controlling for environmental factors that are beyond the control of health system decision makers. Nationally, average technical efficiency with respect to improving child survival was 61.5% (95% CI 58.2% to 64.8%), which suggests that there is a huge inefficiency in resource use in the country and the potential to expand services without injecting additional resources into the system. Districts that were more urbanised and had a higher proportion of educated women were more technically efficient. Improved cooking methods and donor funding had no significant effect on efficiency. With the pressing need to accelerate progress in population health, decision makers must seek efficient ways to deliver services to achieve universal health coverage. Understanding the factors that drive performance and seeking ways to enhance efficiency offer a practical pathway through which low-income countries could improve population health without necessarily seeking additional resources. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

7 CFR 305.17 - Authorized treatments; exceptions.

Science.gov (United States)

2010-01-01

... 7 Agriculture 5 2010-01-01 2010-01-01 false Authorized treatments; exceptions. 305.17 Section 305.17 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH..., Libya, Malta, Macedonia, Morocco, Sardinia, Serbia and Montenegro, Slovenia, Spain, Syria, Tunisia, and...

Ethical Guideline to Authors,Editors,and Reviewers

Institute of Scientific and Technical Information of China (English)

Editorial office of CHM

2016-01-01

Drug products are specific goods with safety and effectiveness in medical health case.All of researchers(authors),reviewers,and editors must abide by medical ethical obligation,and also must deter to the ethical obligation for publication.These guidelines are offered as ethical

Communication with the public in the health-care system: a descriptive study of the use of social media in local health authorities and public hospitals in Italy.

Science.gov (United States)

Vanzetta, Marina; Vellone, Ercole; Dal Molin, Alberto; Rocco, Gennaro; De Marinis, Maria Grazia; Rosaria, Alvaro

2014-01-01

In 2010 the Italian Ministry of Health set out recommendations for the use of social technology and Web 2.0, inviting organisations within the Italian national health service (Servizio Sanitario Nazionale, SSN) to equip themselves with instruments. 1. to ascertain how many local health authorities (Aziende Sanitarie Locali, ASL) and public hospitals have a presence on the most widely used social media websites in Italy: Facebook, Twitter and YouTube; 2. to find out how well the Facebook, Twitter and YouTube pages of ASLs and public hospitals are known among the general population; 3. to find out how ASLs and public hospitals engage with the general public on social media sites. The websites of all ASLs and public hospitals across the country were visited to look for the icons of the social media sites under examination. The data considered were publicly available upon access. A total of 245 websites were analysed. 7.34% ASLs and hospitals had social media accounts. 8 organisations had an account on all three of the social media sites considered in the study. The results show a low presence of ASLs and hospitals on social media. Other studies are needed in this field.

Interventions for hiring, retaining and training district health systems managers in low- and middle-income countries.

Science.gov (United States)

Rockers, Peter C; Bärnighausen, Till

2013-04-30

District managers are playing an increasingly important role in determining the performance of health systems in low- and middle-income countries as a result of decentralization. To assess the effectiveness of interventions to hire, retain and train district health systems managers in low- and middle-income countries. We searched a wide range of international databases, including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. We also searched online resources of international agencies, including the World Bank, to find relevant grey literature. Searches were conducted in December 2011. District health systems managers are those persons who are responsible for overseeing the operations of the health system within a defined, subnational geographical area that is designated as a district. Hiring and retention interventions include those that aim to increase the attractiveness of district management positions, as well as those related to hiring and retention processes, such as private contracting. Training interventions include education programs to develop future managers and on-the-job training programs for current managers. To be included, studies needed to use one of the following study designs: randomized controlled trial, nonrandomized controlled trial, controlled before-and-after study, and interrupted time series analysis. We report measures of effect in the same way that the primary study authors have reported them. Due to the varied nature of interventions included in this review we could not pool data across studies. Two studies met our inclusion criteria. The findings of one study conducted in Cambodia provide low quality evidence that private contracts with international nongovernmental organizations (NGOs) for district health systems management ('contracting-in') may improve health care access and utilization. Contracting-in increased use of antenatal care by 28% and use of public facilities by 14%. However, contracting

Women in Authority: A Sociopsychological Analysis

Science.gov (United States)

Bayes, Marjorie; Newton, Peter M.

1978-01-01

A case study of a woman manager and her staff within a mental health center is analyzed in an attempt to interrelate organizational structure, leadership style, and staff group dynamics. The approach to the exercise of authority is sociopsychological. Available from: JAB S Order Dept., NTL Institute for Applied Behavioral Science, P.O. Box 9155,…

Tools and approaches to operationalize the commitment to equity, gender and human rights: towards leaving no one behind in the Sustainable Development Goals.

Science.gov (United States)

Zamora, Gerardo; Koller, Theadora Swift; Thomas, Rebekah; Manandhar, Mary; Lustigova, Eva; Diop, Adama; Magar, Veronica

2018-01-01

The objective of this article is to present specific resources developed by the World Health Organization on equity, gender and human rights in order to support Member States in operationalizing their commitment to leave no one behind in the health Sustainable Development Goals (SDGs), and other health-related goals and targets. The resources cover: (i) health inequality monitoring; (ii) barrier analysis using mixed methods; (iii) human rights monitoring; (iv) leaving no one behind in national and subnational health sector planning; and (v) equity, gender and human rights in national health programme reviews. Examples of the application of the tools in a range of country contexts are provided for each resource.

75 FR 70932 - Office of the Commissioner of Food and Drugs; Delegation of Authority

Science.gov (United States)

2010-11-19

... exercise of the authorities delegated herein prior to the effective date of this delegation. This... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Office of the Secretary... delegated to the Commissioner of Food and Drugs the authorities vested in the Secretary of Health and Human...

76 FR 3143 - Office of Child Care; Delegation of Authority

Science.gov (United States)

2011-01-19

... exercise of the authorities delegated herein prior to the effective date of this delegation. Dated: January... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Office of Child... Health and Human Services in the memorandum dated August 20, 1991, pertaining to the Head Start Program...

Sector-wide or disease-specific? Implications of trends in development assistance for health for the SDG era.

Science.gov (United States)

Buffardi, Anne L

2018-04-01

The record of the Millennium Development Goals broadly reflects the trade-offs of disease-specific financing: substantial progress in particular areas, facilitated by time-bound targets that are easy to measure and communicate, which shifted attention and resources away from other areas, masked inequalities and exacerbated fragmentation. In many ways, the Sustainable Development Goals reflect a profound shift towards a more holistic, system-wide approach. To inform responses to this shift, this article builds upon existing work on aggregate trends in donor financing, bringing together what have largely been disparate analyses of sector-wide and disease-specific financing approaches. Looking across the last 26 years, the article examines how international donors have allocated development assistance for health (DAH) between these two approaches and how attempts to bridge them have fared in practice. Since 1990, DAH has overwhelmingly favoured disease-specific earmarks over health sector support, with the latter peaking in 1998. Attempts to integrate system strengthening elements into disease-specific funding mechanisms have varied by disease, and more integrated funding platforms have failed to gain traction. Health sector support largely remains an unfulfilled promise: proportionately low amounts (albeit absolute increases) which have been inconsistently allocated, and the overall approach inconsistently applied in practice. Thus, the expansive orientation of the Sustainable Development Goals runs counter to trends over the last several decades. Financing proposals and efforts to adapt global health institutions must acknowledge and account for the persistent challenges in the financing and implementation of integrated, cross-sector policies. National and subnational experimentation may offer alternatives within and beyond the health sector.

Designing "Real-World" trials to meet the needs of health policy makers at marketing authorization.

Science.gov (United States)

Calvert, Melanie; Wood, John; Freemantle, Nick

2011-07-01

There is increasing interest in conducting "Real-World" trials that go beyond traditional assessment of efficacy and safety to examine market access and value for money questions before marketing authorization of a new pharmaceutical product or health technology. This commentary uses practical examples to demonstrate how high-quality evidence of the cost-effectiveness of an intervention may be gained earlier in the development process. Issues surrounding the design and analysis of "Real-World" trials to demonstrate relative cost-effectiveness early in the life of new technologies are discussed. The modification of traditional phase III trial designs, de novo trial designs, the combination of trial-based and epidemiological data, and the use of simulation model-based approaches to address reimbursement questions are described. Modest changes to a phase III trial protocol and case report form may be undertaken at the design stage to provide valid estimates of health care use and the benefits accrued; however, phase III designs often preclude "real-life" practice. Relatively small de novo trials may be used to address adherence to therapy or patient preference, although simply designed studies with active comparators enrolling large numbers of patients may provide evidence on long-term safety and rare adverse events. Practical examples demonstrate that it is possible to provide high-quality evidence of the cost-effectiveness of an intervention earlier in the development process. Payers and decision makers should preferentially adopt treatments with such evidence than treatments for which evidence is lacking or of lower quality. Copyright © 2011 Elsevier Inc. All rights reserved.

How decentralisation influences the retention of primary health care workers in rural Nigeria.

Science.gov (United States)

Abimbola, Seye; Olanipekun, Titilope; Igbokwe, Uchenna; Negin, Joel; Jan, Stephen; Martiniuk, Alexandra; Ihebuzor, Nnenna; Aina, Muyi

2015-01-01

In Nigeria, the shortage of health workers is worst at the primary health care (PHC) level, especially in rural communities. And the responsibility for PHC - usually the only form of formal health service available in rural communities - is shared among the three tiers of government (federal, state, and local governments). In addition, the responsibility for community engagement in PHC is delegated to community health committees. This study examines how the decentralisation of health system governance influences retention of health workers in rural communities in Nigeria from the perspective of health managers, health workers, and people living in rural communities. The study adopted a qualitative approach, and data were collected using semi-structured in-depth interviews and focus group discussions. The multi-stakeholder data were analysed for themes related to health system decentralisation. The results showed that decentralisation influences the retention of rural health workers in two ways: 1) The salary of PHC workers is often delayed and irregular as a result of delays in transfer of funds from the national to sub-national governments and because one tier of government can blame failure on another tier of government. Further, the primary responsibility for PHC is often left to the weakest tier of government (local governments). And the result is that rural PHC workers are attracted to working at levels of care where salaries are higher and more regular - in secondary care (run by state governments) and tertiary care (run by the federal government), which are also usually in urban areas. 2) Through community health committees, rural communities influence the retention of health workers by working to increase the uptake of PHC services. Community efforts to retain health workers also include providing social, financial, and accommodation support to health workers. To encourage health workers to stay, communities also take the initiative to co-finance and co

Prácticas iliberales y antidemocráticas a nivel subnacional: enfoques comparados

Directory of Open Access Journals (Sweden)

Jacqueline Behrend

2017-07-01

Full Text Available What is that we have learned after ten years of the territorial democratic disparity phenomena? This article seeks to contribute upon the sub-national democratization debates in two aspects: using a conceptual proposal to understand the territorial democratic variation and through a development of an analytic framework identifying three paths toward subnational democratization. This article introduces the non-liberal sub-national structural practices concept, and makes it different to the anti-democratic practices. It also provides examples upon the territorial democratic disparity to illustrate theory arguments.

Socioeconomic inequalities and mortality trends in BRICS, 1990–2010

Science.gov (United States)

Mújica, Oscar J; Vázquez, Enrique; Duarte, Elisabeth C; Cortez-Escalante, Juan J; Molina, Joaquin

2014-01-01

Abstract Objective To explore the presence and magnitude of – and change in – socioeconomic and health inequalities between and within Brazil, the Russian Federation, India, China and South Africa – the countries known as BRICS – between 1990 and 2010. Methods Comparable data on socioeconomic and health indicators, at both country and primary subnational levels, were obtained from publicly available sources. Health inequalities between and within countries were identified and summarized by using standard gap and gradient metrics. Findings Four of the BRICS countries showed increases in both income level and income inequality between 1990 and 2010. The exception was Brazil, where income inequality decreased over the same period. Between-country inequalities in level of education and access to sanitation remained mostly unchanged but the largest between-country difference in mean life expectancy increased, from 9 years in 1990 to 20 years in 2010. Throughout the study period, there was disproportionality in the burden of disease between BRICS. However, the national infant mortality rate fell substantially over the study period in all five countries. In Brazil and China, the magnitude of subnational income-related inequalities in infant mortality, both absolute and relative, also decreased substantially. Conclusion Despite the economic prosperity and general improvements in health seen since 1990, profound inequalities in health persist both within and between BRICS. However, the substantial reductions observed – within Brazil and China – in the inequalities in income-related levels of infant mortality are encouraging. PMID:24940014

Sugary beverage taxation in South Africa: Household expenditure, demand system elasticities, and policy implications.

Science.gov (United States)

Stacey, Nicholas; Tugendhaft, Aviva; Hofman, Karen

2017-12-01

South Africa faces a severe and growing obesity epidemic. Obesity and its co-morbidities raise public and private expenditures on healthcare. Sugary beverages are heavily consumed in South Africa and are linked to the onset of overweight and obesity. Excise taxation of sugary beverages has been proposed and adopted in other settings as a means to reduce harms from their consumption. A tax on the sugar content of non-alcoholic beverages has been proposed for implementation in South Africa, however, the public health effects and revenue raising potential of this measure hinges on estimates of the targeted beverages own- and cross-price elasticities. This study applies demand system methods by combining expenditure survey data and sub-national price data to provide the first estimates of price and expenditure elasticities for categories of soft drinks that would be subject to South Africa's proposed sugary beverage tax. The results suggest that demand for these products is sufficiently price-elastic such that a significant reduction in consumption may result from a tax. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

The quality of sample surveys in a developing nation

Directory of Open Access Journals (Sweden)

Paul A Bourne

2010-08-01

Full Text Available Paul A Bourne1, Christopher AD Charles2,3, Neva South-Bourne4, Chloe Morris1, Denise Eldemire-Shearer1, Maureen D Kerr-Campbell51Department of Community Health and Psychiatry, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica; 2King Graduate School, Monroe College, Bronx, New York, USA; 3Center for Victim Support, Harlem Hospital Center, New York, USA; 4Research assistant for Paul A Bourne; 5Systems Development Unit, Main Library, Faculty of Humanities and Education, University of the West Indies, Mona, Kingston, JamaicaBackground: In Jamaica, population census began in 1844, and many intercensal ratios obtained from the census data showed that there is a general high degree of accuracy of the data. However, statistics from the Jamaican Ministry of Health showed that there are inaccuracies in health data collected from males using sample surveys.Objectives: The objectives of the present research are to 1 investigate the accuracy of a national sample survey, 2 explore the feasibility and quality of using a subnational sample survey to represent a national survey, 3 aid other scholars in understanding the probability of using national sample surveys and subnational sample surveys, 4 assess older men’s ­evaluation of their health status, and 5 determine whether dichotomization changes self-evaluated health status.Methods: For the current study, the data used in the analysis were originally collected from 2 different sources: 1 the Jamaica Survey of Living Conditions (JSLC and 2 Survey of Older Men (SOM. Cross validation of self-evaluated data of men in Jamaica was done with comparable samples of the complete JSLC data and the SOM data, where men older than 55 years were selected from each sample.Results: In study 1, 50.2% of respondents indicated at least good self-evaluated health status compared with 74.0% in study 2. Statistical associations were found between health status and survey sample (Χ2 [df = 5

Environmental health--champions of One Health.

Science.gov (United States)

Eddy, Christopher; Stull, Paul A; Balster, Erik

2013-01-01

The authors find overwhelming evidence among environmental health practitioners that One Health disease reporting concepts are essential to the early detection of, and expedient recovery from, pandemic disease events. The authors also find, however, extraordinary evidence that local public health is not prepared, and potentially unaware of their responsibility, to be the initiator of the zoonotic infectious disease information intelligence necessary to make such early event mitigation possible. The authors propose that NEHA take an affirmative step towards the development of local public health-initiated biosurveillance systems by organizing and leading a tabletop study group that includes the Centers for Disease Control and Prevention, American Veterinary Medical Association, American Medical Association, Food and Drug Administration, U.S. Department of Agriculture, Institute of Medicine, and a robust panel of NEHA state affiliates. This study group should discuss the infrastructure necessary for local public health-the frontline against community-acquired infectious disease-to be the initiators of environmental health, veterinary, and medical One Health biosurveillance systems. The need to establish a community-focused, integrated disease prevention strategy that cautions people about the risks associated with food, water, animal, and contaminated environmental media, both prior to and during epidemic and pandemic events is equally important.

Communication with the public in the health-care system: a descriptive study of the use of social media in Local Health Authorities and public hospitals in Italy

Directory of Open Access Journals (Sweden)

Marina Vanzetta

2014-06-01

Full Text Available INTRODUCTION. In 2010 the Italian Ministry of Health set out recommendations for the use of social technology and Web 2.0, inviting organisations within the Italian national health service (Servizio Sanitario Nazionale, SSN to equip themselves with instruments. Objectives. 1. to ascertain how many local health authorities (Aziende Sanitarie Locali, ASL and public hospitals have a presence on the most widely used social media websites in Italy: Facebook, Twitter and YouTube; 2. to find out how well the Facebook, Twitter and YouTube pages of ASLs and public hospitals are known among the general population; 3. to find out how ASLs and public hospitals engage with the general public on social media sites. MATERIALS AND METHODS. The websites of all ASLs and public hospitals across the country were visited to look for the icons of the social media sites under examination. The data considered were publicly available upon access. RESULTS. A total of 245 websites were analysed. 7.34% ASLs and hospitals had social media accounts. 8 organisations had an account on all three of the social media sites considered in the study. CONCLUSIONS. The results show a low presence of ASLs and hospitals on social media. Other studies are needed in this field.

76 FR 30174 - Statement of Organization, Functions, and Delegations of Authority

Science.gov (United States)

2011-05-24

... and consultation to domestic and international governmental and non-governmental organizations on... Organization, Functions, and Delegations of Authority Part C (Centers for Disease Control and Prevention) of the Statement of Organization, Functions, and Delegations of Authority of the Department of Health and...

75 FR 10296 - Statement of Organization, Functions, and Delegations of Authority

Science.gov (United States)

2010-03-05

... Organization, Functions, and Delegations of Authority Part C (Centers for Disease Control and Prevention) of the Statement of Organization, Functions, and Delegations of Authority of the Department of Health and...-based methods and guidelines mandated by the Energy Employees Occupational Illness Compensation Program...

Desafíos claves del fortalecimiento de la gestión de los gobiernos subnacionales chilenos en Educación Desafios-chave do fortalecimento da gestão dos governos subnacionais chilenos na educação Key challenges in the strengthening of management of Chilean subnational governments in education

Directory of Open Access Journals (Sweden)

Sebastián Donoso Díaz

2006-09-01

ão menores do que o esperado, o que constitui um dos desafios principais, permanentes e mais relevantes que é a potencialização da capacidade de gestão dos governos subnacionais. O trabalho revisa a noção de Estado e de Governo aplicada ao caso chileno, porquanto os processos de descentralização constituem o marco, no qual se inscrevem os desafios de gestão dos governos subnacionais. Mais adiante se estabelecem alguns critérios de reforma na gestão do Estado, para avançar na relação entre governos subnacionais e desenvolvimento da educação, aspecto que, em essência, analisa resultados da reforma educativa chilena e os processos de gestão dos governos nacional e subnacionais, identificando aqueles aspectos que requerem uma revisão mais acurada em matérias como as políticas de financiamento do sistema educativo, os resultados em matéria de qualidade e as dificuldades dos processos de gestão no atual contexto legal. Finalmente, reforça-se a educação pública como opção de desenvolvimento democrático, numa visão de liderança convocante de outros agentes participantes do campo educacional, e com um claro sentido de gerador de uma identidade local.Chile needs to deepen the management of the subnational governments in education like a strategic measurement for its development. Although the diagnoses build the matter arouses almost unanimous support, recognizing the necessity to undertake this task decidedly, has not advanced with the speed and required depth, product of which, the profits in this field are smaller of hoped, the matter that is constituted in one of the main challenges, permanent and more excellent than it is the involution of the capacity of management of the subnational governments. The work reviews the notion of the State and the Government applied in the Chilean case, inasmuch as the decentralization processes, constitute the frame in which the challenges of management of the subnational governments register. More ahead some

A systematic review of economic evaluations of local authority commissioned preventative public health interventions in overweight and obesity, physical inactivity, alcohol and illicit drugs use and smoking cessation in the United Kingdom.

Science.gov (United States)

White, Pam; Skirrow, Helen; George, Abraham; Memon, Anjum

2018-02-16

Since 2013, local authorities in England have been responsible for commissioning preventative public health interventions. The aim of this systematic review was to support commissioning by collating published data on economic evaluations and modelling of local authority commissioned public health preventative interventions in the UK. Following the PRISMA protocol, we searched for economic evaluations of preventative intervention studies in four different areas: overweight and obesity, physical inactivity, alcohol and illicit drugs use and smoking cessation. The systematic review identified studies between January 1994 and February 2015, using five databases. We synthesized the studies to identify the key methods and examined results of the economic evaluations. The majority of the evaluations related to cost-effectiveness, rather than cost-benefit analyses or cost-utility analyses. These analyses found preventative interventions to be cost effective, though the context of the interventions differed between the studies. Preventative public health interventions in general are cost-effective. There is a need for further studies to support justification of continued and/or increased funding for public health interventions. There is much variation between the types of economically evaluated preventative interventions in our review. Broader studies incorporating different contexts may help support funding for local authority-sponsored public health initiatives.

Consumer attitudes toward health policy and knowledge about health legislation.

Science.gov (United States)

Riska, E; Taylor, J A

1978-01-01

Consumer attitudes toward key issues affecting health policy decisions in the local community have been ignored both by local health policy makers and by medical sociologists. The authors report an empirical analysis of: (1) consumer attitudes towards federal intervention in health care; (2) consumer perceptions of the free market philosophy of health providers; (3) consumer perceptions of their involvement in health policy making; (4) consumer confidence in present systems of health services delivery; and (5) consumer awareness of recent major health legislation. It was found that consumers are poorly informed about recent health care legislation. The authors compared the attitudes of consumers with those held by local hospital board members toward health policy issues. The differences for all comparisons were statistically significant. The authors argue that hospital board members attribute problems in health services delivery to demand dysfunctions while consumers perceive the problems to be a result of supply dysfunctions. Thus, failure to include consumers on health policy boards guarantees the absence of a solution-oriented dialogue and promotes the continuing predominance of a provider-biased ideology.

75 FR 14178 - Statement of Organization, Functions, and Delegations of Authority

Science.gov (United States)

2010-03-24

... Organization, Functions, and Delegations of Authority Part C (Centers for Disease Control and Prevention) of the Statement of Organization Functions, and Delegations of Authority of the Department of Health and... inclusive environment and values diversity that empowers employees to participate and support CDC's global...

75 FR 6399 - Statement of Organization, Functions and Delegation of Authority

Science.gov (United States)

2010-02-09

... DUCS Case Managers which, in effect, involved the exercise of these authorities prior to the effective... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Statement of... the January 12, 2010 earthquake in Haiti. (c) Effective Date This delegation of authority is effective...

Applying the Innov8 approach for reviewing national health programmes to leave no one behind: lessons learnt from Indonesia

Science.gov (United States)

Saint, Victoria; Floranita, Rustini; Koemara Sakti, Gita Maya; Pambudi, Imran; Hermawan, Lukas; Villar, Eugenio; Magar, Veronica

2018-01-01

ABSTRACT The World Health Organization’s Innov8 Approach for Reviewing National Health Programmes to Leave No One Behind is an eight-step process that supports the operationalization of the Sustainable Development Goals’ commitment to ‘leave no one behind’. In 2014–2015, Innov8 was adapted and applied in Indonesia to review how the national neonatal and maternal health action plans could become more equity-oriented, rights-based and gender-responsive, and better address critical social determinants of health. The process was led by the Indonesian Ministry of Health, with the support of WHO. It involved a wide range of actors and aligned with/fed into the drafting of the maternal newborn health action plan and the implementation planning of the newborn action plan. Key activities included a sensitization meeting, diagnostic checklist, review workshop and in-country work by the review teams. This ‘methods forum’ article describes this adaptation and application process, the outcomes and lessons learnt. In conjunction with other sources, Innov8 findings and recommendations informed national and sub-national maternal and neonatal action plans and programming to strengthen a ‘leave no one behind’ approach. As follow-up during 2015–2017, components of the Innov8 methodology were integrated into district-level planning processes for maternal and newborn health, and Innov8 helped generate demand for health inequality monitoring and its use in planning. In Indonesia, Innov8 enhanced national capacity for equity-oriented, rights-based and gender-responsive approaches and addressing critical social determinants of health. Adaptation for the national planning context (e.g. decentralized structure) and linking with health inequality monitoring capacity building were important lessons learnt. The pilot of Innov8 in Indonesia suggests that this approach can help operationalize the SDGs’ commitment to leave no one behind, in particular in relation to

Financial sustainability planning for immunization services in Cambodia.

Science.gov (United States)

Soeung, Sann Chan; Grundy, John; Maynard, Jim; Brooks, Alan; Boreland, Marian; Sarak, Duong; Jenkinson, Karl; Biggs, Beverley-Ann

2006-07-01

The expanded programme of immunization was established in Cambodia in 1986. In 2002, 67% of eligible children were immunized, despite significant health sector and macro-economic financial constraints. A financial sustainability planning process for immunization was introduced in 2002, in order to mobilize national and international resources in support of the achievement of child health objectives. The aim of this paper is to outline this process, describe its early impact as an advocacy tool and recommend additional strategies for mobilizing additional resources for health. The methods of financial sustainability planning are described, including the advocacy strategies that were applied. Analysis of financial sustainability planning results indicates rising programme costs associated with new vaccine introduction and new technologies. Despite this, the national programme has demonstrated important early successes in using financial sustainability planning to advocate for increased mobilization of national and international sources of funding for immunization. The national immunization programme nevertheless faces formidable system and financial challenges in the coming years associated with rising costs, potentially diminishing sources of international assistance, and the developing role of sub-national authorities in programme management and financing.

An assessment of equity in the distribution of non-financial health care inputs across public primary health care facilities in Tanzania.

Science.gov (United States)

Kuwawenaruwa, August; Borghi, Josephine; Remme, Michelle; Mtei, Gemini

2017-07-11

There is limited evidence on how health care inputs are distributed from the sub-national level down to health facilities and their potential influence on promoting health equity. To address this gap, this paper assesses equity in the distribution of health care inputs across public primary health facilities at the district level in Tanzania. This is a quantitative assessment of equity in the distribution of health care inputs (staff, drugs, medical supplies and equipment) from district to facility level. The study was carried out in three districts (Kinondoni, Singida Rural and Manyoni district) in Tanzania. These districts were selected because they were implementing primary care reforms. We administered 729 exit surveys with patients seeking out-patient care; and health facility surveys at 69 facilities in early 2014. A total of seventeen indices of input availability were constructed with the collected data. The distribution of inputs was considered in relation to (i) the wealth of patients accessing the facilities, which was taken as a proxy for the wealth of the population in the catchment area; and (ii) facility distance from the district headquarters. We assessed equity in the distribution of inputs through the use of equity ratios, concentration indices and curves. We found a significant pro-rich distribution of clinical staff and nurses per 1000 population. Facilities with the poorest patients (most remote facilities) have fewer staff per 1000 population than those with the least poor patients (least remote facilities): 0.6 staff per 1000 among the poorest, compared to 0.9 among the least poor; 0.7 staff per 1000 among the most remote facilities compared to 0.9 among the least remote. The negative concentration index for support staff suggests a pro-poor distribution of this cadre but the 45 degree dominated the concentration curve. The distribution of vaccines, antibiotics, anti-diarrhoeal, anti-malarials and medical supplies was approximately

42 CFR 136.30 - Payment to Medicare-participating hospitals for authorized Contract Health Services.

Science.gov (United States)

2010-10-01

... HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH... responsible after the provider of services has coordinated benefits and all other alternative resources have... consistent with part 136 of this title or section 503(a) of the Indian Health Care Improvement Act (IHCIA...

Mapping local variation in educational attainment across Africa

Science.gov (United States)

Graetz, Nicholas; Friedman, Joseph; Osgood-Zimmerman, Aaron; Burstein, Roy; Biehl, Molly H.; Shields, Chloe; Mosser, Jonathan F.; Casey, Daniel C.; Deshpande, Aniruddha; Earl, Lucas; Reiner, Robert C.; Ray, Sarah E.; Fullman, Nancy; Levine, Aubrey J.; Stubbs, Rebecca W.; Mayala, Benjamin K.; Longbottom, Joshua; Browne, Annie J.; Bhatt, Samir; Weiss, Daniel J.; Gething, Peter W.; Mokdad, Ali H.; Lim, Stephen S.; Murray, Christopher J. L.; Gakidou, Emmanuela; Hay, Simon I.

2018-03-01

Educational attainment for women of reproductive age is linked to reduced child and maternal mortality, lower fertility and improved reproductive health. Comparable analyses of attainment exist only at the national level, potentially obscuring patterns in subnational inequality. Evidence suggests that wide disparities between urban and rural populations exist, raising questions about where the majority of progress towards the education targets of the Sustainable Development Goals is occurring in African countries. Here we explore within-country inequalities by predicting years of schooling across five by five kilometre grids, generating estimates of average educational attainment by age and sex at subnational levels. Despite marked progress in attainment from 2000 to 2015 across Africa, substantial differences persist between locations and sexes. These differences have widened in many countries, particularly across the Sahel. These high-resolution, comparable estimates improve the ability of decision-makers to plan the precisely targeted interventions that will be necessary to deliver progress during the era of the Sustainable Development Goals.

Author response to letter. Ref: Madsen et al. "Unnecessary work tasks and mental health: a prospective analysis of Danish human service workers".

Science.gov (United States)

Madsen, Ida Eh; Rugulies, Reiner

2015-03-01

We read with interest the letter from Drs Durand-Moreau, Loddé, and Dewitte (1) regarding our article on unnecessary work tasks and mental health (2). The authors argue that: (i) the article is flawed by an imprecise one-item exposure measurement, (ii) the results may be affected by reverse causality, and (iii) ultimately the elimination of unnecessary work tasks may increase "psychic suffering". We would like to take this opportunity to address their concerns. We acknowledge, as we did in the article itself, that measuring unnecessary work tasks using only one item is less than ideal and could have increased measurement error in our analyses. The item we used to measure unnecessary work tasks assesses the employee's overall evaluation regarding the extent to which they must conduct work tasks that they, for whatever reason, deem unnecessary. We are unconvinced by the claim by Drs Durand-Moreau, Loddé, and Dewitte that this phenomenon is somehow unrelated to Semmer's definition of unnecessary tasks (3, 4), regardless of the sense-making processes underlying an individual employee's evaluation of a particular work task as unnecessary. Regarding the issue of reverse causality, the analyses were longitudinal and the effect estimates were adjusted for the baseline mental health level of the participants. Consequently, we examined changes in mental health over time, and our results cannot be explained by poorer mental health making workers think "that what they're doing is useless" as claimed in the commentary. Although causal inference is always a delicate issue when applying observational research methods, the adjustment for baseline mental health should account for reverse causality at least. Drs Durand-Moreau, Loddé, and Dewitte question that our findings suggest that the elimination of unnecessary work tasks may be beneficial to employee mental health. Instead they propose that unnecessary work tasks may be conducive to mental health because "some tasks may seem

Provision of out-of-hours interventional radiology services in the London Strategic Health Authority

International Nuclear Information System (INIS)

Illing, R.O.; Ingham Clark, C.L.; Allum, C.

2010-01-01

Aim: To review the provision of out-of-hours interventional radiology (IR) services in the London Strategic Health Authority (SHA). Materials and methods: All 29 acute hospitals in the London SHA were contacted between November 2008 and January 2009. A questionnaire based on the Royal College of Radiologists (RCR) guidelines assessed the provision of out-of-hours IR services. An 'ad-hoc' service was defined as on-call provision where not all the radiologists could perform intervention: If IR was required out of hours, an interventionalist came in when off-duty or the patient was transferred. Results: Seventeen out of the 29 (59%) hospitals provided ad-hoc out-of-hours services, eight (28%) provided a 24-hour rota, and four (14%) provide no out-of-hours cover. No ad-hoc service had formal transfer arrangements to a centre providing a 24 h service. Only two hospitals providing a 24 h service had six radiologists on the rota. Conclusion: Strategic planning for out-of-hours IR across London is recommended. This is likely to be welcomed by the hospitals involved, allowing informal arrangements to be formalized, and collaboration to provide comprehensive regional networks, provided appropriate funding is made available. A national audit is recommended; it is unlikely these findings are unique to London.

Provision of out-of-hours interventional radiology services in the London Strategic Health Authority

Energy Technology Data Exchange (ETDEWEB)

Illing, R.O., E-mail: rowland@doctors.org.u [University College London Hospitals NHS Foundation Trust, 235 Euston Road, London NW1 2BU (United Kingdom); Ingham Clark, C.L.; Allum, C. [Whittington Hospital NHS Trust, London (United Kingdom)

2010-04-15

Aim: To review the provision of out-of-hours interventional radiology (IR) services in the London Strategic Health Authority (SHA). Materials and methods: All 29 acute hospitals in the London SHA were contacted between November 2008 and January 2009. A questionnaire based on the Royal College of Radiologists (RCR) guidelines assessed the provision of out-of-hours IR services. An 'ad-hoc' service was defined as on-call provision where not all the radiologists could perform intervention: If IR was required out of hours, an interventionalist came in when off-duty or the patient was transferred. Results: Seventeen out of the 29 (59%) hospitals provided ad-hoc out-of-hours services, eight (28%) provided a 24-hour rota, and four (14%) provide no out-of-hours cover. No ad-hoc service had formal transfer arrangements to a centre providing a 24 h service. Only two hospitals providing a 24 h service had six radiologists on the rota. Conclusion: Strategic planning for out-of-hours IR across London is recommended. This is likely to be welcomed by the hospitals involved, allowing informal arrangements to be formalized, and collaboration to provide comprehensive regional networks, provided appropriate funding is made available. A national audit is recommended; it is unlikely these findings are unique to London.

Education Improves Public Health and Promotes Health Equity.

Science.gov (United States)

Hahn, Robert A; Truman, Benedict I

2015-01-01

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health - an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits. © The Author(s) 2015.

45 CFR 170.465 - Revocation of authorized testing and certification body status.

Science.gov (United States)

2010-10-01

... INFORMATION TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY Temporary Certification Program for HIT § 170.465 Revocation of authorized testing and certification body status. (a) Type-1...

5 CFR 890.106 - Delegation of authority for resolving certain contract disputes.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Delegation of authority for resolving... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administration and General Provisions § 890.106 Delegation of authority for resolving certain contract disputes. For...

Local fishing associations and environment authorities visit CERN

CERN Document Server

AUTHOR|(CDS)2099575

2016-01-01

Local fishing associations and Host-States environment authorities visited CERN on Thursday 21st April 2016. They discovered the efforts made by CERN and its Health, Safety and Environment (HSE) unit to control and limit the impact of the Laboratory's activities on natural environment, and more specifically local rivers.

Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016

DEFF Research Database (Denmark)

Moesgaard Iburg, Kim

2017-01-01

calculated from the sum of each death multiplied by the standard life expectancy at each age. We used the GBD cause of death database composed of: vital registration (VR) data corrected for under-registration and garbage coding; national and subnational verbal autopsy (VA) studies corrected for garbage...... that required high levels of care but for which effective treatments remain elusive, potentially increasing costs to health systems. Funding Bill & Melinda Gates Foundation....

Effects of Health Literacy and Social Capital on Health Information Behavior.

Science.gov (United States)

Kim, Yong-Chan; Lim, Ji Young; Park, Keeho

2015-01-01

This study aimed to examine whether social capital (bonding and bridging social capital) attenuate the effect of low functional health literacy on health information resources, efficacy, and behaviors. In-person interviews were conducted with 1,000 residents in Seoul, Korea, in 2011. The authors found that respondents' functional health literacy had positive effects on the scope of health information sources and health information self-efficacy but not health information-seeking intention. Respondents' social capital had positive effects on the scope of health information sources, health information efficacy, and health information-seeking intention. The authors found (a) a significant moderation effect of bridging social capital on the relation between health literacy and health information self-efficacy and (b) a moderation effect of bonding social capital on the relation between health literacy and health information-seeking intention.

United by Discord, Divided by Consensus: National and Sub-national Articulation in Bolivia and Peru, 2000–2010 Unidos por el disenso, separados por el consenso: La articulación nacional y subnacional en Bolivia y Perú, 2000–2010

Directory of Open Access Journals (Sweden)

Alberto Vergara

2011-01-01

Full Text Available From 2000 to 2010, Bolivia and Peru underwent similar processes of political decentralization toward the meso level of the government. Three elections later in Peru and two in Bolivia, the ability of national political parties to articulate interests differs markedly between the two countries. Peru tends toward fragmentation with national parties incapable of participating or successfully competing in subnational elections, while in Bolivia, the Movimiento al Socialismo (MAS – and other parties to a lesser extent – are increasingly capable of participating and winning subnational offices. This paper argues that, despite having undergone very similar institutional reforms, the difference between the cases can largely be explained by two “society-side” variables: the caliber of the political ideas in debate and political social density. The substantive quality of ideas in debate and a greater political social density have been crucial to the Bolivian trend, while their absence has lessened the possibility of anything similar occurring in Peru. In general terms, the article sheds light on the social conditions that favor party-building in a context of decentralization reform.Entre el 2000 y el 2010, Bolivia y Perú emprendieron procesos similares de descentralización política hacia el nivel meso de gobierno. Después de tres elecciones en Perú y dos en Bolivia, la capacidad de los partidos políticos nacionales para articular intereses difiere sustantivamente en ambos países. El Perú tiende a la fragmentación pues los partidos nacionales son incapaces de participar con éxito en los niveles sub-nacionales de competencia política, mientras que en Bolivia el Movimiento al Socialismo (MAS – y, en menor medida, otros partidos - incrementan su capacidad de participar y conseguir victorias en los niveles sub-nacionales. En este artículo se sostiene que, a pesar de haber pasado por reformas institucionales muy similares, la diferencia

Stagnant Neonatal Mortality and Persistent Health Inequality in Middle-Income Countries: A Case Study of the Philippines

Science.gov (United States)

Kraft, Aleli D.; Nguyen, Kim-Huong; Jimenez-Soto, Eliana; Hodge, Andrew

2013-01-01

Background The probability of survival through childhood continues to be unequal in middle-income countries. This study uses data from the Philippines to assess trends in the prevalence and distribution of child mortality and to evaluate the country’s socioeconomic-related child health inequality. Methodology Using data from four Demographic and Health Surveys we estimated levels and trends of neonatal, infant, and under-five mortality from 1990 to 2007. Mortality estimates at national and subnational levels were produced using both direct and indirect methods. Concentration indices were computed to measure child health inequality by wealth status. Multivariate regression analyses were used to assess the contribution of interventions and socioeconomic factors to wealth-related inequality. Findings Despite substantial reductions in national under-five and infant mortality rates in the early 1990s, the rates of declines have slowed in recent years and neonatal mortality rates remain stubbornly high. Substantial variations across urban-rural, regional, and wealth equity-markers are evident, and suggest that the gaps between the best and worst performing sub-populations will either be maintained or widen in the future. Of the variables tested, recent wealth-related inequalities are found to be strongly associated with social factors (e.g. maternal education), regional location, and access to health services, such as facility-based delivery. Conclusion The Philippines has achieved substantial progress towards Millennium Development Goal 4, but this success masks substantial inequalities and stagnating neonatal mortality trends. This analysis supports a focus on health interventions of high quality – that is, not just facility-based delivery, but delivery by trained staff at well-functioning facilities and supported by a strong referral system – to re-start the long term decline in neonatal mortality and to reduce persistent within-country inequalities in child

Stagnant neonatal mortality and persistent health inequality in middle-income countries: a case study of the Philippines.

Directory of Open Access Journals (Sweden)

Aleli D Kraft

Full Text Available BACKGROUND: The probability of survival through childhood continues to be unequal in middle-income countries. This study uses data from the Philippines to assess trends in the prevalence and distribution of child mortality and to evaluate the country's socioeconomic-related child health inequality. METHODOLOGY: Using data from four Demographic and Health Surveys we estimated levels and trends of neonatal, infant, and under-five mortality from 1990 to 2007. Mortality estimates at national and subnational levels were produced using both direct and indirect methods. Concentration indices were computed to measure child health inequality by wealth status. Multivariate regression analyses were used to assess the contribution of interventions and socioeconomic factors to wealth-related inequality. FINDINGS: Despite substantial reductions in national under-five and infant mortality rates in the early 1990s, the rates of declines have slowed in recent years and neonatal mortality rates remain stubbornly high. Substantial variations across urban-rural, regional, and wealth equity-markers are evident, and suggest that the gaps between the best and worst performing sub-populations will either be maintained or widen in the future. Of the variables tested, recent wealth-related inequalities are found to be strongly associated with social factors (e.g. maternal education, regional location, and access to health services, such as facility-based delivery. CONCLUSION: The Philippines has achieved substantial progress towards Millennium Development Goal 4, but this success masks substantial inequalities and stagnating neonatal mortality trends. This analysis supports a focus on health interventions of high quality--that is, not just facility-based delivery, but delivery by trained staff at well-functioning facilities and supported by a strong referral system--to re-start the long term decline in neonatal mortality and to reduce persistent within

Stagnant neonatal mortality and persistent health inequality in middle-income countries: a case study of the Philippines.

Science.gov (United States)

Kraft, Aleli D; Nguyen, Kim-Huong; Jimenez-Soto, Eliana; Hodge, Andrew

2013-01-01

The probability of survival through childhood continues to be unequal in middle-income countries. This study uses data from the Philippines to assess trends in the prevalence and distribution of child mortality and to evaluate the country's socioeconomic-related child health inequality. Using data from four Demographic and Health Surveys we estimated levels and trends of neonatal, infant, and under-five mortality from 1990 to 2007. Mortality estimates at national and subnational levels were produced using both direct and indirect methods. Concentration indices were computed to measure child health inequality by wealth status. Multivariate regression analyses were used to assess the contribution of interventions and socioeconomic factors to wealth-related inequality. Despite substantial reductions in national under-five and infant mortality rates in the early 1990s, the rates of declines have slowed in recent years and neonatal mortality rates remain stubbornly high. Substantial variations across urban-rural, regional, and wealth equity-markers are evident, and suggest that the gaps between the best and worst performing sub-populations will either be maintained or widen in the future. Of the variables tested, recent wealth-related inequalities are found to be strongly associated with social factors (e.g. maternal education), regional location, and access to health services, such as facility-based delivery. The Philippines has achieved substantial progress towards Millennium Development Goal 4, but this success masks substantial inequalities and stagnating neonatal mortality trends. This analysis supports a focus on health interventions of high quality--that is, not just facility-based delivery, but delivery by trained staff at well-functioning facilities and supported by a strong referral system--to re-start the long term decline in neonatal mortality and to reduce persistent within-country inequalities in child health.

Healthful School Living: Environmental Health in the School.

Science.gov (United States)

Rowe, Daryl E.

1987-01-01

Environmental health, as it relates to schools, is defined. Site, chemical, biological, and physical health hazards are identified. Recommendations and precautions to help achieve optimal health, safety, and comfort are presented. Resources are noted. (Author/MT)

Sub-national population policy: the case of North Sulawesi.

Science.gov (United States)

Jones, G W

1989-04-01

Since the 1970s, Indonesia has placed increasing emphasis on the development of stronger planning capacity at the regional level; however, the concept of regional autonomy is still viewed with suspicion given Indonesia's history of regional separatist movements. This fact has implications for the need for national population policy to be formulated and implemented with a view toward the varying conditions faced by different provinces and regions. The author presents a case study of fertility, mortality, migration, urbanization, and the development of human capital in 1 Indonesian province--North Sulawesi--to illustrate that special characteristics and internal diversity can demand individualized responses by policy makers. In terms of these 5 areas, the following observations can be made about conditions in North Sulawesi: 1) mortality rates are already below the national average, although infant mortality remains unacceptably high; 2) fertility rates are also well below the national average and approaching replacement level without any aggressive family planning outreach activities, but there remains a need to identify the ultimate fertility target and the extent to which intervention is required; 3) there is little scope for absorbing transmigrants, but there are some major issues regarding population redistribution within the province; 4) although there are no large cities, the increasing dominance of Manado is a concern; and 5) the quality of education and an employment structure to match the well-educated labor force are more important than an expansion of these services. A central concern is the ability of North Sulawesi to prevent "brain drain" to Jakarta; however, the province's capacity to do so is dependent on decisions made in Jakarta about the allocation of revenue, regulations regarding the processing of copra and cloves, new air routes, and the extent of regional autonomy to be tolerated in decisions affecting provincial growth.

[Workplace health promotion in public health policies in Poland].

Science.gov (United States)

Puchalski, Krzysztof; Korzeniowska, Elzbieta

2008-01-01

In this paper the author analyses how far in Poland the idea of workplace health promotion (WHP) does exist in the area of public health understood in its broadest sense. The analysis encapsulates the following issues: (a) the national legislative policy, (b) strategies, programs and projects concerning health issues launched or coordinated by the state or local administration, (c) grassroots initiatives for health promotion supported by local and regional administration, (d) civic projects or business strategies for health. In addition, the author emphasizes the marginalization of workplace health promotion and lack of cohesive policy in this field as well as, the fact that health problems of the working population arising from current demographic, technological, economic and social changes that could be dealt with through developing and implementing WHP projects are not yet fully perceived by public health policy makers.

[History of the evaluation of medicines aiming for marketing authorization].

Science.gov (United States)

Caulin, C

2008-01-01

The European Directive on Medicines Evaluation and Marketing Authorization were issued in 1975. For more than 30 years, Marketing Authorization criteria have been defined as pharmaceutical and biological quality, therapeutic efficacy, and safety. The application comes from the pharmaceutical company and must include the full data on drug development. French procedures have always included practical assessment of the drug by health practitioners: clinicians, pharmacists, biologists, and specialists in biostatistics.

Health locus of control, acculturation, and health-related Internet use among Latinas.

Science.gov (United States)

Roncancio, Angelica M; Berenson, Abbey B; Rahman, Mahbubur

2012-01-01

Among individuals residing in the United States, the Internet is the third most used source for obtaining health information. Little is known, however, about its use by Latinas. To understand health-related Internet use among Latinas, the authors examined it within the theoretical frameworks of health locus of control and acculturation. The authors predicted that acculturation would serve as a mediator between health locus of control and health-related Internet use, age and health-related Internet use, income and health-related Internet use, and education and health-related Internet use. Data were collected via a 25-minute self-report questionnaire. The sample consisted of 932 young (M age = 21.27 years), low-income Latinas. Using structural equation modeling, the authors observed that acculturation partially mediated the relation between health locus of control and health-related Internet use and fully mediated the relations among age, income, and Internet use. An internal health locus of control (p income (p Internet use. The Internet is a powerful tool that can be used to effectively disseminate information to Latinas with limited access to health care professionals. These findings can inform the design of Internet-based health information dissemination studies targeting Latinas.

Health promotion in globalization

Directory of Open Access Journals (Sweden)

Álvaro Franco-Giraldo

2012-10-01

Full Text Available Objective: to unravel some theoretical and factual elements required to implement more effective health promotion strategies and practices in the field of health services whilst following the great challenges that globalization has imposed on the health systems, which are inevitably expressed in the local context (glocalization. Methodology: a narrative review taking into account the concepts of globalization and health promotion in relation to health determinants. The authors approach some courses of action and strategies for health promotion based on the social principles and universal values that guide health promotion, health service reorientation and primary healthcare, empowerment, social participation, and inter-sectoral and social mobilization. Discussion: the discussion focuses on the redirection of health promotion services in relation to the wave of health reforms that has spread throughout the world under the neoliberal rule. The author also discusses health promotion, its ineffectiveness, and the quest for renewal. Likewise, the author sets priorities for health promotion in relation to social determinants. Conclusion: the current global order, in terms of international relations, is not consistent with the ethical principles of health promotion. In this paper, the author advocates for the implementation of actions to change the social and physical life conditions of people based on changes in the use of power in society and the appropriate practice of politics in the context of globalization in order to achieve the effectiveness of the actions of health promotion.

HIV pretreatment drug resistance trends in three geographic areas of Mexico.

Science.gov (United States)

García-Morales, Claudia; Tapia-Trejo, Daniela; Quiroz-Morales, Verónica S; Navarro-Álvarez, Samuel; Barrera-Arellano, Carlos A; Casillas-Rodríguez, Jesús; Romero-Mora, Karla A; Gómez-Palacio-Schjetnan, María; Murakami-Ogasawara, Akio; Ávila-Ríos, Santiago; Reyes-Terán, Gustavo

2017-11-01

Pretreatment drug resistance (PDR) levels to NNRTI approaching 10% have recently been reported in Mexico. However, subnational differences may exist in PDR prevalence and transmission dynamics. We longitudinally assessed HIV PDR in three geographic areas of Mexico. HIV-infected, antiretroviral-naive individuals were recruited from 2008 to 2016, from the Central Metropolitan Zone (CMZ), Cancun and Tijuana (1194, 773 and 668 respectively). PDR was estimated using the Stanford HIVdb tool from plasma HIV pol sequences. A higher proportion of females, lower education and lower employment rate were observed in Tijuana, while a higher proportion of MSM was observed in the CMZ (P Mexico. Even when increasing trends in efavirenz resistance were observed in the three areas, our observations support that, in a large country such as Mexico, subnational surveillance and locally tailored interventions to address drug resistance may be a reasonable option. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Fragmented implementation of maternal and child health home-based records in Vietnam: need for integration

Science.gov (United States)

Aiga, Hirotsugu; Nguyen, Vinh Duc; Nguyen, Cuong Dinh; Nguyen, Tho Thi Thi; Nguyen, Lien Thi Phuong

2016-01-01

Background Home-based records (HBRs) are globally implemented as the effective tools that encourage pregnant women and mothers to timely and adequately utilise maternal and child health (MCH) services. While availability and utilisation of nationally representative HBRs have been assessed in several earlier studies, the reality of a number of HBRs subnationally implemented in a less coordinated manner has been neither reported nor analysed. Objectives This study is aimed at estimating the prevalence of HBRs for MCH and the level of fragmentation of and overlapping between different HBRs for MCH in Vietnam. The study further attempts to identify health workers’ and mothers’ perceptions towards HBR operations and utilisations. Design A self-administered questionnaire was sent to the provincial health departments of 28 selected provinces. A copy of each HBR available was collected from them. A total of 20 semi-structured interviews with health workers and mothers were conducted at rural communities in four of 28 selected provinces. Results Whereas HBRs developed exclusively for maternal health and exclusively for child health were available in four provinces (14%) and in 28 provinces (100%), respectively, those for both maternal health and child health were available in nine provinces (32%). The mean number of HBRs in 28 provinces (=5.75) indicates over-availability of HBRs. All 119 minimum required items for recording found in three different HBRs under nationwide scale-up were also included in the Maternal and Child Health Handbook being piloted for nationwide scaling-up. Implementation of multiple HBRs is likely to confuse not only health workers by requiring them to record the same data on several HBRs but also mothers about which HBR they should refer to and rely on at home. Conclusions To enable both health workers and pregnant women to focus on only one type of HBR, province-specific HBRs for maternal and/or child health need to be nationally standardised

Promoting US-China Critical Zone Science Collaboration and Coordination Through Established Subnational Bilateral Science Partnerships: The US-China EcoPartnership for Economic and Environmental Sustainability.

Science.gov (United States)

Filley, T. R.; Guo, D.; Plante, A. F.

2015-12-01

The concept of critical zone (CZ) science has gained wide recognition with actively funded and emerging CZ observatory programs across the globe. There is much to be gained through international collaboration that links field, laboratory, and modeling efforts from across the emerging global CZ networks, but building international ties is difficult, especially when peer-to-peer connections are nascent, separated by great distances, and span different cultural and political environments. The U.S. and China share many climatic and geological similarities but differ greatly in the magnitude and timescale of human alteration of their landscapes making the comparative study of their respective pasts, current state, and future co-evolution an outstanding scientific opportunity to better understand, predict, and respond to human influence on the CZ. Leveraging the infrastructure and trust capital of longstanding sub-national volunteer scientific networks to bring together people and organizations is a resource-efficient mechanism to build cross-network CZ programs. The U.S.-China EcoPartnership for Environmental Sustainability (USCEES) is one of 30 current EcoPartnerships established beginning in May 2008 by a joint agreement between the U.S. Department of State and China's National Development and Reform Commission with the overarching goal of addressing the interconnected challenges of environmental, social, and economic sustainability through bi-national research innovation, communication, and entrepreneurship. The 2015 USCEES annual conference on "Critical Zone Science, Sustainability, and Services in a Changing World" was co-sponsored by the U.S. Cross-CZO Working Group on Organic Matter Dynamics and hosted three NSF-funded workshops on organic matter dynamics:1) methods for large and complex data analysis, 2) erosion and deposition processes, and 3) mineralogical and microbial controls on reactivity and persistence. This paper highlights outcomes from the workshops

Progress and priorities for reproductive, maternal, newborn, and child health in Kenya: a Countdown to 2015 country case study.

Science.gov (United States)

Keats, Emily C; Ngugi, Anthony; Macharia, William; Akseer, Nadia; Khaemba, Emma Nelima; Bhatti, Zaid; Rizvi, Arjumand; Tole, John; Bhutta, Zulfiqar A

2017-08-01

Progress in reproductive, maternal, newborn, and child health (RMNCH) in Kenya has been inconsistent over the past two decades, despite the global push to foster accountability, reduce child mortality, and improve maternal health in an equitable manner. Although several cross-sectional assessments have been done, a systematic analysis of RMNCH in Kenya was needed to better understand the push and pull factors that govern intervention coverage and influence mortality trends. As such, we aimed to determine coverage and impact of key RMNCH interventions between 1990 and 2015. We did a comprehensive, systematic assessment of RMNCH in Kenya from 1990 to 2015, using data from nationally representative Demographic Health Surveys done between 1989 and 2014. For comparison, we used modelled mortality estimates from the UN Inter-Agency Groups for Child and Maternal Mortality Estimation. We estimated time trends for key RMNCH indicators, as defined by Countdown to 2015, at both the national and the subnational level, and used linear regression methods to understand the determinants of change in intervention coverage during the past decade. Finally, we used the Lives Saved Tool (LiST) to model the effect of intervention scale-up by 2030. After an increase in mortality between 1990 and 2003, there was a reversal in all mortality trends from 2003 onwards, although progress was not substantial enough for Kenya to achieve Millennium Development Goal targets 4 or 5. Between 1990 and 2015, maternal mortality declined at half the rate of under-5 mortality, and changes in neonatal mortality were even slower. National-level trends in intervention coverage have improved, although some geographical inequities remain, especially for counties comprising the northeastern, eastern, and northern Rift Valley regions. Disaggregation of intervention coverage by wealth quintile also revealed wide inequities for several health-systems-based interventions, such as skilled birth assistance

Ethical behaviour of authors in biomedical journalism.

Science.gov (United States)

Bevan, Joan C

2002-03-01

Biomedical journals communicate new information that changes health-care decisions. If authors ignore the fundamental values of honesty and trust, that information becomes flawed, and society or patients may be harmed. By describing two cases of unethical behaviour by authors, and using them as a focus to review acceptable ethics in publication, this article aims to educate readers who have not considered the ethical implications in writing manuscripts for biomedical journals. Two cases of unethical behaviour by authors occurred when the results of new drug trials were reported. They were discovered after publication in a biomedical journal, and in the review process after the submission of a manuscript for publication respectively. In the first case, duplicate publication was identified because the same control data were used, but not acknowledged, in three publications by the same investigators. In the second, ghost writing by a pharmaceutical company writer was suspected because of the atypical presentation of a senior author's work. The editor consulted with the authors of both reports. In the first case, the authors concurred about the duplication, and the editors of the three journals wrote editorials to record the duplicate publications. The second case of ghost writing was unconfirmed by the authors, but the submission was withdrawn, and the article was later published in another journal. These cases draw attention to recently recognized types of scientific misconduct that influence the perception of scientific work. Duplicate publication and ghost writing not only deceive the reader, but may also conceal flawed study design and conflict of interest.

Who makes European Cohesion Policy: a practitioners’ learning perspective

Directory of Open Access Journals (Sweden)

Fanny Sbaraglia

2016-01-01

Full Text Available Through the European Social Fund (ESF, the European Union subsidizes social inclusion and occupational trainee projects. This policy instrument is formulated by European Union institutions and implemented by regions through a call for projects which requires innovative actions and a result-oriented strategy. It is a key vantage point to observe sub-national implementation of an European Union policy instrument in a sub-national practitioner’s perspective, a topic under-investigated in the literature. For a project to receive funding, sub-national practitioners must take the European Union requirements (accounting standards, evidence of innovation etc. and their social needs into account. Against this backdrop, this research tackles an original question: how can local practitioners adapt their policy actions to fit with European Union requirements? Taking the region of Wallonia in Belgium as a case study, the ESF implementation is considered as a specific policy process in sub-national policy sectors. Adopting an in-depth qualitative perspective, this research contends that it depends on practitioners’ learning, practices and experience of past applications, their specific socio-economic context and income maximization.

Third Level of International Relations: Characteristics of Sub-State Actors

Directory of Open Access Journals (Sweden)

Sergey P. Arteev

2016-01-01

Full Text Available The article is in the genre of the review for textbook O. V. Plotnikova and O. Y. Dubrovina International relations of the regions States: characteristics and features (Moscow: Norma; INFRA-M, 2016. 192 p.. Textbook on international activities of sub-state/subnational actors in international relations. Under the sub-state/subnational actors refers to the regions of the States. The authors propose an along with interstate relations (first level and supranational organizations (second level to distinguish a third level of international relations - international relations of the regions in Federal and unitary States. The topic is very relevant due to the ongoing restructuring of the architecture of international relations and world politics. In addition, these processes lead to involvement in international relations new actors. The resulting configuration and the role of traditional players. In addition to long-term evolutionary processes, we should not forget about the position of Russia in the last few years. It is obvious that the current tensions around the Russian Federation may not be fully resolved with the old methods. At the same time, sub-state/ subnational actors as subjects of a combined nature, the role played by regions of the Russian Federation, able to combine harmoniously in its international activities as the techniques characteristic of the traditional actors - States and developments in the tools of non-traditional actors - international non-governmental and non-profit organizations etc. As a result of positive results can be achieved faster and at the interstate level. The review considers the subject and the relevance of the topic, presents the analysis of the content of the work. Marked strengths of the textbook, including those associated with the consideration of the diagonal ties and the political components in the international activities of the regions. In addition to the advantages, attention is paid to the analysis of

Everyday discrimination and physical health: Exploring mental health processes.

Science.gov (United States)

Earnshaw, Valerie A; Rosenthal, Lisa; Carroll-Scott, Amy; Santilli, Alycia; Gilstad-Hayden, Kathryn; Ickovics, Jeannette R

2016-10-01

Goals of this study were to examine the mental health processes whereby everyday discrimination is associated with physical health outcomes. Data are drawn from a community health survey conducted with 1299 US adults in a low-resource urban area. Frequency of everyday discrimination was associated with overall self-rated health, use of the emergency department, and one or more chronic diseases via stress and depressive symptoms operating in serial mediation. Associations were consistent across members of different racial/ethnic groups and were observed even after controlling for indicators of stressors associated with structural discrimination, including perceived neighborhood unsafety, food insecurity, and financial stress. © The Author(s) 2015.

42 CFR 1005.4 - Authority of the ALJ.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Authority of the ALJ. 1005.4 Section 1005.4 Public... documents at or in relation to hearings; (6) Rule on motions and other procedural matters; (7) Regulate the... Secretary; (5) Review the exercise of discretion by the OIG to exclude an individual or entity under section...

77 FR 32642 - Patents and Inventions; Delegation of Authority

Science.gov (United States)

2012-06-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Patents and... Prevention (CDC), the Deputy Director, DLPP, LSPPPO, OSELS, CDC, and the Chief, Technology Management Branch... regarding the invention and patent program of CDC and the authority to make determinations of rights in...

Status report on Texas Low-Level Radioactive Waste Disposal Authority activities

International Nuclear Information System (INIS)

Avant, R.V. Jr.

1990-01-01

In 1981, the Texas Low-Level Radioactive Waste Disposal Authority was created by Article 4590f-1 to site, develop, operate, decommission, and close a low-level radioactive waste disposal facility for Texas generated waste. In 1989, the Authority's act was recodified by the Texas legislature in the Health and Safety Code., Title 5. Sanitation and Environmental Quality, Subtitle D. Nuclear and Radioactive Materials, Chapter 402. The Authority is governed by a Board of Directors appointed by the Governor, composed of a certified health physicist, geologist, attorney, medical doctor, and two private citizens. Under the statute, low-level radioactive waste is defined as any radioactive material with a half-life of 35 years or less or having less than 10 nanocuries per gram of transuranics. Materials with half-lives of greater than 35 years may be classed as low-level waste if special criteria are established by the Texas Department of Health Bureau of Radiation Control. Subsequent sessions of the legislature have amended the act to revise siting criteria, require consideration of state land, create a Citizen's Advisory Committee, incorporate alternative designs, and establish a special low-level radioactive waste account in the state treasury. The Authority began its activities in 1982. The Authority has proposed a site in far West Texas near Fort Hancock, but El Paso County, the neighboring county to the west, has instituted three separate lawsuits to slow or stop the site selection process. Particular attention was paid early in the site selection process to items which could be fatal flaws from a licensing standpoint. This paper discusses the Fort Hancock site description, site evaluation studies, siting issues, waste volume projections, facility design, license application, cost and schedule

Digital health care--the convergence of health care and the Internet.

Science.gov (United States)

Frank, S R

2000-04-01

The author believes that interactive media (the Internet and the World Wide Web) and associated applications used to access those media (portals, browsers, specialized Web-based applications) will result in a substantial, positive, and measurable impact on medical care faster than any previous information technology or communications tool. Acknowledging the dynamic environment, the author classifies "pure" digital health care companies into three business service areas: content, connectivity, and commerce. Companies offering these services are attempting to tap into a host of different markets within the health care industry including providers, payers, pharmaceutical and medical products companies, employers, distributors, and consumers. As the fastest growing medium in history, and given the unique nature of health care information and the tremendous demand for content among industry professionals and consumers, the Internet offers a more robust and targeted direct marketing opportunity than traditional media. From the medical consumer's standpoint (i.e., the patient) the author sees the Internet as performing five critical functions: (1) Disseminate information, (2) Aid informed decision making, (3) Promote health, (4) Provide a means for information exchange and support--the community concept, and (5) Increase self-care and manage demand for health services, lowering direct medical costs. The author firmly submits the Web will provide overall benefits to the health care economy as health information consumers manage their own health problems that might not directly benefit from an encounter with a health professional. Marrying the Internet to other interactive technologies, including voice recognition systems and telephone-based triage lines among others, holds the promise of reducing unnecessary medical services.

National poverty reduction strategies and HIV/AIDS governance in Malawi: a preliminary study of shared health governance.

Science.gov (United States)

Wachira, Catherine; Ruger, Jennifer Prah

2011-06-01

The public health and development communities understand clearly the need to integrate anti-poverty efforts with HIV/AIDS programs. This article reports findings about the impact of the Poverty Reduction Strategy Paper (PRSP) process on Malawi's National HIV/AIDS Strategic Framework (NSF). In this article we ask, how does the PRSP process support NSF accountability, participation, access to information, funding, resource planning and allocation, monitoring, and evaluation? In 2007, we developed and conducted a survey of Malawian government ministries, United Nations agencies, members of the Country Coordination Mechanism, the Malawi National AIDS Commission (NAC), and NAC grantees (N = 125, 90% response rate), seeking survey respondents' retrospective perceptions of NSF resource levels, participation, inclusion, and governance before, during, and after Malawi's PRSP process (2000-2004). We also assessed principle health sector and economic indicators and budget allocations for HIV/AIDS. These indicators are part of a new conceptual framework called shared health governance (SHG), which seeks congruence among the values and goals of different groups and actors to reflect a common purpose. Under this framework, global health policy should encompass: (i) consensus among global, national, and sub-national actors on goals and measurable outcomes; (ii) mutual collective accountability; and (iii) enhancement of individual and group health agency. Indicators to assess these elements included: (i) goal alignment; (ii) adequate resource levels; (iii) agreement on key outcomes and indicators for evaluating those outcomes; (iv) meaningful inclusion and participation of groups and institutions; (v) special efforts to ensure participation of vulnerable groups; and (vi) effectiveness and efficiency measures. Results suggest that the PRSP process supported accountability for NSF resources. However, the process may have marginalized key stakeholders, potentially undercutting the

Modelling of resource allocation to health care authorities in Stockholm county

DEFF Research Database (Denmark)

Andersson, Paula; Varde, E; Diderichsen, Finn

2000-01-01

ahead. Moreover, two calibration methods are compared: Cross-sectional modelling, based on data for one year only, versus prospective modelling, using population characteristics for one year and registered health-care costs for a following year. While models including diagnostic information are deemed...

The process of regulatory authorization. A report by the CRPPH expert group on the regulatory application of Authorization (EGRA)

International Nuclear Information System (INIS)

2006-01-01

Governments and regulatory authorities are responsible for the definition of regulatory controls or conditions, if any, that should be applied to radioactive sources or radiation exposure situations in order to protect the public, workers and the environment. Although countries use different policy and structural approaches to fulfill this responsibility, the recommendations of the International Commission on Radiological Protection (ICRP) are generally used as at least part of the basis for protection. Previously, the ICRP recommended the use of variable approaches to protection. New ICRP recommendations are proposing a single, conceptually simple and self-coherent approach to defining appropriate protection under all circumstances. While the ICRP has been reviewing the broad principles of protection, the NEA Committee on Radiation Protection and Public Health (CRPPH) has been focusing its efforts on how radiological protection could be better implemented by governments and/or regulatory authorities. To this end, the CRPPH has developed a concept that it calls ''the process of regulatory authorization''. It is described in detail in this report, and is intended to help regulatory authorities apply more transparently, coherently and simply the broad recommendations of the ICRP to the real-life business of radiological protection regulation and application. In developing this concept, the CRPPH recognizes the importance of an appropriate level of stakeholder involvement in the process. (author)

Military Health System Transformation Implications on Health Information Technology Modernization.

Science.gov (United States)

Khan, Saad

2018-03-01

With the recent passage of the National Defense Authorization Act for Fiscal Year 2017, Congress has triggered groundbreaking Military Health System organizational restructuring with the Defense Health Agency assuming responsibility for managing all hospitals and clinics owned by the Army, Navy, and Air Force. This is a major shift toward a modern value-based managed care system, which will require much greater military-civilian health care delivery integration to be in place by October 2018. Just before the National Defense Authorization Act for Fiscal Year 2017 passage, the Department of Defense had already begun a seismic shift and awarded a contract for the new Military Health System-wide electronic health record system. In this perspective, we discuss the implications of the intersection of two large-scope and large-scale initiatives, health system transformation, and information technology modernization, being rolled out in the largest and most complex federal agency and potential risk mitigating steps. The Military Health System will require an expanded unified clinical leadership to spearhead short-term transformation; furthermore, developing, organizing, and growing a cadre of informatics expertise to expand the use and diffusion of novel solutions such as health information exchanges, data analytics, and others to transcend organizational barriers are still needed to achieve the long-term aim of health system reform as envisioned by the National Defense Authorization Act for Fiscal Year 2017.

Author! author!: creating a digital archive of publications in a hospital library setting.

Science.gov (United States)

Rourke, Diane; Samsundar, Devica Ramjit; Shalini, Channapatna

2005-01-01

Baptist Hospital of Miami has been honoring its staff authors annually during National Library Week since 1979, at the time the library was relocated. Upon "doing the math" and realizing that twenty-five years had passed, a special event was planned to celebrate the occasion in 2004. A merger of four hospitals in 1995 to form Baptist Health South Florida, and an addition of a fifth hospital in 2003 added into the complexity of these publications. Organizing the event led to the conclusion that there had to be a "better way" to manage the publication archive. This paper will include a look back at the event's past, present efforts to develop an archival database, and future plans to make articles available electronically to users, copyright permitting.

[Recommendations for inspections of the French nuclear safety authority].

Science.gov (United States)

Rousse, C; Chauvet, B

2015-10-01

The French nuclear safety authority is responsible for the control of radiation protection in radiotherapy since 2002. Controls are based on the public health and the labour codes and on the procedures defined by the controlled health care facility for its quality and safety management system according to ASN decision No. 2008-DC-0103. Inspectors verify the adequacy of the quality and safety management procedures and their implementation, and select process steps on the basis of feedback from events notified to ASN. Topics of the inspection are communicated to the facility at the launch of a campaign, which enables them to anticipate the inspectors' expectations. In cases where they are not physicians, inspectors are not allowed to access information covered by medical confidentiality. The consulted documents must therefore be expunged of any patient-identifying information. Exchanges before the inspection are intended to facilitate the provision of documents that may be consulted. Finally, exchange slots between inspectors and the local professionals must be organized. Based on improvements achieved by the health care centres and on recommendations from a joint working group of radiotherapy professionals and the nuclear safety authority, changes will be made in the control procedure that will be implemented when developing the inspection program for 2016-2019. Copyright © 2015. Published by Elsevier SAS.

The role of narcissism in health-risk and health-protective behaviors.

Science.gov (United States)

Hill, Erin M

2016-09-01

This study examined the role of narcissism in health-risk and health-protective behaviors in a sample of 365 undergraduate students. Regression analyses were used to test the influence of narcissism on health behaviors. Narcissism was positively predictive of alcohol use, marijuana use, and risky driving behaviors, and it was associated with an increased likelihood of consistently having a healthy eating pattern. Narcissism was also positively predictive of physical activity. Results are discussed with reference to the potential short-term and long-term health implications and the need for future research on the factors involved in the relationship between narcissism and health behaviors. © The Author(s) 2015.

Sub-national constitutions in Ethiopia

African Journals Online (AJOL)

eliasn

practice.9 Consequently, the reference to the practice is merely tangential and is intended for ... ico, and Malaysia, from among others. See James A. .... ereignty and the principle of self-rule that constitutes an aspect of federal ..... ernment, to levy and collect state taxes on their own revenue sources, to es- tablish and ...

Using exercises to improve public health preparedness in Asia, the Middle East and Africa.

Science.gov (United States)

Dausey, David J; Moore, Melinda

2014-07-27

Exercises are increasingly common tools used by the health sector and other sectors to evaluate their preparedness to respond to public health threats. Exercises provide an opportunity for multiple sectors to practice, test and evaluate their response to all types of public health emergencies. The information from these exercises can be used to refine and improve preparedness plans. There is a growing body of literature about the use of exercises among local, state and federal public health agencies in the United States. There is much less information about the use of exercises among public health agencies in other countries and the use of exercises that involve multiple countries. We developed and conducted 12 exercises (four sub-national, five national, three sub-regional) from August 2006 through December 2008. These 12 exercises included 558 participants (average 47) and 137 observers (average 11) from 14 countries. Participants consistently rated the overall quality of the exercises as very good or excellent. They rated the exercises lowest on their ability to identifying key gaps in performance. The vast majority of participants noted that they would use the information they gained at the exercise to improve their organization's preparedness to respond to an influenza pandemic. Participants felt the exercises were particularly good at raising awareness and understanding about public health threats, assisting in evaluating plans and identifying priorities for improvement, and building relationships that strengthen preparedness and response across sectors and across countries. Participants left the exercises with specific ideas about the most important actions that they should engage in after the exercise such as improved planning coordination across sectors and countries and better training of health workers and response personnel. These experiences suggest that exercises can be a valuable, low-burden tool to improve emergency preparedness and response in

Measuring population health in Moldova: health expectancies

Directory of Open Access Journals (Sweden)

Cristina Avram

2018-05-01

Full Text Available Health measures are decisive for the development and implementation of population health policies. Monitoring health indicators can lead to improvements in health and decrease in the inequalities among subpopulations. The life expectancy at birth for the Moldovan population did not increase considerably during the last decades, due to the social and economic crisis which led to high mortality and poor health. In Moldova, no aggregated health indicators are utilized for health monitoring. Therefore, the authors calculated health indicators to assess the population health and argue their importance. Mortality and subjective data on self-perceived health and self-rated morbidity from the Household Budget Survey was used for constructing period morbidity-mortality tables. Thus, the authors applied Sullivan’s method to calculate the life expectancy in very good/good/fair health and the life expectancy without chronic morbidity for the period 2006 - 2015. The life expectancies in very good/good/fair health showed a compression of morbidity in the older ages for both sexes, and for rural and urban types of residence. The life expectancies without chronic morbidity for males and for urban dwellers demonstrated an expansion of morbidity. Although the life expectancy is slowly increasing, the trends in population health are contradictory, depending on the applied measures. The health expectancy indicators, based on self-perceived health, depict the actual situation in the population health. These indicators are becoming more essential with the ageing process and can be used for the tailoring of social and health policies and services to the real needs of the population.

Authoring Tools

Science.gov (United States)

Treviranus, Jutta

Authoring tools that are accessible and that enable authors to produce accessible Web content play a critical role in web accessibility. Widespread use of authoring tools that comply to the W3C Authoring Tool Accessibility Guidelines (ATAG) would ensure that even authors who are neither knowledgeable about nor particularly motivated to produce accessible content do so by default. The principles and techniques of ATAG are discussed. Some examples of accessible authoring tools are described including authoring tool content management components such as TinyMCE. Considerations for creating an accessible collaborative environment are also covered. As part of providing accessible content, the debate between system-based personal optimization and one universally accessible site configuration is presented. The issues and potential solutions to address the accessibility crisis presented by the advent of rich internet applications are outlined. This challenge must be met to ensure that a large segment of the population is able to participate in the move toward the web as a two-way communication mechanism.

Becoming Co-Authors: Toward Sharing Authority in Religious Education

Science.gov (United States)

Kim, Hyun-Sook

2009-01-01

This article offers an alternative model, the model of shared authority, to the traditional, authoritarian model for authority and obedience for Religious Education. This model moves away from the authoritarian model of a teacher as the authority and the students as obedient listeners in the direction of a shared authority model in which teachers…

Ethiopia's assessment of emergency obstetric and newborn care: setting the gold standard for national facility-based assessments.

Science.gov (United States)

Keyes, Emily B; Haile-Mariam, Abonesh; Belayneh, Neghist T; Gobezie, Wasihun A; Pearson, Luwei; Abdullah, Muna; Kebede, Henok

2011-10-01

To describe the methods used to implement Ethiopia's 2008 emergency obstetric and newborn care services (EmONC) assessment; highlight how the collaborative process contributed to immediate integration of results into national and subnational planning; and explain how the experience informed the development of a set of tools providing best practices and guidelines for other countries conducting similar assessments. A team of maternal and newborn health experts from the Federal Ministry of Health (FMOH), the United Nations Children's Fund (UNICEF), the World Health Organization (WHO), and the United Nations Population Fund (UNFPA), together with representatives from the Ethiopian Society of Obstetricians and Gynecologists, provided technical guidance for the 18-month process and facilitated demand for and use of the assessment results. Eighty-four trained data collectors administered 9 data collection modules in 806 public and private facilities. Field work and data were managed by a private firm who, together with the core team, implemented a multi-layered plan for data quality. Columbia University's Averting Maternal Death and Disability Program provided technical assistance. Results were published in national and regional reports and in 1-page facility factsheets informing subnational planning activities. Assessment results-which have been published in journal articles-informed water infrastructure improvements, efforts to expand access to magnesium sulfate, and FMOH and UN planning documents. The assessment also established a permanent database for future monitoring of the health system, including geographic locations of surveyed facilities. Ethiopia's assessment was successful largely because of active local leadership, a collaborative process, ample financial and technical support, and rapid integration of results into health system planning. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Review of the ideas of the EGRP: comprehensive authorization

International Nuclear Information System (INIS)

Osborne, R.V.; Turvey, F.J.

2004-01-01

One of the questions addressed in the review of the ideas of the EGRP was whether the process of comprehensive authorization as described in 'The Way Forward: a Contribution to the Evolution of the System of Radiological Protection' would lead to a better system of protection. The process can be seen as a particular application of the general approach taken in assessing and managing health risks of all kinds. Such an approach is to define the problem and put it in context; to analyse the risks; to examine the options for addressing the risk; to decide which option to implement - i.e., the optimum solution; to implement the decision; and to evaluate the results. The EGRP ideas cover the first four steps. In the review we have tested the process of characterisation, screening, and optimisation called here 'comprehensive authorization' - on a variety of sources and exposures, ranging from cosmic ray exposures of the public to radioactive releases from nuclear facilities. Our finding has been that the scores obtained in the characterisation range from less than 35% to more then 65%, the values suggested (see Part 1 of this presentation) as the criteria for excusing from regulatory action and for indicating the need for stakeholder involvement. The comprehensive authorization process would appear to lead to the same general outcomes as does the present system but in a more unified way without some of the confusing terminology. Characterisation looks to be a helpful way of triggering stakeholder involvement, though there may be some difficulty in arriving at a common set of attributes - some 'tuning' is needed. There is still a need for international recommendations on dose constraints and other quantitative guidelines for consideration in the optimisation process. The process of comprehensive authorization appears to be an evolution of the present system, able to take advantage of those parts of the current system that work well. With the comprehensive authorization

Corruption and use of antibiotics in regions of Europe.

Science.gov (United States)

Rönnerstrand, Björn; Lapuente, Victor

2017-03-01

The aim of this article is to investigate the association between corruption and antibiotic use at sub-national level. We explore the correlation between, on the one hand, two measures of corruption (prevalence of corruption in the health sector and prevalence of bribes in the society) at regional level from the European Quality of Government Index; and, on the other, the consumption of antibiotics in those European regions from a 2009 Special Euro Barometer. In a multivariate regression model, we control for potential confounders: purchasing power of standardized regional gross domestic product, inhabitants per medical doctor and age-standardized all-cause mortality rates. We find that there is a strong positive association between both measures of corruption (i.e. in the health sector, and in the society at large) and antibiotics use; and that this association is robust to the introduction of the control variables. These results support previous findings in the literature linking corruption to higher antibiotic use at cross-national level. We show that corruption does seem to account for some of the remarkable between-region variation in antibiotic consumption in Europe. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Evaluation of a medication order writing standards policy in a regional health authority

Science.gov (United States)

Raymond, Colette B.; Coates, Jan; Woloschuk, Donna M. M.

2013-01-01

Background: The Winnipeg Regional Health Authority (WRHA) implemented a medication order writing standards (MOWS) policy (including banned abbreviations) to improve patient safety. Widespread educational campaigns and direct prescriber feedback were implemented. Methods: We audited orders within the WRHA from 2005 to 2009 and surveyed all WRHA staff in 2011 about the policy and suggestions for improving education and compliance. Results: Overall, orders containing banned abbreviations, acronyms or symbols numbered 2261/8565 (26.4%) preimplementation. After WRHA-wide didactic education, the proportion declined to 1358/5461 (24.9%) (p = 0.043) and then, with targeted prescriber feedback, to 1186/6198 (19.1%) (p < 0.0001). A survey of 723 employees showed frequent violations of the MOWS, despite widespread knowledge of the policy. Respondents supported ongoing efforts to enforce the policy within the WRHA. Nonprescribers were significantly more likely than prescribers to agree with statements regarding enhancing compliance by defining prescriber/transcriber responsibilities and placing sanctions on noncompliant prescribers. Discussion: Education, raising general awareness and targeted feedback to prescribers alone are insufficient to ensure compliance with MOWS policies. WRHA staff supported ongoing communication, improved tools such as compliant preprinted orders and reporting and feedback about medication incidents. A surprising number of respondents supported placing sanctions on noncompliant prescribers. Conclusion: Serial audits and targeted interventions such as direct prescriber feedback improve prescription quality in inpatient hospital settings. Education plus direct prescriber feedback had a greater impact than education alone on improving compliance with a MOWS policy. Future efforts at the WRHA to improve compliance will require an expanded focus on incentives, resources and development of action plans that involve all affected staff, not just prescribers

The Relationship Between Airline Cargo Carriers and Port Health Authorities

OpenAIRE

Thakker, Amit

2012-01-01

Over the past few years, UK has seen a steep increase in the demand for imported perishable items, particularly food such as meat and fresh produce. Reports have suggested that the ratio of imports to exports of perishable items in the UK is at 2:1. Significant amounts of these imports are from countries outside the European Union. Many environment and health related events in the last decade, such as the Foot & Mouth disease epidemic in 2001, followed by numerous instances of food contam...

Transnational issue-specific expert networking: A pathway to local policy change.

Science.gov (United States)

O'Brien, Cheryl

2015-12-01

This article reports on key findings from a study of subnational governments in Mexico and Nigeria (O'Brien, 2013). With empirical richness of the case study method and small-n statistical analysis across the subnational units for each country, this study asks: How can we push the needle toward more progressive policy change on violence against women in developing and democratizing contexts? This study finds that issue-specific expert networking is a civic pathway to subnational policy responsiveness in Mexico and Nigeria. The dynamics of this pathway illuminate local-global political connections, and this study shows how issue-specific expert networking is important for the diffusion of an international norm and policies on violence against women. Copyright © 2015 Elsevier Ltd. All rights reserved.

Deployment of community health workers across rural sub-Saharan Africa: financial considerations and operational assumptions.

Science.gov (United States)

McCord, Gordon C; Liu, Anne; Singh, Prabhjot

2013-04-01

To provide cost guidance for developing a locally adaptable and nationally scalable community health worker (CHW) system within primary-health-care systems in sub-Saharan Africa. The yearly costs of training, equipping and deploying CHWs throughout rural sub-Saharan Africa were calculated using data from the literature and from the Millennium Villages Project. Model assumptions were such as to allow national governments to adapt the CHW subsystem to national needs and to deploy an average of 1 CHW per 650 rural inhabitants by 2015. The CHW subsystem described was costed by employing geographic information system (GIS) data on population, urban extents, national and subnational disease prevalence, and unit costs (from the field for wages and commodities). The model is easily replicable and configurable. Countries can adapt it to local prices, wages, population density and disease burdens in different geographic areas. The average annual cost of deploying CHWs to service the entire sub-Saharan African rural population by 2015 would be approximately 2.6 billion (i.e. 2600 million) United States dollars (US$). This sum, to be covered both by national governments and by donor partners, translates into US$ 6.86 per year per inhabitant covered by the CHW subsystem and into US$ 2.72 per year per inhabitant. Alternatively, it would take an annual average of US$ 3750 to train, equip and support each CHW. Comprehensive CHW subsystems can be deployed across sub-Saharan Africa at cost that is modest compared with the projected costs of the primary-health-care system. Given their documented successes, they offer a strong complement to facility-based care in rural African settings.

Health care agreements as a tool for coordinating health and social services

DEFF Research Database (Denmark)

Rudkjøbing, Andreas; Strandberg-Larsen, Martin; Vrangbaek, Karsten

2014-01-01

of general practitioners (n = 700/853). RESULTS: The health care agreements were considered more useful for coordinating care than the previous health plans. The power relationship between the regional and municipal authorities in drawing up the agreements was described as more equal. Familiarity......INTRODUCTION: In 2007, a substantial reform changed the administrative boundaries of the Danish health care system and introduced health care agreements to be signed between municipal and regional authorities. To assess the health care agreements as a tool for coordinating health and social...... with the agreements among general practitioners was higher, as was the perceived influence of the health care agreements on their work. DISCUSSION: Health care agreements with specific content and with regular follow-up and systematic mechanisms for organising feedback between collaborative partners exemplify...

Health 2.0-Lessons Learned: Social Networking With Patients for Health Promotion.

Science.gov (United States)

Sharma, Suparna; Kilian, Reena; Leung, Fok-Han

2014-07-01

The advent of social networking as a major platform for human interaction has introduced a new dimension into the physician-patient relationship, known as Health 2.0. The concept of Health 2.0 is young and evolving; so far, it has meant the use of social media by health professionals and patients to personalize health care and promote health education. Social networking sites like Facebook and Twitter offer promising platforms for health care providers to engage patients. Despite the vast potential of Health 2.0, usage by health providers remains relatively low. Using a pilot study as an example, this commentary reviews the ways in which physicians can effectively harness the power of social networking to meaningfully engage their patients in primary prevention. © The Author(s) 2014.

75 FR 44265 - Office of the Assistant Secretary for Preparedness and Response; Delegation of Authority

Science.gov (United States)

2010-07-28

... involved the exercise of the authorities delegated herein prior to the effective date of the delegation... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Office of the Assistant Secretary... of Health and Human Services under sections 1201-1232 of title 12 of the Public Health Service Act...

Using key performance indicators as knowledge-management tools at a regional health-care authority level.

Science.gov (United States)

Berler, Alexander; Pavlopoulos, Sotiris; Koutsouris, Dimitris

2005-06-01

The advantages of the introduction of information and communication technologies in the complex health-care sector are already well-known and well-stated in the past. It is, nevertheless, paradoxical that although the medical community has embraced with satisfaction most of the technological discoveries allowing the improvement in patient care, this has not happened when talking about health-care informatics. Taking the above issue of concern, our work proposes an information model for knowledge management (KM) based upon the use of key performance indicators (KPIs) in health-care systems. Based upon the use of the balanced scorecard (BSC) framework (Kaplan/Norton) and quality assurance techniques in health care (Donabedian), this paper is proposing a patient journey centered approach that drives information flow at all levels of the day-to-day process of delivering effective and managed care, toward information assessment and knowledge discovery. In order to persuade health-care decision-makers to assess the added value of KM tools, those should be used to propose new performance measurement and performance management techniques at all levels of a health-care system. The proposed KPIs are forming a complete set of metrics that enable the performance management of a regional health-care system. In addition, the performance framework established is technically applied by the use of state-of-the-art KM tools such as data warehouses and business intelligence information systems. In that sense, the proposed infrastructure is, technologically speaking, an important KM tool that enables knowledge sharing amongst various health-care stakeholders and between different health-care groups. The use of BSC is an enabling framework toward a KM strategy in health care.

Authority of Pharmacists to Administer Human Papillomavirus Vaccine: Alignment of State Laws With Age-Level Recommendations.

Science.gov (United States)

Dingman, Deirdre A; Schmit, Cason D

One strategy to increase the uptake of human papillomavirus (HPV) vaccine among adolescents is through the use of pharmacists. Our objectives were to (1) use a publicly available database to describe the statutory and regulatory authority of pharmacists to administer the HPV vaccine in the United States and (2) discuss how the current status of laws may influence achievement of the Healthy People 2020 goal of 80% HPV vaccination rate for teenagers aged 13-15. Using information from the Centers for Disease Control and Prevention's (CDC's) Public Health Law Program database, we identified state laws in effect as of January 1, 2016, giving pharmacists authority to administer vaccines. We used a standardized analysis algorithm to determine whether states' laws (1) authorized pharmacists to administer HPV vaccine, (2) required third-party authorization for pharmacist administration, and (3) restricted HPV vaccine administration by pharmacists to certain patient age groups. Of 50 states and the District of Columbia, 40 had laws expressly granting pharmacists authority to administer HPV vaccine to patients, but only 22 had laws that authorized pharmacists to vaccinate preadolescents aged 11 or 12 (ie, the CDC-recommended age group). Pharmacists were granted prescriptive authority by 5 states, and they were given authority pursuant to general (non-patient-specific) third-party authorization (eg, a licensed health care provider) by 32 states or patient-specific third-party authorization by 3 states. Most states permitted pharmacists to administer HPV vaccines only to boys and girls older than 11 or 12, which may hinder achievement of the Healthy People 2020 goal for HPV vaccination. Efforts should be made to strengthen the role of pharmacists in addressing this public health issue.

21 CFR 101.108 - Temporary exemptions for purposes of conducting authorized food labeling experiments.

Science.gov (United States)

2010-04-01

... authorized food labeling experiments. 101.108 Section 101.108 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD LABELING Exemptions From Food Labeling Requirements § 101.108 Temporary exemptions for purposes of conducting authorized food...

New Developments in Undergraduate Education in Public Health: Implications for Health Education and Health Promotion

Science.gov (United States)

Barnes, Michael D.; Wykoff, Randy; King, Laura Rasar; Petersen, Donna J.

2012-01-01

The article provides an overview of efforts to improve public health and health education training and on the potential use of Critical Component Elements (CCEs) for undergraduate health education programs toward more consistent quality assurance across programs. Considered in the context of the Galway Consensus Conference, the authors discuss the…

Surveillance systems to track progress toward global polio eradication - worldwide, 2012-2013.

Science.gov (United States)

Levitt, Alexandra; Diop, Ousmane M; Tangermann, Rudolf H; Paladin, Fem; Kamgang, Jean Baptiste; Burns, Cara C; Chenoweth, Paul J; Goel, Ajay; Wassilak, Steven G F

2014-04-25

In 2012, the World Health Assembly of the World Health Organization (WHO) declared completion of polio eradication a programmatic emergency. Polio cases are detected through surveillance of acute flaccid paralysis (AFP) cases and subsequent testing of stool specimens for polioviruses (PVs) at WHO-accredited laboratories within the Global Polio Laboratory Network (GPLN). AFP surveillance is supplemented by environmental surveillance, testing sewage samples from selected sites for PVs. Virologic surveillance, including genomic sequencing to identify isolates by genotype and measure divergence between isolates, guides Global Polio Eradication Initiative (GPEI) activities by confirming the presence of PV, tracking chains of PV transmission, and highlighting gaps in AFP surveillance quality. This report provides AFP surveillance quality indicators at national and subnational levels during 2012-2013 for countries that experienced PV cases during 2009-2013 in the WHO African Region (AFR) and Eastern Mediterranean Region (EMR), the remaining polio-endemic regions. It also summarizes the results of environmental surveillance and reviews indicators assessing the timeliness of reporting of PV isolation and of virus strain characterization globally. Regional-level performance indicators for timely reporting of PV isolation were met in five of six WHO regions in 2012 and 2013. Of 30 AFR and EMR countries that experienced cases of PV (wild poliovirus [WPV], circulating vaccine-derived poliovirus [cVDPV], or both) during 2009-2013, national performance indicator targets for AFP surveillance and collection of adequate specimens were met in 27 (90%) countries in 2012 and 22 (73%) in 2013. In 17 (57%) countries, ≥80% of the population lived in subnational areas meeting both AFP performance indicators in 2012, decreasing to 13 (43%) in 2013. To achieve polio eradication and certify interruption of PV transmission, intensive efforts to strengthen and maintain AFP surveillance are

The emergence of maternal health as a political priority in Madhya Pradesh, India: a qualitative study.

Science.gov (United States)

Jat, Tej Ram; Deo, Prakash Ramchandra; Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel

2013-09-30

Politics plays a critical role in agenda setting in health affairs; therefore, understanding the priorities of the political agenda in health is very important. The political priority for safe motherhood has been investigated at the national level in different countries. The objective of this study was to explore why and how maternal health became a political priority at sub-national level in the state of Madhya Pradesh in India. This study followed a qualitative design. Data were collected by carrying out interviews and review of documents. Semi-structured interviews were carried out with twenty respondents from four stakeholder groups: government officials, development partners, civil society and academics. Data analysis was performed using thematic analysis. The analysis was guided by Kingdon's multiple streams model. The emergence of maternal health as a political priority in Madhya Pradesh was the result of convergence in the developments in different streams: the development of problem definition, policy generation and political change. The factors which influenced this process were: emerging evidence of the high magnitude of maternal mortality, civil society's positioning of maternal mortality as a human rights violation, increasing media coverage, supportive policy environment and launch of the National Rural Health Mission (NRHM), the availability of effective policy solutions, India's aspiration of global leadership, international influence, maternal mortality becoming a hot debate topic and political transition at the national and state levels. Most of these factors first became important at national level which then cascaded to the state level. Currently, there is a supportive policy environment in the state for maternal health backed by greater political will and increased resources. However, malnutrition and population stabilization are the competing priorities which may push maternal health off the agenda. The influence of the events and factors

Health products inspection

International Nuclear Information System (INIS)

Stoltz, M.

2009-01-01

To protect public health, the Health Products Inspection is a public service mission where the application of regulations concerning activities on human health products and cosmetic products is verified. This mission permits a global approach to assess the health products risk-based benefit and, in monitoring by laboratory testing and by on site inspections, to verify their compliance with appropriate regulations. The seventy five inspectors perform about eight hundred inspections per year, in France and abroad. These inspections are related to data provided in the health products assessment and also to manufacturing and delivery practices. The French inspection body is also involved in the training of foreign inspectors and in the harmonization of national, European and international practices either for operators than for the competent authorities. (author)

Freedom and Authority: a conceptual focus in work with violent ...

African Journals Online (AJOL)

The author presents a case example and makes recommendations regarding how psycho-analytically informed work with offenders could be adapted in order to respond to the particular demands encountered in therapeutic endeavours. Southern African Jnl Child and Adolescent Mental Health Vol.14(1) 2002: 37-49.

Hypochondriasis, somatization, and perceived health and utilization of health care services.

Science.gov (United States)

Hollifield, M; Paine, S; Tuttle, L; Kellner, R

1999-01-01

The authors determined the different effects of hypochondriasis and somatization on health perceptions, health status, and service utilization in a primary care population. The subjects with hypochondriacal responses (HR) on the Illness Attitudes Scales or high somatic concern (HSC) on the Symptom Questionnaire had a worse perception of health and variably used more health services than the control subjects, even though the HR and HSC subjects had the same level of chronic medical disorders. Regression analyses determined that somatization contributed more to negative health perception and service utilization than did hypochondriasis, although an interaction between the two contributed to the use of psychiatric care. The authors discuss the boundary between hypochondriasis and somatization for its implications for research and clinical practice.

Uses of population census data for monitoring geographical imbalance in the health workforce: snapshots from three developing countries

Directory of Open Access Journals (Sweden)

Diallo Khassoum

2003-12-01

terms of constraints for the effective deployment, management and retention of HRH, and ultimately for the equitable delivery of health services. A number of advantages were revealed of using census data in health research, notably the potential for producing detailed statistics on health workforce characteristics at the sub-national level. However, lack of consistency in the compilation and processing of occupational information over time and across countries continues to hamper comparative analyses for HRH policy monitoring and evaluation.

International safeguards and nuclear terrorism

International Nuclear Information System (INIS)

Moglewer, S.

1987-01-01

This report provides a critical review of the effectiveness of International Atomic Energy Agency (IAEA) safeguards against potential acts of nuclear terrorism. The author argues that IAEA safeguards should be made applicable to deterring diversions of nuclear materials from civil to weapons purposes by subnational groups as well as by nations. Both technical and institutional factors are considered, and suggestions for organizational restructuring and further technical development are made. Awareness of the necessity for effective preventive measures is emphasized, and possible directions for further effort are suggested

UNEARTHING THE PURPORTS OF TRUST IN AUTHORITIES AND POWER OF AUTHORITIES IN THE LATIN AMERICAN TAX CLIMATE

Directory of Open Access Journals (Sweden)

LARISSA BǍTRÂNCEA

2014-06-01

decision-making on comprehensive valuations of trust and power may prove cost-effective for any authority concerned with enacting the appropriate weighting of tax incentives and enforcement strategies in order to enhance compliance; it may urge taxpayers to match the actions of an equitable authority and cooperate; it may serve investors as a guide to determine the efficiency, credibility and stability of Latin American fiscal systems; it may assist financing international organizations to detect the possible risks and vulnerabilities of the relationship between authorities and taxpayers and evaluate the headway/regress registered by a particular country within this tax climate. In terms of trust, various countries in the region have implemented solid strategies to sustain competitiveness, infrastructure, innovation or health. In terms of power, several tax authorities are deemed as rather weak in mitigating noncompliance. Nevertheless, massive investments in infrastructure prove commitment in nixing evasion.

BOOK REVIEW - OCCUPATIONAL HEALTH FOR HEALTH CARE PROFESSIONALS

Directory of Open Access Journals (Sweden)

VARIOUS AUTHORS

2008-01-01

Full Text Available This compendium of essays by 30 authors is a contribution to the Malaysian ever growing storehouse of medical publications. It is a worthwhile project for the Malaysian Medical Association to have undertaken to publish this long awaited book, because the content of the book involves the care of its own members. The health of the healthcare providers is often taken for granted while carrying out their duties of a doctor. They forget their own health and they expose themselves to the risk of disease every day of their lives. This book, with twenty-two chapters, covers in detail the occupational concerns of health care professionals. The chapters outline the common pitfalls in the healthcare system into which the professionals may fall into. All health care facilities are high risk venues for which not sufficient preventive systems are in place. The various risk factors are highlighted by the different authors both from the point of view of the professional and the patient. In support of preventive efforts the authors refer to the various statutory requirements in place. In spite of the provisions, the authors cite many instances of diseases and disasters the professional suffer from and are exposed to daily. This book will be of use both not only to the student of occupational health but also to every healthcare professional. It raises the awareness of personal protection and prevention since the chance of disaster awaits every morning. The dictum of “Physician, heal thyself” may come too late if this book does not evoke caution every day. It is well written with cases documenting poor infrastructure requirements to carry out their duties in a safe and efficient manner. References are well documented by all the authors to inspire further work in this area. Associate Professor Dr Jayakumar comes from the backgrounds of both academic and corporate sectors and therefore contributes his wealth of knowledge and experience while Associate Professor

Use of a knowledge synthesis by decision makers and planners to facilitate system level integration in a large Canadian provincial health authority

Directory of Open Access Journals (Sweden)

Esther Suter

2011-03-01

Full Text Available Purpose: The study is an examination of how a knowledge synthesis, conducted to fill an information gap identified by decision makers and planners responsible for integrating health systems in a western Canadian health authority, is being used within that organisation. Methods: Purposive sampling and snowball technique were used to identify 13 participants who were interviewed about how they are using the knowledge synthesis for health services planning and decision-making. Results: The knowledge synthesis is used by those involved in the strategic direction of the provincial healthcare organisation and those tasked with the operationalization of integration at the provincial or local level. Both groups most frequently use the ten key principles for integration, followed by the sections on integration processes, strategies and models. The key principles facilitate discussion on priority areas to be considered and provide a reference point for a desired future state. Perceived information gaps relate to a lack of detail on "how to" strategies, tools and processes that would lead to successful integration. Discussion and conclusion: The current project demonstrates that decision makers and planners will effectively use a knowledge synthesis if it is timely, relevant and accessible. The information can be applied at strategic and operations levels. Attention needs to be paid to include more information on implementation strategies and processes. Including knowledge users in identifying research questions will increase information uptake.