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Sample records for system strengthening national

  1. Governing the Lebanese health system: strengthening the national response to the burden of Syrian refugees.

    Science.gov (United States)

    Santoro, Alessio; McKee, Martin

    2017-08-20

    Lebanon is providing sanctuary to an estimated 1.5 million Syrian refugees, with potential consequences for its health system. Here, we analyse how it has responded to this challenge, identify sensitive areas where a strong national governance system is needed and explore how it might be implemented. An effective response to the Syrian refugee crisis requires concerted international action. Nonetheless, geography dictates that the Lebanese health system must play a central role. We identify some areas where a strengthened stewardship role of the Ministry of Public Health is urgently required. We argue that the Ministry is well placed to take a lead, with its detailed knowledge of the Lebanese health system and its legitimacy to formulate a national health response. Finally, we suggest that this crisis could be a catalyst for the strengthening of the Lebanese health system, based on evidence-informed policies that would benefit refugees and the Lebanese population alike.

  2. Strengthening systems for integrated early childhood development services: a cross-national analysis of governance.

    Science.gov (United States)

    Britto, Pia Rebello; Yoshikawa, Hirokazu; van Ravens, Jan; Ponguta, Liliana Angelica; Reyes, Maria; Oh, Soojin; Dimaya, Roland; Nieto, Ana María; Seder, Richard

    2014-01-01

    While there has been substantial growth in early childhood development (ECD) services in low- and middle-income countries (LMICs), there is considerable inequity in their distribution and quality. Evidence-based governance strategies are necessary, but currently they are insufficient for widespread, quality implementation. In particular, there is a limited understanding of the use of systems approaches for the analysis of ECD services as they go to scale. The aim of this paper is to present findings from four countries, using a cross-national case study approach to explore governance mechanisms required to strengthen national systems of ECD services. While different sets of governance strategies and challenges were identified in each country, overarching themes also emerged with implications for systems strengthening. Study results focus on local, mid-level and central governance, with recommendations for effective coordination and the integration of ECD services in LMICs. © 2014 New York Academy of Sciences.

  3. Regional Innovation System Strengthening Program (SIDa as an Exit Strategy National Community Development Program (PNPM

    Directory of Open Access Journals (Sweden)

    Teguh Narutomo

    2014-06-01

    Full Text Available The aim of this study was to evaluate the PNPM program and follow the program with SIDA Strengthening Program. The research method used is a qualitative method approach of this research through the evaluation research design that builds on the CIPP evaluation model (Context-Input-Process-Product. Since the failure of theories and models of development are too glorifies growth, makes many people turn to focus on people development, which includes requiring optimization of local resources, participation, and empowerment. Since then, "empowerment" which was introduced in Indonesia has been anesthetized and made many hopes among many parties. In 2007 started the National Program for Community Empowerment (PNPM which continue Kecamatan Development Program (KDP. PNPM 2014 which is part of the United Indonesia Cabinet Volume 2 is going to end. For that we need to look for an exit strategy program that can maintain sustainability of PNPM. Regional Innovation Systems Strengthening Program (SIDA is a program of the whole process in one system to foster innovation made between government institutions, local governments, research institutions, educational institutions, innovation support institutions, businesses, and communities in areas that have been implemented since the 2012 SIDA program is an empowerment program as well, both to the public and even empowering to all elements such as academia, private industry, government and society.

  4. Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems.

    Science.gov (United States)

    Stucki, Gerold; Bickenbach, Jerome; Melvin, John

    2017-09-01

    A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

  5. Evaluation of regional project to strengthen national health research systems in four countries in West Africa: lessons learned.

    Science.gov (United States)

    Sombié, Issiaka; Aidam, Jude; Montorzi, Gabriela

    2017-07-12

    Since the Commission on Health Research for Development (COHRED) published its flagship report, more attention has been focused on strengthening national health research systems (NHRS). This paper evaluates the contribution of a regional project that used a participatory approach to strengthen NHRS in four post-conflict West African countries - Guinea-Bissau, Liberia, Sierra Leone and Mali. The data from the situation analysis conducted at the start of the project was compared to data from the project's final evaluation, using a hybrid conceptual framework built around four key areas identified through the analysis of existing frameworks. The four areas are governance and management, capacities, funding, and dissemination/use of research findings. The project helped improve the countries' governance and management mechanisms without strengthening the entire NHRS. In the four countries, at least one policy, plan or research agenda was developed. One country put in place a national health research ethics committee, while all four countries could adopt a research information management system. The participatory approach and support from the West African Health Organisation and COHRED were all determining factors. The lessons learned from this project show that the fragile context of these countries requires long-term engagement and that support from a regional institution is needed to address existing challenges and successfully strengthen the entire NHRS.

  6. Recommendations for strengthening the national systems and the international regime for combating of illicit trafficking. Keynote address/session 10

    International Nuclear Information System (INIS)

    Ek, P.; Wredberg, L.

    2001-01-01

    internal control, quality assurance, security culture and individual responsibilities; Shortage of suitable and modern equipment for monitoring and detection of radioactive material; Shortage of staff and training capabilities and insufficient financial resources concerning supervision and law enforcement authorities; Insufficient access to relevant information and data bases. A first step to improve national systems would be to assist states, by educating key-persons and authority staff, how to establish good, state-of-the-art national systems for combating of illicit trafficking, which would meet the requirements of international legal instruments, recommendations and guidelines. State Governments need to be made more aware of the seriousness of the proliferation threat and be convinced that supervision and law enforcement resources must be reinforced for bringing their national systems up to international standard. On the international level, combating of illicit trafficking would be ameliorated by improving the communication links between national authorities bi-laterally and with the international organisations. Also increased information exchange between national and international databases would improve prevention and detection capabilities. For the effective and consequent combating of illicit trafficking of nuclear material and equipment, it is, however, necessary that the international non-proliferation regime be strengthened through new initiatives and approaches. These should focus on, inter alia, a set of minimum requirements to be implemented, and to pursue, impose, follow-up and audit the implementation of those requirements into the national systems for combating of illicit trafficking. The IAEA is the recognised international organisation, both for nuclear energy promoting activities, and for the implementation of the international non-proliferation regime. The IAEA has, within its area of competence, relevant know-how and capability, including qualified

  7. Health Systems Strengthening

    DEFF Research Database (Denmark)

    Hanlin, Rebecca; Andersen, Margrethe Holm

    The Global Network for the Economics of Learning, Innovation, and Competence Building Systems (Globelics) is an open and diverse community of scholars working on innovation and competence building in the context of economic development. The major purpose of the network is to contribute to building...... capacity and create a forum for exchange worldwide in the innovation and development research field. This book is the fourth in the series of thematic reviews from the Globelics Secretariat. Aalborg University and Sida, the Swedish International Development Cooperation Agency, support the series....

  8. Strengthening National Identity through National Symbols and ...

    African Journals Online (AJOL)

    The objective is that the onus falls on national leaders to take ownership of the symbols so that these symbols can be internalised and a stronger national identity created. The use of national symbols must transcend issues of ethnicity, race and language. The method utilised assists in developing a conceptual approach to ...

  9. The interface between the national tuberculosis control programme and district hospitals in Cameroon: missed opportunities for strengthening the local health system -a multiple case study.

    Science.gov (United States)

    Keugoung, Basile; Macq, Jean; Buve, Anne; Meli, Jean; Criel, Bart

    2013-03-22

    Tuberculosis remains a major public health problem in sub-Saharan Africa. District hospitals (DHs) play a central role in district-based health systems, and their relation with vertical programmes is very important. Studies on the impact of vertical programmes on DHs are rare. This study aims to fill this gap. Its purpose is to analyse the interaction between the National Tuberculosis Control Programme (NTCP) and DHs in Cameroon, especially its effects on the human resources, routine health information system (HIS) and technical capacity at the hospital level. We used a multiple case study methodology. From the Adamaoua Region, we selected two DHs, one public and one faith-based. We collected qualitative and quantitative data through document reviews, semi-structured interviews with district and regional staff, and observations in the two DHs. The NTCP trained and supervised staff, designed and provided tuberculosis data collection and reporting tools, and provided anti-tuberculosis drugs, reagents and microscopes to DHs. However, these interventions were limited to the hospital units designated as Tuberculosis Diagnostic and Treatment Centres and to staff dedicated to tuberculosis control activities. The NTCP installed a parallel HIS that bypassed the District Health Services. The DH that performs well in terms of general hospital care and that is well managed was successful in tuberculosis control. Based on the available resources, the two hospitals adapt the organisation of tuberculosis control to their settings. The management teams in charge of the District Health Services are not involved in tuberculosis control. In our study, we identified several opportunities to strengthen the local health system that have been missed by the NTCP and the health system managers. Well-managed DHs perform better in terms of tuberculosis control than DHs that are not well managed. The analysis of the effects of the NTCP on the human resources, HIS and technical capacity of DHs

  10. Strengthening public health surveillance and response using the health systems strengthening agenda in developing countries

    Directory of Open Access Journals (Sweden)

    Mukanga David

    2010-12-01

    Full Text Available Abstract There is increased interest in strengthening health systems for developing countries. However, at present, there is common uncertainty about how to accomplish this task. Specifically, several nations are faced with an immense challenge of revamping an entire system. To accomplish this, it is essential to first identify the components of the system that require modification. The World Health Organization (WHO has proposed health system building blocks, which are now widely recognized as essential components of health systems strengthening. With increased travel and urbanization, the threat of emerging diseases of pandemic potential is increasing alongside endemic diseases such as human immunodeficiency virus (HIV, tuberculosis (TB, malaria, and hepatitis virus infections. At the same time, the epidemiologic patterns are shifting, giving rise to a concurrent increase in disease burden due to non-communicable diseases. These diseases can be addressed by public health surveillance and response systems that are operated by competent public health workers in core public health positions at national and sub-national levels with a focus on disease prevention. We describe two ways that health ministries in developing countries could leverage President Obama’s Global Health Initiative (GHI to build public health surveillance and response systems using proven models for public health systems strengthening and to create the public health workforce to operate those systems. We also offer suggestions for how health ministries could strengthen public health systems within the broad health systems strengthening agenda. Existing programs (e.g., the Global Vaccine Alliance [GAVI] and the Global Fund Against Tuberculosis, AIDS, and Malaria [GFTAM] can also adapt their current health systems strengthening programs to build sustainable public health systems.

  11. An analysis of Liberia's 2007 national health policy: lessons for health systems strengthening and chronic disease care in poor, post-conflict countries

    Directory of Open Access Journals (Sweden)

    Chan Brian T

    2011-10-01

    Full Text Available Abstract Background Globally, chronic diseases are responsible for an enormous burden of deaths, disability, and economic loss, yet little is known about the optimal health sector response to chronic diseases in poor, post-conflict countries. Liberia's experience in strengthening health systems and health financing overall, and addressing HIV/AIDS and mental health in particular, provides a relevant case study for international stakeholders and policymakers in other poor, post-conflict countries seeking to understand and prioritize the global response to chronic diseases. Methods We conducted a historical review of Liberia's post-conflict policies and their impact on general economic and health indicators, as well as on health systems strengthening and chronic disease care and treatment. Key sources included primary documents from Liberia's Ministry of Health and Social Welfare, published and gray literature, and personal communications from key stakeholders engaged in Liberia's Health Sector Reform. In this case study, we examine the early reconstruction of Liberia's health care system from the end of conflict in 2003 to the present time, highlight challenges and lessons learned from this initial experience, and describe future directions for health systems strengthening and chronic disease care and treatment in Liberia. Results Six key lessons emerge from this analysis: (i the 2007 National Health Policy's 'one size fits all' approach met aggregate planning targets but resulted in significant gaps and inefficiencies throughout the system; (ii the innovative Health Sector Pool Fund proved to be an effective financing mechanism to recruit and align health actors with the 2007 National Health Policy; (iii a substantial rural health delivery gap remains, but it could be bridged with a robust cadre of community health workers integrated into the primary health care system; (iv effective strategies for HIV/AIDS care in other settings should be

  12. Strengthening Injury Surveillance System in Iran

    Directory of Open Access Journals (Sweden)

    Motevalian Seyed Abbas

    2012-02-01

    Full Text Available 【Abstract】Objective: To strengthen the current Injury Surveillance System (IS System in order to better monitor injury conditions, improve protection ways and promote safety. Methods: At first we carried out a study to evaluate the frameworks of IS System in the developed countries. Then all the available documents from World Health Organization, Eastern Mediterranean Regional Organization, as well as Minister of Health and Medical Education concerning Iran were reviewed. Later a national stakeholder抯 consultation was held to collect opinions and views. A national workshop was also intended for provincial representatives from 41 universities to identify the barriers and limitations of the existing program and further to strengthen injury surveillance. Results: The evaluation of the current IS System revealed many problems, mainly presented as lack of accurate pre- and post-hospital death registry, need of precise injury data registry in outpatient medical centers, incomplete injury data registry in hospitals and lack of accuracy in definition of variables in injury registry. The five main characteristics of current IS System including flexibility, acceptability, simplicity, usefulness and timeliness were evaluated as moderate by experts. Conclusions: Major revisions must be considered in the current IS System in Iran. The following elements should be added to the questionnaire: identifier, manner of arrival to the hospital, situation of the injured patient, consumption of alcohol and opioids, other involved participants in the accident, intention, severity and site of injury, side effects of surgery and medication, as well as one month follow-up results. Data should be collected from 10% of all hospitals in Iran and analyzed every 3 months. Simultaneously data should be online to be retrieved by researches. Key words: Wounds and injuries; Population surveillance; Registries; Iran

  13. Strengthening Dairy Cooperative through National Development of Livestock Region

    Directory of Open Access Journals (Sweden)

    Priyono

    2016-02-01

    Full Text Available Establishment of dairy cattle development region needs to be conducted in accordance with the national dairy industry development plan. Dairy cattle regions have been designed and equipped with infrastructure supplies, supporting facilities, technologies, finance, processing, marketing, institutional and human resources. Dairy cooperative is one of the marketing channels of milk and milk products which have strategic roles to support the national dairy industry. Collaborations between dairy cooperatives and smallholder farmers within a district region have to be done based on agricultural ecosystems, agribusiness system, integrated farming and participatory approach. This may improve dairy cooperatives as an independent and competitive institution. Strengthening dairy cooperatives in national region dairy cattle was carried out through institutional inventory and dairy cooperatives performance; requirement of capital access, market and networks as well as education and managerial training; certification and accreditation feasibility analysis and information and technology utilization. Establishment of emerging dairy cooperatives towards small and micro enterprises is carried out by directing them to establish cooperatives which have legal certainty and business development opportunities. The impact of strengthening dairy cooperative may support dairy cattle development through increase population and milk production. Sustainable dairy cattle development needs to be supported by regional and national government policies.

  14. Strengthening agricultural innovation systems in Nigeria | Esu ...

    African Journals Online (AJOL)

    This study highlighted the relevance of agricultural innovation systems, challenges encountered by the organisations associated with these innovation systems and the various ways of strengthening the linkages among these organizations. Agricultural innovation systems such as commodity-based innovation system, ...

  15. Addressing the social determinants of health through health system strengthening and inter-sectoral convergence: the case of the Indian National Rural Health Mission

    Science.gov (United States)

    Prasad, Amit Mohan; Chakraborty, Gautam; Yadav, Sajjan Singh; Bhatia, Salima

    2013-01-01

    Background At the turn of the 21st century, India was plagued by significant rural–urban, inter-state and inter-district inequities in health. For example, in 2004, the infant mortality rate (IMR) was 24 points higher in rural areas compared to urban areas. To address these inequities, to strengthen the rural health system (a major determinant of health in itself) and to facilitate action on other determinants of health, India launched the National Rural Health Mission (NRHM) in April 2005. Methods Under the NRHM, Rs. 666 billion (US$12.1 billion) was invested in rural areas from April 2005 to March 2012. There was also a substantially higher allocation for 18 high-focus states and 264 high-focus districts, identified on the basis of poor health and demographic indicators. Other determinants of health, especially nutrition and decentralized action, were addressed through mechanisms like State/District Health Missions, Village Health, Sanitation and Nutrition Committees, and Village Health and Nutrition Days. Results Consequently, in bigger high-focus states, rural IMR fell by 15.6 points between 2004 and 2011, as compared to 9 points in urban areas. Similarly, the maternal mortality rate in high-focus states declined by 17.9% between 2004–2006 and 2007–2009 compared to 14.6% in other states. Conclusion The article, on the basis of the above approaches employed under NRHM, proposes the NRHM model to ‘reduce health inequities and initiate action on SDH’. PMID:23458089

  16. Distribution network strengthens sales systems

    International Nuclear Information System (INIS)

    Janoska, J.

    2003-01-01

    Liberalisation of the electricity market pushes Slovak distribution companies to upgrade their sale technologies. The first one to invest into a complex electronic sales system will be Stredoslovenska energetika, a.s., Zilina. The system worth 200 million Sk (4,83 million Euro) will be supplied by Polish software company Winuel. The company should also supply a software that would allow forecasting and planning of sales. The system should be fully operational by 2006. TREND has not managed to obtain information regarding plans Zapadoslovenska energetika - the largest and most active distribution company - might have in this area. In eastern Slovakia distribution company Vychodoslovenska energetika, a.s., Kosice has also started addressing this issue. (Author)

  17. Strengthening health systems in Africa | IDRC - International ...

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

    2016-04-29

    Apr 29, 2016 ... Strengthening health systems means overcoming challenges such as staff shortages and inequities in access to care. Ten teams focused their research primarily on frontline health workers and health information systems. Through various studies and interventions, these researchers aimed to make health ...

  18. Contextual factors affecting health information system strengthening.

    Science.gov (United States)

    Thomas, James C

    2017-12-01

    At the turn of the century, several major efforts were initiated to combat HIV/AIDS and other major epidemics affecting low- and middle-income countries (LMICs). They were accompanied by initiatives to enable recipient countries to collect and use data to guide their public health programmes. These health information systems (HIS) typify systems in that they have multiple interacting components, and they are embedded within larger systems. Components of a larger system act as the context for all lower-level systems. Their effects can be pervasive, and thus be taken for granted or regarded as unchangeable. We identify four contextual factors that affect efforts to strengthen HIS: hierarchical roles, aid funding, corruption, and competing priorities. We provide examples of each as experienced by those working to strengthen HIS in LMICs. Each of these contextual factors can seriously diminish the effectiveness of HIS strengthening efforts and their long-term sustainability. We propose research questions about each that would enable those engaged in HIS strengthening to work effectively and sustainably.

  19. Coordinating and Strengthening the Health Research System in ...

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

    ... interview expert witnesses, make field trips, commission papers and design a comprehensive plan for a NHRB that will strengthen health research capacity in the country. The architecture of the NHRB will be the actual output of the project. The expected outcome will be a robust, functional national health research system.

  20. Strengthening Governance in Health Systems for Reproductive ...

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

    Strengthening Governance in Health Systems for Reproductive Health and Rights in Pakistan. Pakistan, with the world's sixth largest population, is part of a region that is notorious for its social and gender inequities. As a low-income country, its population has faced numerous economic challenges, especially in the last two ...

  1. Strengthening Local Agricultural Innovation Systems in Tanzania ...

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

    Strengthening Local Agricultural Innovation Systems in Tanzania and Malawi. In many sub-Saharan African countries, poverty is linked to low agricultural productivity, which climate change threatens to aggravate. This action-research project aims to bring together institutions and individuals from the research, policymaking ...

  2. Strengthening Health Systems Research Capacity in Mozambique ...

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

    There have been some successes in reducing the disease burden through programs targeting specific communicable diseases such as tuberculosis, malaria, and HIV-AIDS. However, further improvements cannot be achieved without addressing broad health systems issues. This research project will strengthen health ...

  3. A study on strategy for strengthening national nuclear competitive force

    International Nuclear Information System (INIS)

    Yang, M. H.; Oh, K. B.; Lee, H. M. and others

    2002-02-01

    It is expected that world energy and electric power demand will continuously increase in the 21st century. To secure energy resources, therefore, is emerging as the major issue of national policy. Korea, because of his scarcity of energy resources, should improve the national energy security through expansion of nuclear energy utilization. This means that policy to strengthen nuclear energy competitiveness should have a high priority over other national policies. The USA is implementing the policy of expansion and activation of nuclear energy utilization to coping with national energy demand growth. To do this, the USA are carrying out the development of Generation IV Nuclear Energy System(Gen IV) with an international collaboration. IAEA also promote an international program to develop the future innovative nuclear reactors and fuel cycles (INPRO). It is expected that Gen IV and INPRO will lead the future nuclear energy market. The Gen IV will have better economics and safety than existing nuclear energy systems and consider the non-proliferation and physical protection concepts. It is, therefore, essential to reinforce the R and D of proliferation-resistant nuclear technologies. The enhancement of national competitiveness in nuclear energy field requires the integration of a policy of nuclear industrial competitiveness improvement with that of nuclear technological capability enhancement. This integration will be beneficial and essential to explore a foreign nuclear market and global competitiveness in association with domestic industrial development. In addition, international cooperation and nuclear diplomacy, coupled with the establishment of local institutional environment, is required to advance in foreign market with the domestic competitiveness enhanced. The enhancement of national competitiveness in the nuclear field directly connects with nuclear technology competitiveness, which should be initiated from activation of nuclear R and D and stable fund

  4. Strengthening Health Systems to Accelerate Achievement of ...

    African Journals Online (AJOL)

    Strengthening Health Systems to Accelerate Achievement of Millennium Development Goals 4 and 5: A Case Study of Ketu South and Keta Municipalities in Ghana. ... de santé pour accélérer la réalisation des OMD 4 et 5 dans la région de la Volta au Ghana, avec un accent particulier sur les municipalités Ketu Sud et Keta.

  5. Strengthening the Canadian alcohol advertising regulatory system.

    Science.gov (United States)

    Heung, Carly M; Rempel, Benjamin; Krank, Marvin

    2012-05-24

    Research evidence points to harmful effects from alcohol advertising among children and youth. In particular, exposure to alcohol advertising has been associated with adolescents drinking both earlier and heavier. Although current federal and provincial guidelines have addressed advertising practices to prevent underage drinking, practice has not been supported by existing policy. While protective measures such as social marketing campaigns have the potential for counteracting the effects from alcohol advertising, the effectiveness of such measures can be easily drowned out with increasing advertising activities from the alcohol industry, especially without effective regulation. Research reviewed by the European Focus on Alcohol Safe Environment (FASE) Project has identified a set of key elements that are necessary to make alcohol advertising policy measures effective at protecting children and youth from the harmful effects of alcohol marketing. Using these key elements as an evaluation framework, there are critical components in the Canadian alcohol advertising regulatory system that clearly require strengthening. To protect impressionable children and youth against the harmful effects of alcohol advertising, 13 recommendations to strengthen current alcohol advertising regulations in Canada are provided for Canadian policy-makers, advertising standard agencies, and public health groups.

  6. Use of a Balanced Scorecard in strengthening health systems in developing countries: an analysis based on nationally representative Bangladesh Health Facility Survey.

    Science.gov (United States)

    Khan, M Mahmud; Hotchkiss, David R; Dmytraczenko, Tania; Zunaid Ahsan, Karar

    2013-01-01

    This paper illustrates the importance of collecting facility-based data through regular surveys to supplement the administrative data, especially for developing countries of the world. In Bangladesh, measures based on facility survey indicate that only 70% of very basic medical instruments and 35% of essential drugs were available in health facilities. Less than 2% of officially designated obstetric care facilities actually had required drugs, injections and personnel on-site. Majority of (80%) referral hospitals at the district level were not ready to provide comprehensive emergency obstetric care. Even though the Management Information System reports availability of diagnostic machines in all district-level and sub-district-level facilities, it fails to indicate that 50% of these machines are not functional. In terms of human resources, both physicians and nurses are in short supply at all levels of the healthcare system. The physician-nurse ratio also remains lower than the desirable level of 3.0. Overall job satisfaction index was less than 50 for physicians and 66 for nurses. Patient satisfaction score, however, was high (86) despite the fact that process indicators of service quality were poor. Facility surveys can help strengthen not only the management decision-making process but also the quality of administrative data. Copyright © 2012 John Wiley & Sons, Ltd.

  7. Global health initiative investments and health systems strengthening: a content analysis of global fund investments

    OpenAIRE

    Warren, Ashley E; Wyss, Kaspar; Shakarishvili, George; Atun, Rifat; de Savigny, Don

    2013-01-01

    Background: Millions of dollars are invested annually under the umbrella of national health systems strengthening. Global health initiatives provide funding for low- and middle-income countries through disease-oriented programmes while maintaining that the interventions simultaneously strengthen systems. However, it is as yet unclear which, and to what extent, system-level interventions are being funded by these initiatives, nor is it clear how much funding they allocate to disease-specific a...

  8. Integrated Disease Investigations and Surveillance planning: a systems approach to strengthening national surveillance and detection of events of public health importance in support of the International Health Regulations

    Directory of Open Access Journals (Sweden)

    Kennedy Sarah

    2010-12-01

    Full Text Available Abstract The international community continues to define common strategic themes of actions to improve global partnership and international collaborations in order to protect our populations. The International Health Regulations (IHR[2005] offer one of these strategic themes whereby World Health Organization (WHO Member States and global partners engaged in biosecurity, biosurveillance and public health can define commonalities and leverage their respective missions and resources to optimize interventions. The U.S. Defense Threat Reduction Agency’s Cooperative Biologica Engagement Program (CBEP works with partner countries across clinical, veterinary, epidemiological, and laboratory communities to enhance national disease surveillance, detection, diagnostic, and reporting capabilities. CBEP, like many other capacity building programs, has wrestled with ways to improve partner country buy-in and ownership and to develop sustainable solutions that impact integrated disease surveillance outcomes. Designing successful implementation strategies represents a complex and challenging exercise and requires robust and transparent collaboration at the country level. To address this challenge, the Laboratory Systems Development Branch of the U.S. Centers for Disease Control and Prevention (CDC and CBEP have partnered to create a set of tools that brings together key leadership of the surveillance system into a deliberate system design process. This process takes into account strengths and limitations of the existing system, how the components inter-connect and relate to one another, and how they can be systematically refined within the local context. The planning tools encourage cross-disciplinary thinking, critical evaluation and analysis of existing capabilities, and discussions across organizational and departmental lines toward a shared course of action and purpose. The underlying concepts and methodology of these tools are presented here.

  9. Integrated Disease Investigations and Surveillance planning: a systems approach to strengthening national surveillance and detection of events of public health importance in support of the International Health Regulations.

    Science.gov (United States)

    Taboy, Celine H; Chapman, Will; Albetkova, Adilya; Kennedy, Sarah; Rayfield, Mark A

    2010-12-03

    The international community continues to define common strategic themes of actions to improve global partnership and international collaborations in order to protect our populations. The International Health Regulations (IHR[2005]) offer one of these strategic themes whereby World Health Organization (WHO) Member States and global partners engaged in biosecurity, biosurveillance and public health can define commonalities and leverage their respective missions and resources to optimize interventions. The U.S. Defense Threat Reduction Agency's Cooperative Biological Engagement Program (CBEP) works with partner countries across clinical, veterinary, epidemiological, and laboratory communities to enhance national disease surveillance, detection, diagnostic, and reporting capabilities. CBEP, like many other capacity building programs, has wrestled with ways to improve partner country buy-in and ownership and to develop sustainable solutions that impact integrated disease surveillance outcomes. Designing successful implementation strategies represents a complex and challenging exercise and requires robust and transparent collaboration at the country level. To address this challenge, the Laboratory Systems Development Branch of the U.S. Centers for Disease Control and Prevention (CDC) and CBEP have partnered to create a set of tools that brings together key leadership of the surveillance system into a deliberate system design process. This process takes into account strengths and limitations of the existing system, how the components inter-connect and relate to one another, and how they can be systematically refined within the local context. The planning tools encourage cross-disciplinary thinking, critical evaluation and analysis of existing capabilities, and discussions across organizational and departmental lines toward a shared course of action and purpose. The underlying concepts and methodology of these tools are presented here.

  10. Using Evidence to Strengthen Health Systems in Africa and the ...

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

    The project is timely for Lebanon, a country that is working to strengthen its primary health care system to respond to current priorities such as the emerging crisis of Syrian refugees. Timely access to information The project will strengthen institutional and individual abilities to conduct and use systematic and rapid reviews to ...

  11. Laboratory system strengthening and quality improvement in Ethiopia

    Directory of Open Access Journals (Sweden)

    Tilahun M. Hiwotu

    2014-11-01

    Full Text Available Background: In 2010, a National Laboratory Strategic Plan was set forth in Ethiopia to strengthen laboratory quality systems and set the stage for laboratory accreditation. As a result, the Strengthening Laboratory Management Toward Accreditation (SLMTA programme was initiated in 45 Ethiopian laboratories. Objectives: This article discusses the implementation of the programme, the findings from the evaluation process and key challenges. Methods: The 45 laboratories were divided into two consecutive cohorts and staff from each laboratory participated in SLMTA training and improvement projects. The average amount of supportive supervision conducted in the laboratories was 68 hours for cohort I and two hoursfor cohort II. Baseline and exit audits were conducted in 44 of the laboratories and percent compliance was determined using a checklist with scores divided into zero- to five-star ratinglevels. Results: Improvements, ranging from < 1 to 51 percentage points, were noted in 42 laboratories, whilst decreases were recorded in two. The average scores at the baseline and exit audits were 40% and 58% for cohort I (p < 0.01; and 42% and 53% for cohort II (p < 0.01,respectively. The p-value for difference between cohorts was 0.07. At the exit audit, 61% ofthe first and 48% of the second cohort laboratories achieved an increase in star rating. Poor awareness, lack of harmonisation with other facility activities and the absence of a quality manual were challenges identified. Conclusion: Improvements resulting from SLMTA implementation are encouraging. Continuous advocacy at all levels of the health system is needed to ensure involvement of stakeholders and integration with other improvement initiatives and routine activities.

  12. Development of the strengthened safeguards system and the Additional Protocol

    International Nuclear Information System (INIS)

    Vidaurre-Henry, Jaime

    2001-01-01

    For the past 30 years, the IAEA's safeguards system has contributed to the international non-proliferation regime by providing, inter alia, assurances regarding the peaceful uses of declared nuclear material. However, the discovery of a clandestine nuclear weapons program in Iraq in 1991 drew world-wide attention to the need to strengthen the system to address the absence of undeclared nuclear material and activities. Efforts to strengthen the IAEA's safeguards system began in 1991 and culminated in 1997 when the IAEA's Board of Governors approved a Model Protocol Additional to IAEA Safeguards Agreements which greatly expands the legal basis and scope of IAEA safeguards. Within this strengthened system it is expected that the IAEA be able to provide assurance not only of the absence of diversion of declared nuclear material but also on the absence of undeclared nuclear material and activities. This is to be done within a safeguards system that uses an optimal combination of all safeguards measures available, thereby achieving maximum effectiveness and efficiency within the available resources. The paper summarizes the evolution of the safeguards system, describes strengthened safeguards, reports on the status of implementing the strengthening measures, and outlines plans for integrating all available safeguards measures. (author)

  13. Strengthening the role of Community Health Representatives in the Navajo Nation

    Directory of Open Access Journals (Sweden)

    Caroline King

    2017-04-01

    Full Text Available Abstract Background Strengthening Community Health Worker systems has been recognized to improve access to chronic disease prevention and management efforts in low-resource communities. The Community Outreach and Patient Empowerment (COPE Program is a Native non-profit organization with formal partnerships with both the Navajo Nation Community Health Representative (CHR Program and the clinical facilities serving the Navajo Nation. COPE works to better integrate CHRs into the local health care system through training, strengthening care coordination, and a standardized culturally appropriate suite of health promotion materials for CHRs to deliver to high-risk individuals in their homes. Methods The objective of this mixed methods, cross sectional evaluation of a longitudinal cohort study was to explore how the COPE Program has effected CHR teams over the past 6 years. COPE staff surveyed CHRs in concurrent years (2014 and 2015 about their perceptions of and experience working with COPE, including potential effects COPE may have had on communication among patients, CHRs, and hospital-based providers. COPE staff also conducted focus groups with all eight Navajo Nation CHR teams. Results CHRs and other stakeholders who viewed our results agree that COPE has improved clinic-community linkages, primarily through strengthened collaborations between Public Health Nurses and CHRs, and access to the Electronic Health Records. CHRs perceived that COPE’s programmatic support has strengthened their validity and reputation with providers and clients, and has enhanced their ability to positively effect health outcomes among their clients. CHRs report an improved ability to deliver health coaching to their clients. Survey results show that 80.2% of CHRs feel strongly positive that COPE trainings are useful, while 44.6% of CHRs felt that communication and teamwork had improved because of COPE. Conclusions These findings suggest that CHRs have experienced

  14. Strengthening national infrastructures for the control of radiation sources in Armenia

    International Nuclear Information System (INIS)

    Martirosyan, Ashot; Amirjanyan, Armen

    2008-01-01

    The paper describes the work carried out in Armenia to establish and strengthen regulatory control over radiation sources, including the development of legislation and regulations, the establishment of a national registry of sources, and the development of licensing procedures and training programmes in the area of radiation protection and the safe use of radiation sources. The paper also describes the Regulatory Information System of ANRA, inventarization and licensing process of radiation sources, implementation of the IAEA Code of Conduct on the Safety and Security of Radioactive Sources in Armenia. (author)

  15. Strengthening Health Systems Research Capacity in Mozambique ...

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

    Mozambique's health sector is dealing with system-wide challenges. The country's disease burden continues to struggle under the weight of communicable diseases. Non-communicable diseases are on the rise. There have been some successes in reducing the disease burden through programs targeting specific ...

  16. The Inevitability of Strengthening the Nation-Building Subjectivity of Ethnic and National Groups

    Directory of Open Access Journals (Sweden)

    Dr.sc. Harun Hadzic

    2013-12-01

    Full Text Available This paper presents a very courageous, scientifically founded prediction, concerning the imminent and inevitable process of strengthening  the political and nation-building subjectivity of national minorities and ethnic groups, i.e., minority indigenous people. For, a more lasting peace and stability, for which we want to dominate in Europe and the world, can only be achieved by deflection of the discontent of these nationalities, on one hand, and strengthening of the public recognition of their international legal subjectivity, on the other hand. This implies the exercise of their right to self-determination and the creation of independent autonomies, regions or countries, which also implies reclassification and conversion of the internal, but also of the interstate borders. These new limits must be established precisely in those parts of the world where there is a political struggle, and a long-time demand of these organized groups, which would, in effect, mean that the international community should accept their demand for creation of new states, or, at least, another, lower, level of independence.

  17. Strengthening routine immunization systems to improve global vaccination coverage.

    Science.gov (United States)

    Sodha, S V; Dietz, V

    2015-03-01

    Global coverage with the third dose of diphtheria-tetanus-pertussis vaccine among children under 1 year of age stagnated at ∼ 83-84% during 2008-13. Annual World Health Organization and UNICEF-derived national vaccination coverage estimates. Incomplete vaccination is associated with poor socioeconomic status, lower education, non-use of maternal-child health services, living in conflict-affected areas, missed immunization opportunities and cancelled vaccination sessions. Vaccination platforms must expand to include older ages including the second year of life. Immunization programmes, including eradication and elimination initiatives such as those for polio and measles, must integrate within the broader health system. The Global Vaccine Action Plan (GVAP) 2011-20 is a framework for strengthening immunization systems, emphasizing country ownership, shared responsibility, equity, integration, sustainability and innovation. Immunization programmes should identify, monitor and evaluate gaps and interventions within the GVAP framework. Published by Oxford University Press 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  18. 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

  19. Strengthening Health Information Systems to Support Post-Disaster ...

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

    Strengthening Health Information Systems to Support Post-Disaster Healthcare in Haiti. The occurrence of a natural disaster may seem to carry repercussions that are indiscriminate in nature; however, it is the vulnerable populations that suffer most during such events, and in the days, months and years that follow. In Haiti ...

  20. Strengthening local seed systems within the bean value chain ...

    African Journals Online (AJOL)

    Strengthening local seed systems within the bean value chain: Experience of agricultural innovation platforms in the Democratic Republic of Congo. ... associations, local grain/seed traders, private and public extension agents, researchers, finance and credit cooperatives and Non-Governmental Organisations (NGOs).

  1. Strengthening Dairy Cooperative through National Development of Livestock Region

    OpenAIRE

    Priyono; A.Priyanti

    2016-01-01

    Establishment of dairy cattle development region needs to be conducted in accordance with the national dairy industry development plan. Dairy cattle regions have been designed and equipped with infrastructure supplies, supporting facilities, technologies, finance, processing, marketing, institutional and human resources. Dairy cooperative is one of the marketing channels of milk and milk products which have strategic roles to support the national dairy industry. Collaborations between dairy c...

  2. Seismic strengthening of building 111 at Lawrence Livermore National Laboratory

    International Nuclear Information System (INIS)

    Eli, M.; Coats, D.; Freeland, G.; Kamath, M.

    1991-01-01

    Since being designed and constructed in the late 1960s, the Director's Building (Building 111) at Lawrence Livermore National Laboratory (LLNL) has been evaluated for 1988 seismic criteria and has been upgraded to withstand a major earthquake in the Livermore area. During and immediately after a large earthquake in the Livermore area, Building 111 occupants would be able to exit safely without loss of life. Building 111 itself would be severely damaged, but would not collapse. Highlights of the seismic upgrade design criteria and of the design, analyses, and construction that resulted are presented in this paper

  3. THE STRENGTHENING OF NATIONALISM AMONG THE PEOPLE OF PAPUA, INDONESIA

    Directory of Open Access Journals (Sweden)

    Bernada Meterai

    2015-07-01

    Full Text Available This study is the phenomenon of "problem Indonesian Papuans" often questionable when the "conflict-torn Papua." LIPI in 2007 questioned why it's been 62 years of independent Indonesia, Papua Indonesia nationalism began to be questioned again. We all know that Papua is the province of the very rich natural resources, beautiful panoramic views both on land and at sea to original culture from a number of ethnic groups. the Papua origin ball players like Boaz Salosa, Patrik Wanggai, Ferdinando Pahabol and Riki Kayame continued fighting defend their self-esteem as a nation of Indonesia in the field that when dealing with other countries. However, when the conflict in Papua occurred, appeared a wide pernyataantentang of Papua New Guinea such as: dark, human resources is relatively low, people are still poor and primitive, and the flag frequently offered up morning, arcane, the shooting of human rights violations, the referendum and the independence of the territory of a unitary State the Republic of Indonesia

  4. [Framework for the strengthening of health information systems in Peru].

    Science.gov (United States)

    Curioso, Walter H; Espinoza-Portilla, Elizabeth

    2015-01-01

    In this article we present the essential components and policies that are most relevant regarding the conceptual framework to strengthen the health information systems in Peru. The article also presents the main policies, actions and strategies made in the field of electronic health in Peru that are most significant. The health information systems in Peru play a key role and are expected to achieve an integrated and interoperable information system. This will allow health information to be complete, efficient, of good quality and available in a timely manner to achieve better quality of life for people and allow meaningful modernization of public health in the context of health reform in Peru.

  5. Scaling up antiretroviral therapy in Uganda: using supply chain management to appraise health systems strengthening.

    Science.gov (United States)

    Windisch, Ricarda; Waiswa, Peter; Neuhann, Florian; Scheibe, Florian; de Savigny, Don

    2011-08-01

    Strengthened national health systems are necessary for effective and sustained expansion of antiretroviral therapy (ART). ART and its supply chain management in Uganda are largely based on parallel and externally supported efforts. The question arises whether systems are being strengthened to sustain access to ART. This study applies systems thinking to assess supply chain management, the role of external support and whether investments create the needed synergies to strengthen health systems. This study uses the WHO health systems framework and examines the issues of governance, financing, information, human resources and service delivery in relation to supply chain management of medicines and the technologies. It looks at links and causal chains between supply chain management for ART and the national supply system for essential drugs. It combines data from the literature and key informant interviews with observations at health service delivery level in a study district. Current drug supply chain management in Uganda is characterized by parallel processes and information systems that result in poor quality and inefficiencies. Less than expected health system performance, stock outs and other shortages affect ART and primary care in general. Poor performance of supply chain management is amplified by weak conditions at all levels of the health system, including the areas of financing, governance, human resources and information. Governance issues include the lack to follow up initial policy intentions and a focus on narrow, short-term approaches. The opportunity and need to use ART investments for an essential supply chain management and strengthened health system has not been exploited. By applying a systems perspective this work indicates the seriousness of missing system prerequisites. The findings suggest that root causes and capacities across the system have to be addressed synergistically to enable systems that can match and accommodate investments in

  6. Strengthening national health laboratories in sub-Saharan Africa: a decade of remarkable progress.

    Science.gov (United States)

    Alemnji, G A; Zeh, C; Yao, K; Fonjungo, P N

    2014-04-01

    Efforts to combat the HIV/AIDS pandemic have underscored the fragile and neglected nature of some national health laboratories in Africa. In response, national and international partners and various governments have worked collaboratively over the last several years to build sustainable laboratory capacities within the continent. Key accomplishments reflecting this successful partnership include the establishment of the African-based World Health Organization Regional Office for Africa (WHO-AFRO) Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA); development of the Strengthening Laboratory Management Toward Accreditation (SLMTA) training programme; and launching of a Pan African-based institution, the African Society for Laboratory Medicine (ASLM). These platforms continue to serve as the foundations for national health laboratory infrastructure enhancement, capacity development and overall quality system improvement. Further targeted interventions should encourage countries to aim at integrated tiered referral networks, promote quality system improvement and accreditation, develop laboratory policies and strategic plans, enhance training and laboratory workforce development and a retention strategy, create career paths for laboratory professionals and establish public-private partnerships. Maintaining the gains and ensuring sustainability will require concerted action by all stakeholders with strong leadership and funding from African governments and from the African Union. Published 2014. This article is a U.S. Government work and is in the public domain in the U.S.A.

  7. Strengthening Performance Management System Implementation in South African Municipalities

    Directory of Open Access Journals (Sweden)

    Malefetsane Mofolo

    2012-06-01

    Full Text Available Adoption of a performance management system in municipalities presented a serious challenge for its implementation. This scenario is implicitly manifesting itself in the reports of the Auditor-General on the financial statements and performance of municipalities, as well as in the state of local government in South Africa overview report (2009. These reports called for the conceptualisation of a model that to strengthen the implementation in municipalities of a performance management system that is efficient and effective. And most importantly, this model could be beneficial for growth, development and effective service delivery.

  8. Health governance: principal-agent linkages and health system strengthening.

    Science.gov (United States)

    Brinkerhoff, Derick W; Bossert, Thomas J

    2014-09-01

    Governance is increasingly recognized as an important factor in health system performance, yet conceptually and practically it remains poorly understood and subject to often vague and competing notions of both what its role is and how to address its weaknesses. This overview article for the symposium on health governance presents a model of health governance that focuses on the multiplicity of societal actors in health systems, the distribution of roles and responsibilities among them and their ability and willingness to fulfil these roles and responsibilities. This focus highlights the principal-agent linkages among actors and the resulting incentives for good governance and health system performance. The discussion identifies three disconnects that constitute challenges for health system strengthening interventions that target improving governance: (1) the gap between the good governance agenda and existing capacities, (2) the discrepancy between formal and informal governance and (3) the inattention to sociopolitical power dynamics. The article summarizes the three country cases in the symposium and highlights their governance findings: health sector reform in China, financial management of health resources in Brazilian municipalities and budget reform in hospitals in Lesotho. The concluding sections clarify how the three cases apply the model's principal-agent linkages and highlight the importance of filling the gaps remaining between problem diagnosis and the development of practical guidance that supports 'best fit' solutions and accommodates political realities in health systems strengthening. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  9. Applying principles of health system strengthening to eye care

    Directory of Open Access Journals (Sweden)

    Karl Blanchet

    2012-01-01

    Full Text Available Understanding Health systems have now become the priority focus of researchers and policy makers, who have progressively moved away from a project-centred perspectives. The new tendency is to facilitate a convergence between health system developers and disease-specific programme managers in terms of both thinking and action, and to reconcile both approaches: one focusing on integrated health systems and improving the health status of the population and the other aiming at improving access to health care. Eye care interventions particularly in developing countries have generally been vertically implemented (e.g. trachoma, cataract surgeries often with parallel organizational structures or specialised disease specific services. With the emergence of health system strengthening in health strategies and in the service delivery of interventions there is a need to clarify and examine inputs in terms governance, financing and management. This present paper aims to clarify key concepts in health system strengthening and describe the various components of the framework as applied in eye care interventions.

  10. Empowering Smallholder Farmers in Markets: strengthening the advocacy capacities of national farmer organisations through collaborative research

    NARCIS (Netherlands)

    Ton, G.; Grip, de K.; Lançon, F.; Onumah, G.; Proctor, F.J.

    2014-01-01

    The Empowering Smallholder Farmers in Markets programme (ESFIM) supported the advocacy capacities of national farmer organisations (NFOs) for improving smallholder market access. The programme gave NFOs in 11 countries the opportunity to contract local experts to strengthen the evidence-base of

  11. Global health initiative investments and health systems strengthening: a content analysis of global fund investments.

    Science.gov (United States)

    Warren, Ashley E; Wyss, Kaspar; Shakarishvili, George; Atun, Rifat; de Savigny, Don

    2013-07-26

    Millions of dollars are invested annually under the umbrella of national health systems strengthening. Global health initiatives provide funding for low- and middle-income countries through disease-oriented programmes while maintaining that the interventions simultaneously strengthen systems. However, it is as yet unclear which, and to what extent, system-level interventions are being funded by these initiatives, nor is it clear how much funding they allocate to disease-specific activities - through conventional 'vertical-programming' approach. Such funding can be channelled to one or more of the health system building blocks while targeting disease(s) or explicitly to system-wide activities. We operationalized the World Health Organization health system framework of the six building blocks to conduct a detailed assessment of Global Fund health system investments. Our application of this framework framework provides a comprehensive quantification of system-level interventions. We applied this systematically to a random subset of 52 of the 139 grants funded in Round 8 of the Global Fund to Fight AIDS, Tuberculosis and Malaria (totalling approximately US$1 billion). According to the analysis, 37% (US$ 362 million) of the Global Fund Round 8 funding was allocated to health systems strengthening. Of that, 38% (US$ 139 million) was for generic system-level interventions, rather than disease-specific system support. Around 82% of health systems strengthening funding (US$ 296 million) was allocated to service delivery, human resources, and medicines & technology, and within each of these to two to three interventions. Governance, financing, and information building blocks received relatively low funding. This study shows that a substantial portion of Global Fund's Round 8 funds was devoted to health systems strengthening. Dramatic skewing among the health system building blocks suggests opportunities for more balanced investments with regard to governance, financing, and

  12. Social capital to strengthen health policy and health systems.

    Science.gov (United States)

    Ogden, Jessica; Morrison, Ken; Hardee, Karen

    2014-12-01

    This article recounts the development of a model for social capital building developed over the course of interventions focused on HIV-related stigma and discrimination, safe motherhood and reproductive health. Through further engagement with relevant literature, it explores the nature of social capital and suggests why undertaking such a process can enhance health policy and programmes, advocacy and governance for improved health systems strengthening (HSS) outcomes. The social capital process proposed facilitates the systematic and effective inclusion of community voices in the health policy process-strengthening programme effectiveness as well as health system accountability and governance. Because social capital building facilitates communication and the uptake of new ideas, norms and standards within and between professional communities of practice, it can provide an important mechanism for integration both within and between sectors-a process long considered a 'wicked problem' for health policy-makers. The article argues that the systematic application of social capital building, from bonding through bridging into linking social capital, can greatly enhance the ability of governments and their partners to achieve their HSS goals. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  13. [Strengthening process of the licensing system for physicians in the Republic of China].

    Science.gov (United States)

    Tian, Xiaoxu

    2002-04-01

    The Provisional Regulation for Administration of Physician, issued by the Internal Affairs Department of the Northern Warlords Government on March 9, 1922; The Provisional Regulation of Physician, issued and carried out by Ministry of Health of Nanjing National Government on January 15, 1929; and The Provisional Regulation of Physician, issued and carried out by Executive Yuan of Nanjing National Government on August 8, 1940 marked preliminary formation of the licensing system for physicians. The Standards of Physician, issued and carried out by Nanjing National Government on September 22, 1943 marked formation of the licensing system for physicians in the Republic of China. In the later stage of the War of Resistance Against Japan, some legal documents, like Detailed Rules of the Standards of Physician etc. issued and carried out by Nanjing National Government were the additional remarks for the administration of the Standards of Physician. All of these showed that the licensing system for physicians was strengthened step by step.

  14. National viewpoints: Views on strengthened safeguards from Australia, Cuba and South Africa

    International Nuclear Information System (INIS)

    Biggs, I.; Saburido, E.F.; Mxakato-Diseko, N.J.

    1999-01-01

    This paper presents views of Australia, Cuba and South Africa concerned with strengthened safeguards regime. Australia has been involved with the IAEA safeguards system since the first plenary meeting of the Conference on the IAEA Statute in 1956, joined the NPT in 1973 and began concluding bilateral safeguards agreements in 1977. Australia has the greatest respect for the IAEA coordinated efforts started in 1998 to strengthen and integrate the safeguards system. Cuba has always attached special importance to nuclear safeguards activities, recognizing their high priority as well as the important role they have in respect to international disarmament and security. South Africa supports the efforts in strengthening the safeguards activities and remains hopeful that the international community will address the challenges posed by the Trilateral Initiative between Russian federation, USA and IAEA in a mature and cooperative way

  15. Scaling up antiretroviral therapy in Uganda: using supply chain management to appraise health systems strengthening

    Directory of Open Access Journals (Sweden)

    Neuhann Florian

    2011-08-01

    Full Text Available Abstract Background Strengthened national health systems are necessary for effective and sustained expansion of antiretroviral therapy (ART. ART and its supply chain management in Uganda are largely based on parallel and externally supported efforts. The question arises whether systems are being strengthened to sustain access to ART. This study applies systems thinking to assess supply chain management, the role of external support and whether investments create the needed synergies to strengthen health systems. Methods This study uses the WHO health systems framework and examines the issues of governance, financing, information, human resources and service delivery in relation to supply chain management of medicines and the technologies. It looks at links and causal chains between supply chain management for ART and the national supply system for essential drugs. It combines data from the literature and key informant interviews with observations at health service delivery level in a study district. Results Current drug supply chain management in Uganda is characterized by parallel processes and information systems that result in poor quality and inefficiencies. Less than expected health system performance, stock outs and other shortages affect ART and primary care in general. Poor performance of supply chain management is amplified by weak conditions at all levels of the health system, including the areas of financing, governance, human resources and information. Governance issues include the lack to follow up initial policy intentions and a focus on narrow, short-term approaches. Conclusion The opportunity and need to use ART investments for an essential supply chain management and strengthened health system has not been exploited. By applying a systems perspective this work indicates the seriousness of missing system prerequisites. The findings suggest that root causes and capacities across the system have to be addressed synergistically to

  16. Integrating Information and Communication Technology for Health Information System Strengthening: A Policy Analysis.

    Science.gov (United States)

    Marzuki, Nuraidah; Ismail, Saimy; Al-Sadat, Nabilla; Ehsan, Fauziah Z; Chan, Chee-Khoon; Ng, Chiu-Wan

    2015-11-01

    Despite the high costs involved and the lack of definitive evidence of sustained effectiveness, many low- and middle-income countries had begun to strengthen their health information system using information and communication technology in the past few decades. Following this international trend, the Malaysian Ministry of Health had been incorporating Telehealth (National Telehealth initiatives) into national health policies since the 1990s. Employing qualitative approaches, including key informant interviews and document review, this study examines the agenda-setting processes of the Telehealth policy using Kingdon's framework. The findings suggested that Telehealth policies emerged through actions of policy entrepreneurs within the Ministry of Health, who took advantage of several simultaneously occurring opportunities--official recognition of problems within the existing health information system, availability of information and communication technology to strengthen health information system and political interests surrounding the national Multimedia Super Corridor initiative being developed at the time. The last was achieved by the inclusion of Telehealth as a component of the Multimedia Super Corridor. © 2015 APJPH.

  17. The role of health system governance in strengthening the rural health insurance system in China.

    Science.gov (United States)

    Yuan, Beibei; Jian, Weiyan; He, Li; Wang, Bingyu; Balabanova, Dina

    2017-05-23

    Systems of governance play a key role in the operation and performance of health systems. In the past six decades, China has made great advances in strengthening its health system, most notably in establishing a health insurance system that enables residents of rural areas to achieve access to essential services. Although there have been several studies of rural health insurance schemes, these have focused on coverage and service utilization, while much less attention has been given to the role of governance in designing and implementing these schemes. Information from publications and policy documents relevant to the development of two rural health insurance policies in China was obtained, analysed, and synthesise. 92 documents on CMS (Cooperative Medical Scheme) or NCMS (New Rural Cooperative Medical Scheme) from four databases searched were included. Data extraction and synthesis of the information were guided by a framework that drew on that developed by the WHO to describe health system governance and leadership. We identified a series of governance practices that were supportive of progress, including the prioritisation by the central government of health system development and certain health policies within overall national development; strong government commitment combined with a hierarchal administrative system; clear policy goals coupled with the ability for local government to adopt policy measures that take account of local conditions; and the accumulation and use of the evidence generated from local practices. However these good practices were not seen in all governance domains. For example, poor collaboration between different government departments was shown to be a considerable challenge that undermined the operation of the insurance schemes. China's success in achieving scale up of CMS and NCMS has attracted considerable interest in many low and middle income countries (LMICs), especially with regard to the schemes' designs, coverage, and funding

  18. Where are we now? The strengthened safeguards system: Origins, aims, features, issues and prospects

    International Nuclear Information System (INIS)

    Schriefer, D.

    1998-01-01

    The present status of the strengthened safeguards system includes the origins, aims, features, issues and future prospects. The areas of emphasis concerning the strengthened safeguards system are: access to information (environmental sampling and improved information analysis), access to sites, rational use of resources (cost analysis of present safeguards, increased cooperation with state systems, cost savings in traditional safeguards activities)

  19. Task Analysis as a Resource for Strengthening Health Systems.

    Science.gov (United States)

    Hart, Leah J; Carr, Catherine; Fullerton, Judith T

    2016-01-01

    Task analysis is a descriptive study methodology that has wide application in the health professions. Task analysis is particularly useful in assessment and definition of the knowledge, skills, and behaviors that define the scope of practice of a health profession or occupation. Jhpiego, a US-based nongovernmental organization, has adapted traditional task analysis methods in several countries in assessment of workforce education and practice issues. Four case studies are presented to describe the utility and adaptability of the task analysis approach. Traditional task analysis field survey methods were used in assessment of the general and maternal-child health nursing workforce in Mozambique that led to curriculum redesign, reducing the number of education pathways from 4 to 2. The process of health system strengthening in Liberia, following a long history of civil war conflict, included a traditional task analysis study conducted among 119 registered nurses and 46 certified midwives who had graduated in the last 6 months to 2 years to determine gaps in education and preparation. An innovative approach for data collection that involves "playing cards" to document participant opinions (Task Master, Mining for Data) was developed by Jhpiego for application in other countries. Results of a task analysis involving 54 nurses and 100 nurse-midwives conducted in Lesotho were used to verify the newly drafted scope and standards of practice for nurses and to inform planning for a competency-based preservice curriculum for nursing. The Nursing and Midwifery Council developed a 100-question licensing examination for new graduates following a task analysis in Botswana. The task analysis process in each country resulted in recommendations that were action oriented and were implemented by the country governments. For maximal utility and ongoing impact, a task analysis study should be repeated on a periodic basis and more frequently in countries undergoing rapid change in

  20. 37th National Systems Conference

    CERN Document Server

    Yadav, Sandeep; Adhikari, Bibhas; Seshadri, Harinipriya; Fulwani, Deepak

    2015-01-01

    The book is a collection of peer-reviewed scientific papers submitted by active researchers in the 37th National System Conference (NSC 2013). NSC is an annual event of the Systems Society of India (SSI), primarily oriented to strengthen the systems movement and its applications for the welfare of humanity. A galaxy of academicians, professionals, scientists, statesman and researchers from different parts of the country and abroad are invited to attend the conference. The book presents research articles in the areas of system’s modelling, complex network modelling, cyber security, sustainable systems design, health care systems, socio-economic systems, and clean and green technologies. The book can be used as a tool for further research.

  1. Conceptual Foundations of Strengthening the Fuel Security of the National Economy

    Directory of Open Access Journals (Sweden)

    Kyzym Mykola O.

    2017-03-01

    Full Text Available The aim of the article is to substantiate conceptual foundations for strengthening the fuel security of Ukraine under conditions of achieving energy independence from import of finished petroleum products, ensuring energy efficiency of the transformation of primary fuel and energy resources into motor fuel and its energy saving in the transport sector. The key problems in the sphere of liquid fuel use in Ukraine are non-competitiveness of the national oil refining complex, import orientation of the Ukrainian motor fuel consumer, scarcity of the explored reserves of liquid hydrocarbons on the territory of Ukraine, monopolization of transport routes for external deliveries of crude oil. The development of Ukraine’s fuel sector should be implemented on the basis of the national model of fuel security, which provides for balancing the motor fuel market, ensuring sustainable development of the fuel sector and satisfying interests of market actors. The strategic goals of fuel security are defined as energy independence, energy efficiency and energy saving. In the article they were decomposed at the operational level, and the following necessary components were identified: maximization of the national oil production; diversification of external oil supplies with complete abandonment of imports of finished petroleum products, increase in the yield of light oil products; replacement of oil with the national energy potential, saving of motor fuel at the stage of its consumption.

  2. Strengthening health systems through HIV monitoring and evaluation in Sub-Saharan Africa.

    Science.gov (United States)

    Ekouevi, Didier K; Karcher, Sophie; Coffie, Patrick A

    2011-07-01

    In this review, we describe the challenges faced by using clinical cohorts to perform Monitoring and Evaluation (M&E) and the possible solutions for increasing and strengthening health systems in low-income and middle-income countries. HIV scale-up has facilitated the transition from paper-based medical records to electronic medical records at hundreds of sites in most of the countries in sub-Saharan Africa and the implementation of national HIV databases. However, National M&E systems in resource-limited settings tend to be chronically challenged by persistently incomplete reporting and inaccurate data, which undermines their usefulness. In low-income and middle-income countries, new information technologies such as Web-based systems and mobile phone networks are expanding rapidly. Their use will improve data quality and, therefore, reduce participant dropout and improve reporting rates. These systems have the potential to allow real time access to summary reports and to integrate data from other settings such as maternal and infant health clinics. The efforts to address the AIDS pandemic in sub-Saharan Africa will require enhanced information systems. Stronger systems are needed to deliver primary healthcare for those with and without HIV, and it is also essential to build and take advantage of synergies across health information systems.

  3. Self-Monitoring Strengthening System Based on Carbon Fiber Laminate

    Directory of Open Access Journals (Sweden)

    Rafal Krzywon

    2016-01-01

    Full Text Available Externally bonded composites reinforced with high-strength fibers are increasingly popular in construction, especially in structures’ strengthening, where the best possible mechanical properties are required. At the same time the ability to autodetect threats is one of the most desirable features of contemporary structures. The authors of the paper have developed an intelligent fabric, wherein the carbon fibers play the role of not only tensile reinforcement but also strain sensor. The idea is based on the construction of the strain gauge, where the thread of carbon fibers arranged in zig-zag pattern works as electrical conductor and is insulated by parallel thread of glass or acrylic fibers. Preliminary laboratory tests were designed to create effective measurement techniques and assess the effectiveness of the strengthening of selected building structures, as reinforced concrete and timber beams. Presented in the paper, selected results of these studies are very promising, although there were some noted problems to be considered in next steps. The main problem here is the control of the cross section of the fibers tow, affecting the total resistance of the fabric. One of the main deficiencies of the proposed solution is also sensitivity to moisture.

  4. Application of ICT in strengthening health information systems in developing countries in the wake of globalisation.

    Science.gov (United States)

    Simba, Daudi O; Mwangu, Mughwira

    2004-12-01

    Information Communication Technology (ICT) revolution brought opportunities and challenges to developing countries in their efforts to strengthen the Health Management Information Systems (HMIS). In the wake of globalisation, developing countries have no choice but to take advantage of the opportunities and face the challenges. The last decades saw developing countries taking action to strengthen and modernise their HMIS using the existing ICT. Due to poor economic and communication infrastructure, the process has been limited to national and provincial/region levels leaving behind majority of health workers living in remote/rural areas. Even those with access do not get maximum benefit from ICT advancements due to inadequacies in data quality and lack of data utilisation. Therefore, developing countries need to make deliberate efforts to address constraints threatening to increase technology gap between urban minority and rural majority by setting up favourable policies and appropriate strategies. Concurrently, strategies to improve data quality and utilisation should be instituted to ensure that HMIS has positive impact on people's health. Potential strength from private sector and opportunities for sharing experiences among developing countries should be utilised. Short of this, advancement in ICT will continue to marginalise health workers in developing countries especially those living in remote areas.

  5. Interventions geared towards strengthening the health system of Namibia through the integration of palliative care

    Science.gov (United States)

    Freeman, Rachel; Luyirika, Emmanuel BK; Namisango, Eve; Kiyange, Fatia

    2016-01-01

    The high burden of non-communicable diseases and communicable diseases in Africa characterised by late presentation and diagnosis makes the need for palliative care a priority from the point of diagnosis to death and through bereavement. Palliative care is an intervention that requires a multidisciplinary team to address the multifaceted needs of the patient and family. Thus, its development takes a broad approach that involves engaging all key stakeholders ranging from policy makers, care providers, educators, the public, patients, and families. The main focus of stakeholder engagement should address some core interventions geared towards improving knowledge and awareness, strengthening skills and attitudes about palliative care. These interventions include educating health and allied healthcare professionals on the palliative care-related problems of patients and best practices for care, explaining palliative care as a clinical and holistic discipline and demonstrating its effectiveness, the need to include palliative care into national policies, strategic plans, training curriculums of healthcare professionals and the engagement of patients, families, and communities. Interventions from a five-year programme that was aimed at strengthening the health system of Namibia through the integration of palliative care for people living with HIV and AIDS and cancer in Namibia are shared. This article illustrates how a country can implement the World Health Organisation’s public health strategy for developing palliative care services, which recommends four pillars: government policy, education, drug availability, and implementation. PMID:27563348

  6. National Immunization Commission: strengthening evidence-based decision making in Argentina.

    Science.gov (United States)

    Stecher, Daniel; Gaiano, Alejandra; Biscayart, Cristián; Gentile, Angela; Ayala, Silvia Gonzalez; López, Eduardo; Bonvehí, Pablo; Yedlin, Pablo; Janusz, Cara; Vizzotti, Carla

    2014-04-01

    In Argentina, the National Technical Advisory Group on Immunizations is represented by the National Immunization Commission (CoNaIn), an organization created by the Ministry of Health in 2000. Recently, the Argentine government has decided to prioritize vaccination as a state policy, emphasizing this strategy as a sign of social equity so CoNaIn was restructured to increase its capacity to formulate sound and evidence-based recommendations. The commission shall consist of a group of immunization experts, representatives of scientific societies, the immunization program and the Ministry of Health. Its functions include the formulation of recommendations on the introduction of vaccines into the immunization program. The recommendations are based on technical, programmatic and social criteria. This decision-making process transparent with the support and advice of experts and scientific societies and guided by available evidence decisions help strengthen the Ministry of Health immunization policy generating greater confidence and support from the population and health professionals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. An Automated Analyzer System to Strengthen Teaching and Research Infrastructure at West Virginia State University

    Science.gov (United States)

    2015-08-18

    Mar-2015 Approved for Public Release; Distribution Unlimited Final Report: An Automated Analyzer System to Strengthen Teaching and Research...journals: Number of Papers published in non peer-reviewed journals: Final Report: An Automated Analyzer System to Strengthen Teaching and Research...students are using the equipment for the directed student research to fulfill their requirements for honors program in the Department of Biology

  8. The role of international NGOs in health systems strengthening: the case of Timor-Leste.

    Science.gov (United States)

    Mercer, Mary Anne; Thompson, Susan M; de Araujo, Rui Maria

    2014-01-01

    Achieving the United Nations Millennium Development Goals for health will require that programs supporting health in developing countries focus on strengthening national health care systems. However, the dominant neoliberal model of development mandates reduced public spending on health and other social services, often resulting in increased funding for nongovernmental organizations (NGOs) at the expense of support for government systems. East Timor, later Timor-Leste, is an example of a post-crisis country where international NGO efforts were initially critical to providing relief efforts to a traumatized population. Those groups were not prepared to help develop and support a standardized Timorese national health plan, however, and the cost of their support was unsustainable in the long term. In response, local authorities designed and implemented a post-crisis NGO phase-over plan that addressed risks to service disruption and monitored the process. Since then, some NGOs have worked collaboratively with the Ministry of Health to support specific efforts and initiatives under a framework provided by the ministry. Timor-Leste has shown that ministries of health can facilitate an effective transition of NGO support from crisis to development if they are allowed to plan and manage the process.

  9. Strengthening systems for communicable disease surveillance: creating a laboratory network in Rwanda

    Directory of Open Access Journals (Sweden)

    Ndihokubwayo Jean B

    2011-06-01

    Full Text Available Abstract Background The recent emergence of a novel strain of influenza virus with pandemic potential underscores the need for quality surveillance and laboratory services to contribute to the timely detection and confirmation of public health threats. To provide a framework for strengthening disease surveillance and response capacities in African countries, the World Health Organization Regional Headquarters for Africa (AFRO developed Integrated Disease Surveillance and Response (IDSR aimed at improving national surveillance and laboratory systems. IDSR emphasizes the linkage of information provided by public health laboratories to the selection of relevant, appropriate and effective public health responses to disease outbreaks. Methods We reviewed the development of Rwanda's National Reference Laboratory (NRL to understand essential structures involved in creating a national public health laboratory network. We reviewed documents describing the NRL's organization and record of test results, conducted site visits, and interviewed health staff in the Ministry of Health and in partner agencies. Findings were developed by organizing thematic categories and grouping examples within them. We purposefully sought to identify success factors as well as challenges inherent in developing a national public health laboratory system. Results Among the identified success factors were: a structured governing framework for public health surveillance; political commitment to promote leadership for stronger laboratory capacities in Rwanda; defined roles and responsibilities for each level; coordinated approaches between technical and funding partners; collaboration with external laboratories; and use of performance results in advocacy with national stakeholders. Major challenges involved general infrastructure, human resources, and budgetary constraints. Conclusions Rwanda's experience with collaborative partnerships contributed to creation of a functional

  10. Sharing regulatory data as tools for strengthening health systems in the Region of the Americas

    Directory of Open Access Journals (Sweden)

    Varley Dias Sousa

    Full Text Available ABSTRACT Regulatory transparency is an imperative characteristic of a reliable National Regulatory Authority. In the region of the Americas, the process of building an open government is still fragile and fragmented across various Health Regulatory Agencies (HRAs and Regional Reference Authorities (RRAs. This study assessed the transparency status of RRAs, focusing on various medicine life-cycle documents (the Medicine Dossier, Clinical Trial Report, and Inspection Report as tools for strengthening health systems. Based on a narrative (nonsystematic review of RRA regulatory transparency, transparency status was classified as one of two types: public disclosure of information (intra-agency data and data- and work-sharing (inter-agency data. The risks/benefits of public disclosure of medicine-related information were assessed, taking into account 1 the involvement and roles of multiple stakeholders (health care professionals, regulators, industry, community, and academics and 2 the protection of commercial and personal confidential data. Inter-agency data- and work-sharing was evaluated in the context of harmonization and cooperation projects that focus on regulatory convergence. Technical and practical steps for establishing an openness directive for the pharmaceutical regulatory environment are proposed to improve and strengthen health systems in the Americas. Addressing these challenges requires leadership from entities such as the Pan American Health Organization to steer and support collaborative regional alliances that advance the development and establishment of a trustworthy regulatory environment and a sustainable public health system in the Americas, using international successful initiatives as reference and taking into account the domestic characteristics and experiences of each individual country.

  11. Sharing regulatory data as tools for strengthening health systems in the Region of the Americas.

    Science.gov (United States)

    Sousa, Varley Dias; Ramalho, Pedro I; Silveira, Dâmaris

    2016-05-01

    Regulatory transparency is an imperative characteristic of a reliable National Regulatory Authority. In the region of the Americas, the process of building an open government is still fragile and fragmented across various Health Regulatory Agencies (HRAs) and Regional Reference Authorities (RRAs). This study assessed the transparency status of RRAs, focusing on various medicine life-cycle documents (the Medicine Dossier, Clinical Trial Report, and Inspection Report) as tools for strengthening health systems. Based on a narrative (nonsystematic) review of RRA regulatory transparency, transparency status was classified as one of two types: public disclosure of information (intra-agency data) and data- and work-sharing (inter-agency data). The risks/benefits of public disclosure of medicine-related information were assessed, taking into account 1) the involvement and roles of multiple stakeholders (health care professionals, regulators, industry, community, and academics) and 2) the protection of commercial and personal confidential data. Inter-agency data- and work-sharing was evaluated in the context of harmonization and cooperation projects that focus on regulatory convergence. Technical and practical steps for establishing an openness directive for the pharmaceutical regulatory environment are proposed to improve and strengthen health systems in the Americas. Addressing these challenges requires leadership from entities such as the Pan American Health Organization to steer and support collaborative regional alliances that advance the development and establishment of a trustworthy regulatory environment and a sustainable public health system in the Americas, using international successful initiatives as reference and taking into account the domestic characteristics and experiences of each individual country.

  12. Prestressed Unbonded Reinforcement System with Multiple CFRP Plates for Fatigue Strengthening of Steel Members †

    Directory of Open Access Journals (Sweden)

    Ardalan Hosseini

    2018-03-01

    Full Text Available Carbon fiber reinforced polymer (CFRP composites have exhibited a great potential for strengthening of steel structures. In the current study, an innovative prestressed unbonded reinforcement (PUR system is introduced for fatigue strengthening of existing steel members. The system relies on a pair of mechanical clamps; each holds multiple CFRP plates and anchors their prestressing forces to the steel substrate via friction. A finite element model was established to optimize the design of the required mechanical components of the system. A set of static and fatigue tests was conducted on the developed mechanical clamps as the key elements of the proposed PUR system. The performance of the PUR system was then evaluated using a set of fatigue tests on two precracked steel plate specimens, one without any strengthening system and the other one strengthened with the proposed PUR system. In the latter specimen, the CFRP plates were prestressed up to about 800 MPa (approximately 30% of the CFRP tensile strength, which resulted in a complete fatigue crack arrest in the precracked steel plate. Furthermore, neither slippage of the mechanical clamps nor any prestress loss in the CFRP plates was observed after 7.5 million fatigue cycles. Based on the promising experimental results, obtained from the sets of fatigue tests performed in the current study, it can be concluded that the proposed PUR system can be considered as an efficient alternative to the conventional bonded reinforcement solutions for fatigue strengthening of damaged steel members.

  13. FE Modelling of the Seismic Behavior of Wide Beam-Column Joints Strengthened with CFRP Systems

    Directory of Open Access Journals (Sweden)

    Giuseppe Santarsiero

    2018-02-01

    Full Text Available A large share of reinforced concrete (RC framed buildings is provided with wide beams being a type of beam allowing greater freedom in the architectural arrangement of interiors, beyond further advantage due to fewer formworks needed during the construction. Nevertheless, little attention has been devoted to the seismic vulnerability of this kind of framed RC buildings as well as to the study of strengthening systems purposely developed for wide beams and wide beam-column connections. Under these premises, this paper proposes simple strengthening solutions made by Fibre Reinforced Polymers (FRP systems able to effectively improve seismic capacity through feasible arrangement suitable in case a wide beam is present. On the basis of wide beam-column joints previously tested without strengthening system, detailed nonlinear finite element models were calibrated. Then, an FRP strengthening intervention based on a brand new arrangement was modeled in order to perform additional simulations under seismic actions. This way, the effectiveness of the strengthening intervention was assessed finding out that significant strength and ductility increments were achieved with a relatively simple and cheap strengthening arrangement. Additional research would be desirable in the form of experimental tests on the simulated wide beam-column joints.

  14. [eHealth in Peru: implementation of policies to strengthen health information systems].

    Science.gov (United States)

    Curioso, Walter H

    2014-01-01

    Health information systems play a key role in enabling high quality, complete health information to be available in a timely fashion for operational and strategic decision-making that makes it possible to save lives and improve the health and quality of life of the population. In many countries, health information systems are weak, incomplete, and fragmented. However, there is broad consensus in the literature of the need to strengthen health information systems in countries around the world. The objective of this paper is to present the essential components of the conceptual framework to strengthen health information systems in Peru. It describes the principal actions and strategies of the Ministry of Health of Peru during the process of strengthening health information systems. These systems make it possible to orient policies for appropriate decision-making in public health.

  15. Strengthening health systems through linking research evidence to ...

    African Journals Online (AJOL)

    informed policies. Accordingly, a critical way of addressing these challenges facing health systems in the region is through the linking of health research findings to policy. Keywords: Evidence; Sub-Saharan Africa; Health Policy; Health Systems ...

  16. Service user involvement for mental health system strengthening in India: a qualitative study.

    Science.gov (United States)

    Samudre, Sandesh; Shidhaye, Rahul; Ahuja, Shalini; Nanda, Sharmishtha; Khan, Azaz; Evans-Lacko, Sara; Hanlon, Charlotte

    2016-07-28

    There is a wide recognition that involvement of service users and their caregivers in health system policy and planning processes can strengthen health systems; however, most evidence and experience has come from high-income countries. This study aimed to explore baseline experiences, barriers and facilitators to service user-caregiver involvement in the emerging mental health system in India, and stakeholders' perspectives on how greater involvement could be achieved. A qualitative study was conducted in Sehore district of Madhya Pradesh, India. In-depth interviews (n = 27) and a focus group discussion were conducted among service users, caregivers and their representatives at district, state and national levels and policy makers, service providers and mental health researchers. The topic guide explored the baseline situation in India, barriers and facilitators to service user and caregiver involvement in the following aspects of mental health systems: policy-making and planning, service development, monitoring and quality control, as well as research. Framework analysis was employed. Respondents spoke of the limited involvement of service users and caregivers in the current Indian mental health system. The major reported barriers to this involvement were (1) unmet treatment and economic needs arising from low access to mental health services coupled with the high burden of illness, (2) pervasive stigmatising attitudes operating at the level of service user, caregiver, community, healthcare provider and healthcare administrators, and (3) entrenched power differentials between service providers and service users. Respondents prioritised greater involvement of service users in the planning of their own individual-level mental health care before considering involvement at the mental health system level. A stepwise progression was endorsed, starting from needs assessment, through empowerment and organization of service users and caregivers, leading finally to

  17. Developing a customised approach for strengthening tuberculosis laboratory quality management systems toward accreditation

    Directory of Open Access Journals (Sweden)

    Heidi Albert

    2017-03-01

    Full Text Available Background: Quality-assured tuberculosis laboratory services are critical to achieve global and national goals for tuberculosis prevention and care. Implementation of a quality management system (QMS in laboratories leads to improved quality of diagnostic tests and better patient care. The Strengthening Laboratory Management Toward Accreditation (SLMTA programme has led to measurable improvements in the QMS of clinical laboratories. However, progress in tuberculosis laboratories has been slower, which may be attributed to the need for a structured tuberculosis-specific approach to implementing QMS. We describe the development and early implementation of the Strengthening Tuberculosis Laboratory Management Toward Accreditation (TB SLMTA programme. Development: The TB SLMTA curriculum was developed by customizing the SLMTA curriculum to include specific tools, job aids and supplementary materials specific to the tuberculosis laboratory. The TB SLMTA Harmonized Checklist was developed from the World Health Organisation Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation checklist, and incorporated tuberculosis-specific requirements from the Global Laboratory Initiative Stepwise Process Towards Tuberculosis Laboratory Accreditation online tool. Implementation: Four regional training-of-trainers workshops have been conducted since 2013. The TB SLMTA programme has been rolled out in 37 tuberculosis laboratories in 10 countries using the Workshop approach in 32 laboratories in five countries and the Facility based approach in five tuberculosis laboratories in five countries. Conclusion: Lessons learnt from early implementation of TB SLMTA suggest that a structured training and mentoring programme can build a foundation towards further quality improvement in tuberculosis laboratories. Structured mentoring, and institutionalisation of QMS into country programmes, is needed to support tuberculosis laboratories

  18. Strengthening the Security of ESA Ground Data Systems

    Science.gov (United States)

    Flentge, Felix; Eggleston, James; Garcia Mateos, Marc

    2013-08-01

    A common approach to address information security has been implemented in ESA's Mission Operations (MOI) Infrastructure during the last years. This paper reports on the specific challenges to the Data Systems domain within the MOI and how security can be properly managed with an Information Security Management System (ISMS) according to ISO 27001. Results of an initial security risk assessment are reported and the different types of security controls that are being implemented in order to reduce the risks are briefly described.

  19. An approach to health system strengthening in the Union of Myanmar.

    Science.gov (United States)

    Tin, Nilar; Lwin, Saw; Kyaing, Nyo Nyo; Htay, Thein Thein; Grundy, John; Skold, Margareta; O'Connell, Thomas; Nirupam, Siddharth

    2010-05-01

    In 2007 and 2008, Myanmar developed a health system strengthening (HSS) strategy and proposal through funding support from the Global Alliance for Vaccines and Immunization (GAVI). The aim of this paper is to identify critical success factors in the development of the HSS strategy in Myanmar. The main source of information for this review includes international and national literature, and participant observation by the authors in the health systems analysis and HSS strategy development in Myanmar between 2007 and 2009. Critical success factors in the development of the HSS strategy included evidence-based development of the strategy through a sector analysis, and a long-term approach to strategy development with wide stakeholder participation. This contributed to important strategy breakthroughs in the areas of health planning, health financing, human resource management and civil society partnerships. Implementation of the HSS strategy in Myanmar should position the MOH and partners well to implement challenging system reforms in the areas of health planning, financing and human resource management in the coming years, as well as support more coordinated efforts for relief and recovery effort following the Nargis natural disaster in 2008. These innovations in Myanmar, with evidence of similar breakthroughs in other countries of the Asian region including North Korea, Cambodia, Nepal and Sri Lanka, provides promising evidence of the potential of the HSS approach as an emerging health development paradigm, particularly in relation to responding to the issue of "within country" inequities in access to health care. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  20. Strengthening the regulatory system through the implementation and use of a quality management system

    Directory of Open Access Journals (Sweden)

    Reinhold Eisner

    2017-04-01

    Full Text Available ABSTRACT Quality management systems (QMS, based on ISO 9001 requirements, are applicable to government service organizations such as Health Canada’s Biologics and Genetic Therapies Directorate (BGTD. This communication presents the process that the BGTD followed since the early 2000s to implement a quality management system and describes how the regulatory system was improved as a result of this project. BGTD undertook the implementation of a quality management system based on ISO 9001 and containing aspects of ISO 17025 with the goal of strengthening the regulatory system through improvements in the people, processes, and services of the organization. We discuss the strategy used by BGTD to implement the QMS and the benefits that were realized from the various stages of implementation. The eight quality principals upon which the QMS standards of the ISO 9000 series are based were used by senior management as a framework to guide QMS implementation.

  1. Reverse innovation: an opportunity for strengthening health systems.

    Science.gov (United States)

    Snowdon, Anne W; Bassi, Harpreet; Scarffe, Andrew D; Smith, Alexander D

    2015-02-07

    Canada, when compared to other OECD countries, ranks poorly with respect to innovation and innovation adoption while struggling with increasing health system costs. As a result of its failure to innovate, the Canadian health system will struggle to meet the needs and demands of both current and future populations. The purpose of this initiative was to explore if a competition-based reverse innovation challenge could mobilize and stimulate current and future leaders to identify and lead potential reverse innovation projects that address health system challenges in Canada. An open call for applications took place over a 4-month period. Applicants were enticed to submit to the competition with a $50,000 prize for the top submission to finance their project. Leaders from a wide cross-section of sectors collectively developed evaluation criteria and graded the submissions. The criteria evaluated: proof of concept, potential value, financial impact, feasibility, and scalability as well as the use of prize money and innovation team. The competition received 12 submissions from across Canada that identified potential reverse innovations from 18 unique geographical locations that were considered developing and/or emerging markets. The various submissions addressed health system challenges relating to education, mobile health, aboriginal health, immigrant health, seniors health and women's health and wellness. Of the original 12 submissions, 5 finalists were chosen and publically profiled, and 1 was chosen to receive the top prize. The results of this initiative demonstrate that a competition that is targeted to reverse innovation does have the potential to mobilize and stimulate leaders to identify reverse innovations that have the potential for system level impact. The competition also provided important insights into the capacity of Canadian students, health care providers, entrepreneurs, and innovators to propose and implement reverse innovation in the context of the

  2. National Outbreak Reporting System

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Outbreak Reporting System (NORS) is a web-based platform designed to support reporting to CDC by local, state, and territorial health departments in the...

  3. Local innovations and reforms can help strengthen health system in ...

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

    One such example was from Niger, where Dr Ousmane Haja, head of the Tahoua regional hospital, developed an internal monitoring system with his colleagues. ... Given the high rate of self-induced abortions in the country, her findings will be an important contribution to improving policy and practice. Laz, 34, is a medical ...

  4. Implementation of a Strengthened International Safeguards System. ABACC 15 Years

    International Nuclear Information System (INIS)

    Vicens, H.R.; Maceiras, E.; Dominguez, C.A.

    2011-01-01

    The purpose of the paper is to explain how the system of a regional safeguard has been operating and developing in the framework of the Brazilian-Argentine Agency of Accounting and control of nuclear Materials (ABACC), and how the international recommendations of radiological protection must be taken into account in the safeguards implementation and its impact in the international context.

  5. Strengthening health systems in Africa | CRDI - Centre de ...

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

    Telemedicine studied by researchers in French-speaking Africa helped to reduce decision-making errors in remote areas, increase the number of consultations, and save patients money. The Africa Health Systems Initiative - Support to African Research Partnerships program ran from 2008-2014. It supported teams that ...

  6. Strengthening Procurement Systems in Latin America and the ...

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

    The modernization and reform of public purchasing could have a significant impact both on the effectiveness of public spending and the development of MSMEs and electronic commerce. Information and Communication Technologies (ICTs) are key to modernizing public administration systems in general and public ...

  7. Full Scale RC Beam-Column Joints Strengthened with Steel Reinforced Polymer Systems

    Science.gov (United States)

    De Vita, Alessandro; Napoli, Annalisa; Realfonzo, Roberto

    2017-07-01

    This paper presents the results of an experimental campaign performed at the Laboratory of Materials and Structural Testing of the University of Salerno (Italy) in order to investigate the seismic performance of RC beam-column joints strengthened with Steel Reinforced Polymer (SRP) systems. With the aim to represent typical façade frames’ beam-column subassemblies found in existing RC buildings, specimens were provided with two short beam stubs orthogonal to the main beam and were designed with inadequate seismic details. Five members were strengthened by using two different SRP layouts while the remaining ones were used as benchmarks. Once damaged, two specimens were also repaired, retrofitted with SRP and subjected to cyclic test again. The results of cyclic tests performed on SRP strengthened joints are examined through a comparison with the outcomes of the previous experimental program including companion specimens not provided with transverse beam stubs and strengthened by Carbon Fiber Reinforced Polymer (CFRP) systems. In particular, both qualitative and quantitative considerations about the influence of the confining effect provided by the secondary beams on the joint response, the suitability of all the adopted strengthening solutions (SRP/CFRP systems), the performances and the failure modes experienced in the several cases studied are provided.

  8. An integrated chronic disease management model: a diagonal approach to health system strengthening in South Africa.

    Science.gov (United States)

    Mahomed, Ozayr Haroon; Asmall, Shaidah; Freeman, Melvyn

    2014-11-01

    The integrated chronic disease management model provides a systematic framework for creating a fundamental change in the orientation of the health system. This model adopts a diagonal approach to health system strengthening by establishing a service-linked base to training, supervision, and the opportunity to try out, assess, and implement integrated interventions.

  9. Establishing a regulatory value chain model: An innovative approach to strengthening medicines regulatory systems in resource-constrained settings.

    Science.gov (United States)

    Chahal, Harinder Singh; Kashfipour, Farrah; Susko, Matt; Feachem, Neelam Sekhri; Boyle, Colin

    2016-05-01

    Medicines Regulatory Authorities (MRAs) are an essential part of national health systems and are charged with protecting and promoting public health through regulation of medicines. However, MRAs in resource-constrained settings often struggle to provide effective oversight of market entry and use of health commodities. This paper proposes a regulatory value chain model (RVCM) that policymakers and regulators can use as a conceptual framework to guide investments aimed at strengthening regulatory systems. The RVCM incorporates nine core functions of MRAs into five modules: (i) clear guidelines and requirements; (ii) control of clinical trials; (iii) market authorization of medical products; (iv) pre-market quality control; and (v) post-market activities. Application of the RVCM allows national stakeholders to identify and prioritize investments according to where they can add the most value to the regulatory process. Depending on the economy, capacity, and needs of a country, some functions can be elevated to a regional or supranational level, while others can be maintained at the national level. In contrast to a "one size fits all" approach to regulation in which each country manages the full regulatory process at the national level, the RVCM encourages leveraging the expertise and capabilities of other MRAs where shared processes strengthen regulation. This value chain approach provides a framework for policymakers to maximize investment impact while striving to reach the goal of safe, affordable, and rapidly accessible medicines for all.

  10. Strengthening of RC beams with an innovative timber-FRP composite system

    Science.gov (United States)

    Mazzon, N.; Guadagnini, M.; Valluzzi, M. R.

    2008-05-01

    The results of a theoretical and experimental research project on the use of an innovative technique for strengthening concrete beams are presented. A spacer element is inserted between the tension side of a beam and the composite material to increase its lever arm and to enhance the over all stiffness of the strengthened beam. The main aim of this exploratory project was to increase the ultimate failure load of strengthened beam specimens, whilst guaranteeing acceptable over all deflections at the serviceability limit states. This resulted into a significant reduction in the amount of FPR required and in a better utilization of the materials employed. A preliminary theoretical study was carried out to investigate the effect of Young's modulus, failure strain, and thickness of the element to be used as a spacer in order to determine the best possible candidate material. Three tests on 2.5-m-long beams were carried out, and different anchorage techniques were used to try and prevent the debonding of the strengthening system. The results from this pilot study are very promising, as the strengthening system ensures an adequate initial stiffness along with an improved ultimate flexural capacity.

  11. Self-monitoring fiber reinforced polymer strengthening system for civil engineering infrastructures

    Science.gov (United States)

    Jiang, Guoliang; Dawood, Mina; Peters, Kara; Rizkalla, Sami

    2008-03-01

    Fiber reinforced polymer (FRP) materials are currently used for strengthening civil engineering infrastructures. The strengthening system is dependant on the bond characteristics of the FRP to the external surface of the structure to be effective in resisting the applied loads. This paper presents an innovative self-monitoring FRP strengthening system. The system consists of two components which can be embedded in FRP materials to monitor the global and local behavior of the strengthened structure respectively. The first component of the system is designed to evaluate the applied load acting on a structure based on elongation of the FRP layer along the entire span of the structure. Success of the global system has been demonstrated using a full-scale prestressed concrete bridge girder which was loaded up to failure. The test results indicate that this type of sensor can be used to accurately determine the load prior to failure within 15 percent of the measured value. The second sensor component consists of fiber Bragg grating sensors. The sensors were used to monitor the behavior of steel double-lap shear splices tested under tensile loading up to failure. The measurements were used to identify abnormal structural behavior such as epoxy cracking and FRP debonding. Test results were also compared to numerical values obtained from a three dimensional shear-lag model which was developed to predict the sensor response.

  12. 3D FE Analysis of RC Beams Externally Strengthened with SRG/SRP Systems

    Directory of Open Access Journals (Sweden)

    Francesco Bencardino

    2016-05-01

    Full Text Available The purpose of this study is to evaluate, through a nonlinear Finite Element (FE analysis, the structural behavior of Reinforced Concrete (RC beams externally strengthened by using Steel Reinforced Grout (SRG and Steel Reinforced Polymer (SRP systems. The parameters taken into account were the external strengthening configuration, with or without U-wrap end anchorages, as well as the strengthening materials. The numerical simulations were carried out by using a three-dimensional (3D FE model. The linear and nonlinear behavior of all materials was modeled by appropriate constitutive laws and the connection between concrete substrate and external reinforcing layer was simulated by means of cohesive surfaces with appropriate bond-slip laws. In order to overcome convergence difficulties, to simulate the quasi-static response of the strengthened RC beams, a dynamic approach was adopted. The numerical results in terms of load-displacement curves, failure modes, and load and strain values at critical stages were validated against some experimental data. As a result, the proposed 3D FE model can be used to predict the structural behavior up to ultimate stage of similar strengthened beams without carrying out experimental tests.

  13. Integrated Safeguards Information System for Japan (ISIS-J) - Strengthening SSAC for Enhancing Confidence in Compliance with Safeguards Obligations -

    International Nuclear Information System (INIS)

    Iso, S.; Nishiyama, N.; Kumakura, S.; Takizawa, K.; Yoshida, H.; Kobayashi, I.; Kikuchi, M.; Kimura, N.; Matsubara, T.; Yatsu, S.

    2010-01-01

    IAEA has stated the importance of enhancing cooperation with SSAC. Therefore, Japan has developed the Integrated Safeguards Information System for enhancing confidence in compliance with the national obligation under the safeguards agreement and the additional protocol. Japan already established the National System including national inspections with NDA and DA verification functions and evaluation of data obtained from national inspections and has maintained the National System of safeguards as a SSAC in accordance with the safeguards agreement. Nuclear Material Control Center (NMCC) is engaged in national safeguards activities as designated organization of national inspectorate and information treatment including safeguards data analysis. Recently, purpose of IAEA's safeguards activities may shift to detection of proliferation based on plausible proliferation paths from detection of diversion by certain material accountancy measures. Major safeguards activities of IAEA have changed from quantitative aspects to qualitative them. As supplements for declining the quantitative measures such as the activities based on the safeguards criteria the IAEA would expect the SSAC functions for maintaining the activities of quantitative manners. Japan believes that the State's responsibility for enhancing cooperation between the National System and the IAEA must assure the confidence level of correctness and completeness of the State declarations with accurate and precise accountability as findings from SSAC. Japan has started the development of the strengthened and autonomous national system namely the Integrated safeguards Information System for Japan (ISIS-J) in order to fulfil our responsibility. Japan would seek to improve quality of information including nuclear material accounting data as well as expanded declaration relevant to nuclear activities in Japan, and to increase abilities for explaining safeguards relevant events in Japan. The enhanced findings could include

  14. Implementing a national health research for development platform in a low-income country - a review of Malawi's Health Research Capacity Strengthening Initiative.

    Science.gov (United States)

    Cole, Donald C; Nyirenda, Lot Jata; Fazal, Nadia; Bates, Imelda

    2016-04-01

    National health research for development (R4D) platforms in lower income countries (LICs) are few. The Health Research Capacity Strengthening Initiative (HRCSI, 2008-2013) was a national systems-strengthening programme in Malawi involved in national priority setting, decision-making on funding, and health research actor mobilization. We adopted a retrospective mixed-methods evaluation approach, starting with information gleaned from reports (HRCSI and Malawian) and databases (HRCSI). A framework of a health research system (actors and components) guided report review and interview guide development. From a list of 173 individuals involved in HRCSI, 30 interviewees were selected within categories of stakeholders. Interviews were conducted face-to-face or via telephone/Skype over 1 month, documented with extensive notes. Analysis of emerging themes was iterative among co-evaluators, with synthesis according to the implementation stage. Major HRCSI outputs included (1) National research priority-setting: through the production of themed background papers by Malawian health researchers and broad consultation, HRCSI led the development of a National Health Research Agenda (2012-2016), widely regarded as one of HRCSI's foremost achievements. (2) Institutional research capacity: there was an overwhelming view that HRCSI had produced a step-change in the number of high calibre scientists in Malawi and in fostering research interest among young Malawians, providing support for around 56 MSc and PhD students, and over 400 undergraduate health-related projects. (3) Knowledge sharing: HRCSI supported research dissemination through national and institutional meetings by sponsoring attendance at conferences and through close relationships with individuals in the print media for disseminating information. (4) Sustainability: From 2011-2013, HRCSI significantly improved research systems, processes and leadership in Malawi, but further strengthening was needed for HRCSI to be

  15. Flexural Behaviour of RC Beams Strengthened with Prestressed CFRP NSM Tendon Using New Prestressing System

    Directory of Open Access Journals (Sweden)

    Woo-tai Jung

    2017-01-01

    Full Text Available CFRP has been used mainly for strengthening of existing structures in civil engineering area. Prestressed strengthening is being studied to solve the bond failure model featuring EBR and NSMR methods. The largest disadvantage of the prestressing system is that the system cannot be removed until the filler is cured. This problem lowers the turning rate of the equipment and makes it limited to experiment, which stresses the necessity of a new prestressing system. Therefore, the present study applies a new prestressing system which reliefs the need to wait until the curing of the filler after jacking to the prestressing of NSMR and examines the effect of the prestressing size and location of the anchorage on the strengthened behaviour. The experimental results show that the crack and yield loads increase with higher level of prestress, while the ductility tends to reduce, and the anchor plate should be installed within the effective depth ds to minimize the occurrence of shear-induced diagonal cracks. The comparison of the experimental results and results by section analysis shows that the section analysis could predict the maximum load of the specimens strengthened by prestressed NSMR within an error between 4% and 6%.

  16. Short-term and sustained effects of a health system strengthening ...

    African Journals Online (AJOL)

    Short-term and sustained effects of a health system strengthening intervention to improve mortality trends for paediatric severe malnutrition in rural South African ... Sixty-nine monthly data series were collected on: (i) monthly total SAM case fatality rate (CFR); (ii) monthly SAM CFR within 24 hours of admission; and (iii) ...

  17. Legal frame work and implementation of the strengthened safeguards system in Indonesia

    International Nuclear Information System (INIS)

    Solichah, M.; Zarkasi, A.S.

    2001-01-01

    operator's declaration of nuclear material accountancy including accountancy record and supporting source document. BAPETEN should evaluate and send the Facility's report (ICR, PIL and MBR) to the Agency. Additional Protocol to Safeguards agreement was signed and ratified on 29 September 1999, that means Indonesia committed to implement Strengthened Safeguards System. Indonesia has already participated in developing Strengthened Safeguards regimes by offering itself for trial of a number of new concepts before signing the protocol. Since 1995, Indonesia has reported its thorium import every year, which is known as the Voluntary Reporting Scheme. Indonesia also offered itself for trial of environmental sampling test, which are taken during special visits by IAEA inspectors and during routine inspection, up to the initial declaration submission of the Additional Protocol. IAEA has already conducted six times location for specific environmental sampling and twice wide area environmental sampling. The first year declaration was set to the IAEA six batch declaration submission, three batches of them are pursuant to article 2.a (ix) with respect to export of specified equipment and non nuclear material listed in annex D. It was a very easy task since we just sent a blank form with the statement 'Nothing to declare' on it. The second batch declaration pursuant to the additional protocol article 2.a (I), 2.a (iii), 2.a (iv), 2.a (v), 2.a (vi), 2.a (vii), 2.a (x), and 2.b (i) ran to about 22 pages of information in tabular form of which about half was dedicated to the information of buildings on nuclear sites. The second batch declaration submission was not easy to finish due to a lot of information to fill out. To get and collect this information we conducted several meetings with BATAN, and made a lot of phone calls for confirmation. The third batch declaration are pursuant to the additional protocol article 2.a (v), 2.a (vi) b and c, 2.a (viii), and 2.a (ix), to get source

  18. Strengthening National Disease Surveillance and Response-Haiti, 2010-2015.

    Science.gov (United States)

    Juin, Stanley; Schaad, Nicolas; Lafontant, Donald; Joseph, Gerard A; Barzilay, Ezra; Boncy, Jacques; Barrais, Robert; Louis, Frantz Jean; Jean Charles, Nadia Lapierre; Corvil, Salomon; Barthelemy, Nickolsno; Dismer, Amber; Pierre, Jean Samuel; Archer, Roodly W; Antoine, Mayer; Marston, Barbara; Katz, Mark; Dely, Patrick; Adrien, Paul; Fitter, David L; Lowrance, David; Patel, Roopal

    2017-10-01

    Haiti's health system has faced many challenges over the years, with competing health priorities in the context of chronic financial and human resource limitations. As a result, the existing notifiable disease surveillance system was unable to provide the most basic epidemiologic data for public health decision-making and action. In the wake of the January 2010 earthquake, the Haitian Ministry of Public Health and Population collaborated with the U.S. Centers for Disease Control and Prevention, the Pan American Health Organization, and other local and international partners to implement a functional national surveillance system. More than 7 years later, it is important to take the opportunity to reflect on progress made on surveillance and response in Haiti, including disease detection, reporting, outbreak investigation, and response. The national epidemiologic surveillance network that started with 51 sites in 2010 has been expanded to 357 sites as of December 2015. Disease outbreaks identified via the surveillance system, or other surveillance approaches, are investigated by epidemiologists trained by the Ministry of Health's Field Epidemiology Training Program. Other related surveillance modules have been developed on the same model and electronic platform, allowing the country to document the impact of interventions, track progress, and monitor health problems. Sustainability remains the greatest challenge since most of the funding for surveillance come from external sources.

  19. Strengthening Climate Services Capabilities and Regional Engagement at NOAA's National Climatic Data Center

    Science.gov (United States)

    Shea, E.

    2008-12-01

    Information System (PaCIS) as a regional climate service prototype; and ongoing planning for enhanced climate services activities at NCDC in the context of discussions of a national climate service.

  20. Estimating the behavior of RC beams strengthened with NSM system using artificial neural networks

    Directory of Open Access Journals (Sweden)

    Seyed Rohollah Hosseini Vaez

    2017-12-01

    Full Text Available In the last decade, conventional materials such as steel and concrete are being replaced by fiber reinforced polymer (FRP materials for the strengthening of concrete structures. Among the strengthening techniques based on Fiber Reinforced Polymer composites, the use of near-surface mounted (NSM FRP rods is emerging as a promising technology for increasing flexural and shear strength of deficient concrete, masonry and timber members. An artificial neural network is an information processing tool that is inspired by the way biological nervous systems (such as the brain process the information. The key element of this tool is the novel structure of the information processing system. In engineering applications, a neural network can be a vector mapper which maps an input vector to an output one. In the present study, a new approach is developed to predict the behavior of strengthened concrete beam using a large number of experimental data by applying artificial neural networks. Having parameters used as input nodes in ANN modeling such as elastic modulus of the FRP reinforcement, the ratio of the steel longitudinal reinforcement, dimensions of the beam section, the ratio of the NSM-FRP reinforcement and characteristics of concrete, the output node was the flexural strength of beams. The idealized neural network was employed to generate empirical charts and equations to be used in design. The aim of this study is to investigate the behavior of strengthened RC beam using artificial neural networks.

  1. Strengthening the Global Refugee Protection System: Recommendations for the Global Compact on Refugees

    Directory of Open Access Journals (Sweden)

    Kevin Appleby

    2017-12-01

    • the adoption of coherent strategies, involving all sectors, to address large movements of refugees. This paper draws heavily, albeit not exclusively, from a series of papers published as a special collection in the Journal on Migration and Human Security[1] on strengthening the global system of refugee protection. [1] Rethinking the Global Refugee Protection System, Journal on Migration and Human Security, Center for Migration Studies, 2016-2017. See http://cmsny.org/cms_research/refugeeproject/.

  2. Contribution of the Japan International Cooperation Agency health-related projects to health system strengthening.

    Science.gov (United States)

    Yuasa, Motoyuki; Yamaguchi, Yoshie; Imada, Mihoko

    2013-09-22

    The Japan International Cooperation Agency (JICA) has focused its attention on appraising health development assistance projects and redirecting efforts towards health system strengthening. This study aimed to describe the type of project and targets of interest, and assess the contribution of JICA health-related projects to strengthening health systems worldwide. We collected a web-based Project Design Matrix (PDM) of 105 JICA projects implemented between January 2005 and December 2009. We developed an analytical matrix based on the World Health Organization (WHO) health system framework to examine the PDM data and thereby assess the projects' contributions to health system strengthening. The majority of JICA projects had prioritized workforce development, and improvements in governance and service delivery. Conversely, there was little assistance for finance or medical product development. The vast majority (87.6%) of JICA projects addressed public health issues, for example programs to improve maternal and child health, and the prevention and treatment of infectious diseases such as AIDS, tuberculosis and malaria. Nearly 90% of JICA technical healthcare assistance directly focused on improving governance as the most critical means of accomplishing its goals. Our study confirmed that JICA projects met the goals of bilateral cooperation by developing workforce capacity and governance. Nevertheless, our findings suggest that JICA assistance could be used to support financial aspects of healthcare systems, which is an area of increasing concern. We also showed that the analytical matrix methodology is an effective means of examining the component of health system strengthening to which the activity and output of a project contributes. This may help policy makers and practitioners focus future projects on priority areas.

  3. Strengthening Laboratory Capacity for Early Warning Alert and Response System (EWARS) in Indonesia

    OpenAIRE

    Kandel, Nirmal; Hapsari, Ratna Budi; Riana, Dyah Armi; Setiawaty, Vivi; Larasati, Wita; Wulandari, Endang; Purwanto, Edy

    2017-01-01

    Background: Establishment of Early Warning Alert and Response System (EWARS) in Indonesia was initiated since 2009 in few selected provinces and government was planning to roll out in other provinces. Before initiating this roll out the assessment of performance of EWARS in 2012 was conducted. The aim of the assessment is to strengthen laboratory for supporting to EWARS for alerts testing. Methods: Laboratory capacity mapping tool and laboratory algorithm for twenty two priority diseases of ...

  4. Challenges to strengthening agricultural innovation systems: where do we go from here?

    OpenAIRE

    Hall, A.

    2007-01-01

    This paper was prepared to present at the Farmer First Revisited: 20 Years On conference at IDS, University of Sussex, UK, December 2007. Its focus is the challenge of strengthening agricultural innovation systems. The paper prefaces this discussion by reflecting on an apparent paradox. While agricultural innovation has never been better studied and understood, many of our ideas about innovation have failed to fundamentally change the institutional and policy setting of public and private inv...

  5. Improving skills and institutional capacity to strengthen adolescent immunisation programmes and health systems in African countries through HPV vaccine introduction.

    Science.gov (United States)

    Dochez, Carine; Burnett, Rosemary J; Mbassi, Symplice Mbola; Were, Fred; Musyoki, Andrew; Trovoada, Daisy; Mphahlele, M Jeffrey

    2017-12-01

    Several African countries have recently introduced or are currently introducing the HPV vaccine, either nationwide or through demonstration projects, while some countries are planning for introduction. A collaborative project was developed to strengthen country adolescent immunisation programmes and health systems in the African Region, addressing unique public health considerations of HPV vaccination: adolescents as the primary target group, delivery platforms (e.g. school-based and facility based), socio-behavioural issues, and the opportunity to deliver other health interventions alongside HPV vaccination. Following a successful "taking-stock" meeting, a training programme was drafted to assist countries to strengthen the integration of adolescent health interventions using HPV vaccination as an entry point. Two workshops were conducted in the Eastern and Southern African Regions. All countries reported on progress made during a final joint symposium. Of the 20 countries invited to participate in either of the workshops and/or final symposium, 17 countries participated: Angola, Botswana, Ethiopia, Kenya, Malawi, Mauritius, Mozambique, Namibia, Rwanda, Seychelles, South Africa, South Sudan, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. Countries that are currently implementing HPV vaccination programmes, either nationally or through demonstration projects, reported varying degrees of integration with other adolescent health interventions. The most commonly reported adolescent health interventions alongside HPV vaccination include health education (including sexually transmitted infections), deworming and delivering of other vaccines like tetanus toxoid (TT) or tetanus diphtheria (Td). The project has successfully (a) established an African-based network that will advocate for incorporating the HPV vaccine into national immunisation programmes; (b) created a platform for experience exchange and thereby contributed to novel ideas of revitalising and

  6. Impact of MPH programs: contributing to health system strengthening in low- and middle-income countries?

    Science.gov (United States)

    Zwanikken, Prisca A C; Alexander, Lucy; Scherpbier, Albert

    2016-08-22

    The "health workforce" crisis has led to an increased interest in health professional education, including MPH programs. Recently, it was questioned whether training of mid- to higher level cadres in public health prepared graduates with competencies to strengthen health systems in low- and middle-income countries. Measuring educational impact has been notoriously difficult; therefore, innovative methods for measuring the outcome and impact of MPH programs were sought. Impact was conceptualized as "impact on workplace" and "impact on society," which entailed studying how these competencies were enacted and to what effect within the context of the graduates' workplaces, as well as on societal health. This is part of a larger six-country mixed method study; in this paper, the focus is on the qualitative findings of two English language programs, one a distance MPH program offered from South Africa, the other a residential program in the Netherlands. Both offer MPH training to students from a diversity of countries. In-depth interviews were conducted with 10 graduates (per program), working in low- and middle-income health systems, their peers, and their supervisors. Impact on the workplace was reported as considerable by graduates and peers as well as supervisors and included changes in management and leadership: promotion to a leadership position as well as expanded or revitalized management roles were reported by many participants. The development of leadership capacity was highly valued amongst many graduates, and this capacity was cited by a number of supervisors and peers. Wider impact in the workplace took the form of introducing workplace innovations such as setting up an AIDS and addiction research center and research involvement; teaching and training, advocacy, and community engagement were other ways in which graduates' influence reached a wider target grouping. Beyond the workplace, an intersectoral approach, national reach through policy advisory roles

  7. Flexural Strengthening of RC Slabs with Prestressed CFRP Strips Using Different Anchorage Systems

    Directory of Open Access Journals (Sweden)

    José Sena-Cruz

    2015-10-01

    Full Text Available Externally Bonded Reinforcement (EBR technique has been widely used for flexural strengthening of concrete structures by using carbon fiber-reinforced polymers (CFRP. EBR technique offers several structural advantages when the CFRP material is prestressed. This paper presents an experimental and numerical study on reinforced (RC slabs strengthened in flexure with prestressed CFRP strips as a structural strengthening system. The strips are applied as an externally bonded reinforcement (EBR and anchored with either a mechanical or a gradient anchorage. The former foresees metallic anchorage plates fixed to the concrete substrate, while the latter is based on an accelerated epoxy resin curing followed by a segment-wise prestress force decrease at the strip ends. Both anchorage systems, in combination with different CFRP strip geometries, were subjected to static loading tests. It could be demonstrated that the composite strip’s performance is better exploited when prestressing is used, with slightly higher overall load carrying capacities for mechanical anchorages than for the gradient anchorage. The performed investigations by means of a cross-section analysis supported the experimental observation that in case a mechanical anchorage is used, progressive strip debonding changes the fully bonded configuration to an unbonded end-anchored system. The inclusion of defined debonding criteria for both the anchorage zones and free length between the anchorage regions allowed to precisely capture the ultimate loading forces.

  8. Mapping of health system functions to strengthen priority programs. The case of maternal health in Mexico.

    Science.gov (United States)

    González-Block, Miguel A; Rouvier, Mariel; Becerril, Victor; Sesia, Paola

    2011-03-15

    Health system strengthening is critical to ensure the integration and scaling-up of priority health promotion, disease prevention and control programs. Normative guidelines are available to address health system function imbalances while strategic and analytical frameworks address critical functions in complex systems. Tacit knowledge-based health system constructs can help identify actors' perspectives, contributing to improve strengthening strategies. Using maternal health as an example, this paper maps and analyses the health system functions that critical actors charged with formulating and delivering priority health programs consider important for their success. Using concept mapping qualitative and statistical methods, health system functions were mapped for different categories of actors in high maternal mortality states of Mexico and at the federal level. Functions within and across maps were analyzed for degree of classification, importance, feasibility and coding. Hospital infrastructure and human resource training are the most prominent functions in the maternal health system, associated to federal efforts to support emergency obstetric care. Health policy is a highly diffuse function while program development, intercultural and community participation and social networks are clearly stated although less focused and with lower perceived importance. The importance of functions is less correlated between federal and state decision makers, between federal decision makers and reproductive health/local health area program officers and between state decision makers and system-wide support officers. Two sets of oppositions can be observed in coding across functions: health sector vs. social context; and given structures vs. manageable processes. Concept mapping enabled the identification of critical functions constituting adaptive maternal health systems, including aspects of actor perspectives that are seldom included in normative and analytical frameworks

  9. National Innovation Systems

    DEFF Research Database (Denmark)

    Lundvall, Bengt-Åke

    2007-01-01

    of the innovation system is defined and it is illustrated that it is necessary both to understand micro-behaviour in the core and understand "the wider setting" within which the core operates. Concepts used in organization theory referring to fit and misfit may be used to enrich the understanding of the performance...... of power, to institution building and to the openness of innovation systems.......The term national system of innovation has been around for more than 20 years and today it has become widely spread among policy makers as well as among scholars all over the world. This paper takes stock and looks ahead from a somewhat personal point of view. It also gives some insight into how...

  10. Management Matters: A Leverage Point for Health Systems Strengthening in Global Health

    Directory of Open Access Journals (Sweden)

    Elizabeth H. Bradley

    2015-07-01

    Full Text Available Despite a renewed focus in the field of global health on strengthening health systems, inadequate attention has been directed to a key ingredient of high-performing health systems: management. We aimed to develop the argument that management – defined here as the process of achieving predetermined objectives through human, financial, and technical resources – is a cross-cutting function necessary for success in all World Health Organization (WHO building blocks of health systems strengthening. Management within health systems is particularly critical in low-income settings where the efficient use of scarce resources is paramount to attaining health goals. More generally, investments in management capacity may be viewed as a key leverage point in grand strategy, as strong management enables the achievement of large ends with limited means. We also sought to delineate a set of core competencies and identify key roles to be targeted for management capacity building efforts. Several effective examples of management interventions have been described in the research literature. Together, the existing evidence underscores the importance of country ownership of management capacity building efforts, which often challenge the status quo and thus need country leadership to sustain despite inevitable friction. The literature also recognizes that management capacity efforts, as a key ingredient of effective systems change, take time to embed, as new protocols and ways of working become habitual and integrated as standard operating procedures. Despite these challenges, the field of health management as part of global health system strengthening efforts holds promise as a fundamental leverage point for achieving health system performance goals with existing human, technical, and financial resources. The evidence base consistently supports the role of management in performance improvement but would benefit from additional research with improved

  11. Management Matters: A Leverage Point for Health Systems Strengthening in Global Health

    Science.gov (United States)

    Bradley, Elizabeth H.; Taylor, Lauren A.; Cuellar, Carlos J.

    2015-01-01

    Despite a renewed focus in the field of global health on strengthening health systems, inadequate attention has been directed to a key ingredient of high-performing health systems: management. We aimed to develop the argument that management – defined here as the process of achieving predetermined objectives through human, financial, and technical resources – is a cross-cutting function necessary for success in all World Health Organization (WHO) building blocks of health systems strengthening. Management within health systems is particularly critical in low-income settings where the efficient use of scarce resources is paramount to attaining health goals. More generally, investments in management capacity may be viewed as a key leverage point in grand strategy, as strong management enables the achievement of large ends with limited means. We also sought to delineate a set of core competencies and identify key roles to be targeted for management capacity building efforts. Several effective examples of management interventions have been described in the research literature. Together, the existing evidence underscores the importance of country ownership of management capacity building efforts, which often challenge the status quo and thus need country leadership to sustain despite inevitable friction. The literature also recognizes that management capacity efforts, as a key ingredient of effective systems change, take time to embed, as new protocols and ways of working become habitual and integrated as standard operating procedures. Despite these challenges, the field of health management as part of global health system strengthening efforts holds promise as a fundamental leverage point for achieving health system performance goals with existing human, technical, and financial resources. The evidence base consistently supports the role of management in performance improvement but would benefit from additional research with improved methodological rigor and longer

  12. PRISM framework: a paradigm shift for designing, strengthening and evaluating routine health information systems.

    Science.gov (United States)

    Aqil, Anwer; Lippeveld, Theo; Hozumi, Dairiku

    2009-05-01

    The utility and effectiveness of routine health information systems (RHIS) in improving health system performance in developing countries has been questioned. This paper argues that the health system needs internal mechanisms to develop performance targets, track progress, and create and manage knowledge for continuous improvement. Based on documented RHIS weaknesses, we have developed the Performance of Routine Information System Management (PRISM) framework, an innovative approach to design, strengthen and evaluate RHIS. The PRISM framework offers a paradigm shift by putting emphasis on RHIS performance and incorporating the organizational, technical and behavioural determinants of performance. By describing causal pathways of these determinants, the PRISM framework encourages and guides the development of interventions for strengthening or reforming RHIS. Furthermore, it conceptualizes and proposes a methodology for measuring the impact of RHIS on health system performance. Ultimately, the PRISM framework, in spite of its challenges and competing paradigms, proposes a new agenda for building and sustaining information systems, for the promotion of an information culture, and for encouraging accountability in health systems.

  13. Flexural Strengthening of RC Slabs Using a Hybrid FRP-UHPC System Including Shear Connector

    Directory of Open Access Journals (Sweden)

    Jiho Moon

    2017-01-01

    Full Text Available A polymeric hybrid composite system made of UHPC and CFRP was proposed as a retrofit system to enhance flexural strength and ductility of RC slabs. While the effectiveness of the proposed system was confirmed previously through testing three full-scale one-way slabs having two continuous spans, the slabs retrofitted with the hybrid system failed in shear. This sudden shear failure would stem from the excessive enhancement of the flexural strength over the shear strength. In this study, shear connectors were installed between the hybrid system and a RC slab. Using simple beam, only positive moment section was examined. Two full-scale RC slabs were cast and tested to failure: the first as a control and the second using this new strengthening technique. The proposed strengthening system increased the ultimate load carrying capacity of the slab by 70%, the stiffness by 60%, and toughness by 128%. The efficiency of shear connectors on ductile behavior of the retrofitted slab was also confirmed. After the UHPC top is separated from the slab, the shear connector transfer shear load and the slab system were in force equilibrium by compression in UHPC and tension in CFRP.

  14. The smart alternative : securing and strengthening our nation's vulnerable electric grid

    International Nuclear Information System (INIS)

    Nahigian, K.R.

    2008-01-01

    This article explained the concept of the next generation of electrical power grids known as the Smart Grid, which allows the possibility to either reallocate electricity during times of crisis or peak demand or prevent power disruptions through proactive diagnosis. The author examined the security, economic and environmental benefits of implementing the Smart Grid during a time of rising energy prices and desire for energy independence. The Smart Grid uses advanced communications and information technologies to create a modern transmission and distribution network that facilitates the integration of alternative energy sources such as wind and solar power, as well as energy-efficient technologies such as plug-in hybrid vehicles. The author emphasized that implementing the Smart Grid grid is also vital to strengthening America's resilience and security since a more robust energy infrastructure will ensure the reliable flow of electricity in the event of a crisis. In addition to promoting energy efficiency, the Smart Grid offers economic benefits, such as reducing the billions of dollars lost each year by American businesses on power outages. A Smart Grid could also open lucrative new markets for smart technologies. 2 figs

  15. Individual capacity-building approaches in a global pharmaceutical systems strengthening program: a selected review.

    Science.gov (United States)

    Konduri, Niranjan; Rauscher, Megan; Wang, Shiou-Chu Judy; Malpica-Llanos, Tanya

    2017-01-01

    Medicines use related challenges such as inadequate adherence, high levels of antimicrobial resistance and preventable adverse drug reactions have underscored the need to incorporate pharmaceutical services to help achieve desired treatment outcomes, and protect patients from inappropriate use of medicines. This situation is further constrained by insufficient numbers of pharmaceutical personnel and inappropriate skill mix. Studies have addressed individual capacity building approaches of logistics, supply chain or disease specific interventions but few have documented those involving such pharmacy assistants/professionals, or health workers/professionals charged with improving access and provision of pharmaceutical services. We examined how different training modalities have been employed and adapted to meet country-specific context and needs by a global pharmaceutical systems strengthening program in collaboration with a country's Ministry of Health and local stakeholders. Structured, content analysis of training approaches from twelve selected countries and a survey among conveniently selected trainees in Bangladesh and Ethiopia. Case-based learning, practice and feedback, and repetitive interventions such as post-training action plan, supportive supervision and mentoring approaches are effective, evidence-based training techniques. In Ethiopia and Bangladesh, over 94% of respondents indicated that they have improved or developed skills or competencies as a result of the program's training activities. Supportive supervision structures and mentorship have been institutionalized with appropriate management structures. National authorities have been sensitized to secure funding from domestic resources or from the global fund grants for post-training follow-up initiatives. The Pharmaceutical Leadership Development Program is an effective, case-based training modality that motivates staff to develop quality-improvement interventions and solve specific challenges

  16. Strengthening control over radioactive sources in authorized use and regaining control over orphan sources. National strategies

    International Nuclear Information System (INIS)

    2004-02-01

    The objective of this report is to provide practical guidance to States on the development of a national strategy for improving control over radioactive sources, particularly dangerous sources (Categories 1-3). Part of this process involves the determination of the magnitude of the potential problem with orphan and vulnerable sources and indeed, whether or not a national strategy is needed. The ultimate objective is that States will use this report to develop and then implement a plan of action that will result in all significant sources being managed in a safe and secure manner. This report attempts to provide both the background knowledge and the methodology necessary for an individual or small team of responsible persons to develop a national strategy for improving control over all radioactive sources, but especially orphan and vulnerable sources. The background knowledge given in Chapter 3 is an update of the information on practices that was given in IAEA-TECDOC-804, which focused on spent radioactive sources. After some introductory material, this report provides both the factual information and the general steps needed to develop and implement a national strategy. Part I contains background information for those who are not already familiar with the subject including the need for national strategies, the generic causes of loss of control of sources, with specific examples and the common applications of radioactive sources. Part II details the actual process for the development and implementation of a national strategy, which includes assessing the problem by first gathering specific and national information, determining the nature and magnitude of the problem, developing the national strategy by evaluating, and prioritizing possible solutions, implementing the strategy subsequent to a high level decision; and evaluating the effectiveness of the plan and making changes as a result until the desired objective is achieved. Searches for sources will be part of

  17. [Institutional strengthening and updating of the National Academy of Medicine of Mexico (results and instrumentalization 2010-2012)].

    Science.gov (United States)

    Ruiz de Chávez, Manuel H; Kershenobich, David; Mansilla Olivares, Armando; Mancilla Ramírez, Javier; Kuri Morales, Pablo; Del Valle Muñoz, Alejandro

    2011-01-01

    In order to strengthen the academic and social management of the National Academy of Medicine of Mexico, from the draft paper presented to run for Vice President of the corporation, in 2007 I proposed to the plenary of the institution to develop a planning exercise strategy, in fact supporting the achievement of that objective. The idea behind the proposal, which was supported by most scholars, started from the consideration that although the Academy has always been an area of excellence for the advancement of medicine in the country, it was now necessary to strengthen, modernize and give a new direction to its work, on the basis of an exercise analysis and background checks, work, commitment and vision, under a inclusive, plural and agreed strategy with the academic body of the corporation, i.e. through a designed planning exercise. The result of this surely positive effort is presented in the following pages. To this end, part of the initial project description illustrates the process of technical and methodological development, the lines of action considered as priorities by academics, and details involving its realization. This planning strategy project yielded three specific conclusions: (i) the necessity for a functional reorganization proposal of the Academy's structure; (ii) the need for a self-sustainability financial project to fortify the economic capacity of the Academy; and (iii) the need for an updated project on technological communication of the Academy.

  18. Exploring the nature of governance at the level of implementation for health system strengthening: the DIALHS experience.

    Science.gov (United States)

    Scott, Vera; Schaay, Nikki; Olckers, Patti; Nqana, Nomsa; Lehmann, Uta; Gilson, Lucy

    2014-09-01

    Health system governance has been recognized as a critical element of the health system strengthening agenda. To date, health governance research often focuses at national or global levels, adopting a macro-perspective that deals with governance structures, forms and principles. Little attention has been given to a micro-perspective which recognizes the role of health system actors in governance, or to considering the operational level of the health system. This article presents a South African case study of an intervention to address conflict in roles and responsibilities between multiple actors supporting service delivery at the local level, and explores the broader insights this experience generates about the nature of local health system governance. In an embedded case study, action learning and reflection theory were used to design and implement the intervention. Data in this article were drawn from minutes, observations and recorded reflections of the meetings and workshops that comprised the intervention. A theoretical governance framework was used both to understand the context of the intervention and to analyse the dimensions of governance relevant in the experience. The study shows how, through action learning and reflection, local managers in two organizations came to understand how the higher level misalignment of organizational structures and processes imposed governance constraints on them, and to see the impact this had on their organizational relationships. By re-framing the conflict as organizational, they were then able to create opportunities for staff to understand their context and participate in negotiating principles for communication and collaborative work. The result reduced conflict between staff in the two organizations, leading to improved implementation of programme support. Strengthening relationships among those working at local level by building collaborative norms and values is an important part of local health system governance for

  19. Investment in HIV/AIDS programs: Does it help strengthen health systems in developing countries?

    Directory of Open Access Journals (Sweden)

    Kaufman Joan

    2008-09-01

    Full Text Available Abstract Background There is increasing debate about whether the scaled-up investment in HIV/AIDS programs is strengthening or weakening the fragile health systems of many developing countries. This article examines and assesses the evidence and proposes ways forward. Discussion Considerably increased resources have been brought into countries for HIV/AIDS programs by major Global Health Initiatives. Among the positive impacts are the increased awareness of and priority given to public health by governments. In addition, services to people living with HIV/AIDS have rapidly expanded. In many countries infrastructure and laboratories have been strengthened, and in some, primary health care services have been improved. The effect of AIDS on the health work force has been lessened by the provision of antiretroviral treatment to HIV-infected health care workers, by training, and, to an extent, by task-shifting. However, there are reports of concerns, too – among them, a temporal association between increasing AIDS funding and stagnant reproductive health funding, and accusations that scarce personnel are siphoned off from other health care services by offers of better-paying jobs in HIV/AIDS programs. Unfortunately, there is limited hard evidence of these health system impacts. Because service delivery for AIDS has not yet reached a level that could conceivably be considered "as close to Universal Access as possible," countries and development partners must maintain the momentum of investment in HIV/AIDS programs. At the same time, it should be recognized that global action for health is even more underfunded than is the response to the HIV epidemic. The real issue is therefore not whether to fund AIDS or health systems, but how to increase funding for both. Summary The evidence is mixed – mostly positive but some negative – as to the impact on health systems of the scaled-up responses to HIV/AIDS driven primarily by global health partnerships

  20. Investment in HIV/AIDS programs: does it help strengthen health systems in developing countries?

    Science.gov (United States)

    Yu, Dongbao; Souteyrand, Yves; Banda, Mazuwa A; Kaufman, Joan; Perriëns, Joseph H

    2008-09-16

    There is increasing debate about whether the scaled-up investment in HIV/AIDS programs is strengthening or weakening the fragile health systems of many developing countries. This article examines and assesses the evidence and proposes ways forward. Considerably increased resources have been brought into countries for HIV/AIDS programs by major Global Health Initiatives. Among the positive impacts are the increased awareness of and priority given to public health by governments. In addition, services to people living with HIV/AIDS have rapidly expanded. In many countries infrastructure and laboratories have been strengthened, and in some, primary health care services have been improved. The effect of AIDS on the health work force has been lessened by the provision of antiretroviral treatment to HIV-infected health care workers, by training, and, to an extent, by task-shifting. However, there are reports of concerns, too - among them, a temporal association between increasing AIDS funding and stagnant reproductive health funding, and accusations that scarce personnel are siphoned off from other health care services by offers of better-paying jobs in HIV/AIDS programs. Unfortunately, there is limited hard evidence of these health system impacts. Because service delivery for AIDS has not yet reached a level that could conceivably be considered "as close to Universal Access as possible," countries and development partners must maintain the momentum of investment in HIV/AIDS programs. At the same time, it should be recognized that global action for health is even more underfunded than is the response to the HIV epidemic. The real issue is therefore not whether to fund AIDS or health systems, but how to increase funding for both. The evidence is mixed - mostly positive but some negative - as to the impact on health systems of the scaled-up responses to HIV/AIDS driven primarily by global health partnerships. Current scaled-up responses to HIV/AIDS must be maintained and

  1. National oceanographic information system

    Digital Repository Service at National Institute of Oceanography (India)

    Desai, B.N.; Kunte, P.D.; Bhargava, R.M.S.

    Ocean study is inherently interdisciplinary and therefore calls for a controlled and integrated approach for information generation, processing and decision making. In this context, Indian National Oceanographic Data Centre (INODC) of National...

  2. Exploring pathways for building trust in vaccination and strengthening health system resilience

    Directory of Open Access Journals (Sweden)

    Sachiko Ozawa

    2016-11-01

    Full Text Available Abstract Background Trust is critical to generate and maintain demand for vaccines in low and middle income countries. However, there is little documentation on how health system insufficiencies affect trust in vaccination and the process of re-building trust once it has been compromised. We reflect on how disruptions to immunizations systems can affect trust in vaccination and can compromise vaccine utilization. We then explore key pathways for overcoming system vulnerabilities in order to restore trust, to strengthen the resilience of health systems and communities, and to promote vaccine utilization. Methods Utilizing secondary data and a review of the literature, we developed a causal loop diagram (CLD to map the determinants of building trust in immunizations. Using the CLD, we devised three scenarios to illustrate common vulnerabilities that compromise trust and pathways to strengthen trust and utilization of vaccines, specifically looking at weak health systems, harmful communication channels, and role of social capital. Spill-over effects, interactions and other dynamics in the CLD were then examined to assess leverage points to counter these vulnerabilities. Results Trust in vaccination arises from the interactions among experiences with the health system, the various forms of communication and social capital – both external and internal to communities. When experiencing system-wide shocks such as the case in Ebola-affected countries, distrust is reinforced by feedback between the health and immunization systems where distrust often lingers even after systems are restored and spills over beyond vaccination in the broader health system. Vaccine myths or anti-vaccine movements reinforce distrust. Social capital – the collective value of social networks of community members – plays a central role in increasing levels of trust. Conclusions Trust is important, yet underexplored, in the context of vaccine utilization. Using a CLD to

  3. Perspective and investments in health system strengthening of Gavi, the Vaccine Alliance: a content analysis of health system strengthening-specific funding.

    Science.gov (United States)

    Tsai, Feng-Jen; Lee, Howard; Fan, Victoria Y

    2016-07-01

    This paper aimed to compare the health systems strengthening (HSS) framework of Gavi and WHO and to analyze resource allocation in HSS by Gavi. Among 76 countries which received HSS funding from Gavi from 2006 to 2013, summary reports of 44 countries and approved proposals of 10 countries were collected. After comparing the HSS framework of WHO and Gavi, each activity described in documents was categorized according to Gavi's framework and funding allocation was analyzed. Compared with WHO's HSS framework, Gavi's has a distinctive function within the building block 'Drugs, Equipment, Supplies, Facilities' and a distinctive function of 'providing incentive and bonuses' under the building block 'Human Resource/Performance Management'. Gavi has steadily invested 10% of their total budget on HSS, but 47% were allocated in these categories, whereas 78% were for activities arguably not covered by WHO's HSS framework. In Africa, 70% of Gavi's budget fell under 'Drugs, Equipment, Supplies, Facilities' and 92.8% were for activities arguably not deemed as HSS by WHO. Gavi's HSS support emphasized inputs with short-term measurable outcomes. Harmonization of the concept of HSS and collaboration between Gavi and multilateral international agencies, such as World Bank and WHO, are needed. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. How Robust Refugee Protection Policies Can Strengthen Human and National Security

    Directory of Open Access Journals (Sweden)

    Donald Kerwin

    2016-09-01

    Full Text Available This paper makes the case that refugee protection and national security should be viewed as complementary, not conflicting state goals. It argues that refugee protection can further the security of refugees, affected states, and the international community. Refugees and international migrants can also advance national security by contributing to a state’s economic vitality, military strength, diplomatic standing, and civic values. The paper identifies several strategies that would, if implemented, promote both security and refugee protection. It also outlines additional steps that the US Congress should take to enhance US refugee protection policies and security. Finally, it argues for the efficacy of political engagement in support of pro-protection, pro-security policies, and against the assumption that political populism will invariably impede support for refugee protection.

  5. Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi's Health System Strengthening Grants.

    Science.gov (United States)

    Mimche, Honoré; Squires, Ellen; Miangotar, Yodé; Mokdad, Ali; El Bcheraoui, Charbel

    2018-05-01

    Despite the increase in Health System Strengthening (HSS) grants, there is no consensus among global health actors about how to maximize the efficiency and sustainability of HSS programs and their resulting gains. To formally analyze and compare the efficiency and sustainability of Gavi's HSS grants, we investigated the factors, events and root causes that increased the time and effort needed to implement HSS grants, decreased expected outcomes and threatened the continuity of activities and the sustainability of the results gained through these grants in Cameron and Chad. We conducted 2 retrospective independent evaluations of Gavi's HSS support in Cameroon and Chad using a mixed methodology. We investigated the chain of events and situations that increased the effort and time required to implement the HSS programs, decreased the value of the funds spent and hindered the sustainability of the implemented activities and gains achieved. Root causes affecting the efficiency and sustainability of HSS grants were common to Cameroon and Chad. Weaknesses in health workforce and leadership/governance of the health system in both countries led to interrupting the HSS grants, reprogramming them, almost doubling their implementation period, shifting their focus during implementation toward procurements and service provision, leaving both countries without solid exit plans to maintain the results gained. To increase the efficiency and sustainability of Gavi's HSS grants, recipient countries need to consider health workforce and leadership/governance prior, or in parallel to strengthening other building blocks of their health systems.

  6. Health systems strengthening: a common classification and framework for investment analysis.

    Science.gov (United States)

    Shakarishvili, George; Lansang, Mary Ann; Mitta, Vinod; Bornemisza, Olga; Blakley, Matthew; Kley, Nicole; Burgess, Craig; Atun, Rifat

    2011-07-01

    Significant scale-up of donors' investments in health systems strengthening (HSS), and the increased application of harmonization mechanisms for jointly channelling donor resources in countries, necessitate the development of a common framework for tracking donors' HSS expenditures. Such a framework would make it possible to comparatively analyse donors' contributions to strengthening specific aspects of countries' health systems in multi-donor-supported HSS environments. Four pre-requisite factors are required for developing such a framework: (i) harmonization of conceptual and operational understanding of what constitutes HSS; (ii) development of a common set of criteria to define health expenditures as contributors to HSS; (iii) development of a common HSS classification system; and (iv) harmonization of HSS programmatic and financial data to allow for inter-agency comparative analyses. Building on the analysis of these aspects, the paper proposes a framework for tracking donors' investments in HSS, as a departure point for further discussions aimed at developing a commonly agreed approach. Comparative analysis of financial allocations by the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance for HSS, as an illustrative example of applying the proposed framework in practice, is also presented.

  7. CITY, COUNTRYSIDE AND NATURE AS DISCURSIVE DEVICES USED TO STRENGTHEN THE NATIONAL IDENTITY IN ICELANDIC CINEMATOGRAPHY

    Directory of Open Access Journals (Sweden)

    Jakub Sebastian Konefał

    2015-03-01

    Full Text Available Since its inception the Icelandic film industry has used the strategy of combining telluric elements with national- istic narratives. In many films one may also find visual structures that can be linked with the ‘tourist gaze’ – the term as we know it from the texts of John Urry. Despite a focus on some unique qualities of Icelandic nature and its cultural heritage (that can be attractive to foreign viewers the specificity of cinematic production processes on the island belong to the structure of local, national cinema. Moreover, the 1980s, considered as the time of the rebirth of the Icelandic film industry and its rapid modernization, are full of films containing conservative or leftist telluric topics which are difficult for foreign audiences to understand. A new, transnational quality of Icelandic film features began with the film debut of Friðrik Þór Friðriksson in 1987. His fusion of modernist and postmodernist plots has encouraged other filmmakers to start the process of re-interpretation of the classic narrative structures, and to render the ironic demystification of some nationalistic themes.

  8. Strengthening Health Systems Using HIV Services as an entry point in Plateau State, Nigeria

    Directory of Open Access Journals (Sweden)

    Olubunmi O. Chirdan

    2010-12-01

    Full Text Available AIM: The AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital’s Community Directed Intervention (CDI approach to prevention and control of the spread of HIV/AIDS, in Plateau state, Nigeria commenced in July, 2008. Management of Tuberculosis and Sexually Transmitted Infections were also included in the package. METHODS: The project utilized the ‘hub and spoke’ principle with the Jos University Teaching Hospital as the hub. Provision of health services commenced in December, 2008 after a period of community sensitization, advocacy and mobilization as well as training and re-training of various cadres of health staff and volunteer community members. RESULTS: To date (July, 2009, thirty PHCs have been renovated and furnished; more than 300 healthcare workers trained, about 115 communities reached and about 8000 patients managed. Other outcomes of the project include equipping of the PHCs, strengthening of the PHC and referral systems, and improved community involvement in programme implementation. CONCLUSION: The project methodology utilized showed that it is possible to achieve additional long term benefits from programmes primarily aimed at controlling HIV/AIDS. It is recommended that other programmes adapt this methodology for the control of diseases, so as to achieve similar impact and strengthen existing health care systems. [TAF Prev Med Bull 2010; 9(6.000: 563-568

  9. Do existing research summaries on health systems match immunisation managers' needs in middle- and low-income countries? Analysis of GAVI health systems strengthening support

    Directory of Open Access Journals (Sweden)

    Kelly Marion

    2011-06-01

    Full Text Available Abstract Background The GAVI Alliance was created in 2000 to increase access to vaccines. More recently, GAVI has supported evidence-based health systems strengthening to overcome barriers to vaccination. Our objectives were: to explore countries' priorities for health systems strengthening; to describe published research summaries for each priority area in relation to their number, quality and relevance; and to describe the use of national data from surveys in identifying barriers to immunisation. Methods From 44 health systems strengthening proposals submitted to GAVI in 2007 and 2008, we analysed the topics identified, the coverage of these topics by existing systematic reviews and the use of nation-wide surveys with vaccination data to justify the needs identified in the proposals. Results Thirty topics were identified and grouped into three thematic areas: health workforce (10 topics; organisation and management (14; and supply, distribution and maintenance (6. We found 51 potentially relevant systematic reviews, although for the topic that appeared most frequently in the proposals ('Health information systems' no review was identified. Thematic and geographic relevance were generally categorised as "high" in 33 (65% and 25 (49% reviews, respectively, but few reviews were categorised as "highly relevant for policy" (7 reviews, 14%. With regard to methodological quality, 14 reviews (27% were categorised as "high". The number of topics that were addressed by at least one high quality systematic review was: seven of the 10 topics in the 'health workforce' thematic area; six of the 14 topics in the area of 'organisation and management'; and none of the topics in the thematic area of 'supply, distribution and maintenance'. Only twelve of the 39 countries with available national surveys referred to them in their proposals. Conclusion Relevant, high quality research summaries were found for few of the topics identified by managers. Few proposals

  10. INTER-PHASE CONTACTS IN BITUMEN-MINERAL SYSTEMS AND THEIR STRENGTHENING

    Directory of Open Access Journals (Sweden)

    Ya. N. Kovalev

    2014-01-01

    Full Text Available Presently bitumen-mineral materials (including asphalt-concrete comprise nearly 98 % for construction of expensive road pavement. Large resources of local minerals (quartz sand and industrial wastes in the form of used molding sand (foundry by-product are widely applied for reduction of their cost. Such approach is economically and ecologically reasonable but it requires its justification because an adhesion interaction in the bitumen-quartz substrate system (with SiO2 more than 95 % is rather poor in natural state and due to water action it is still more decreasing. In this connection an objective necessity arises to modify significantly technology of bitumen-mineral compositions for ensuring reliability of road pavements while using silicon components.All the ideas pertaining to strengthening of adhesion bonds in the “quartz mineral substrate - bitumen” system are traditionally of physical and chemical nature and they presuppose mainly usage of colloidal chemistry methods. The paper considers the matter on the basis of molecular kinetic theory of matter taking into account the fact that there is absence of generally accepted calculations for intermolecular interactions of components in the SiO2 - organic matrix material system.As a theoretical supposition the following well-known regulatory principle in physics is used: as every atom or molecular have its own electromagnetic field then action of external electromagnetic fields initiates their interaction that leads to excitement of electrons, deformations and rupture of chemical bonds. Literature analysis shows that the existing electric bonds between components of the SiO2 - organic matrix material system provide the possibility to apply various electro-physical methods having an effect on these components with the purpose to strengthen their adhesion interaction.The paper investigates matters for determination of bond energy during physical adsorption and adhesion in the SiO2 - organic

  11. Strengthening of national capacity in implementation of antimalarial drug quality assurance in Thailand.

    Science.gov (United States)

    Vijaykadga, Saowanit; Cholpol, Sawat; Sitthimongkol, Saipin; Pawaphutanan, Anusorn; Pinyoratanachot, Arunya; Rojanawatsirivet, Chaiporn; Kovithvattanapong, Rojana; Thimasarn, Krongthong

    2006-01-01

    Substandard and counterfeit pharmaceutical products, including antimalarial drugs, appear to be widespread internationally and affect both the developing and developed countries. The aim of the study was to investigate the quality of antimalarial drugs, ie, artesunate (ART), chloroquine (CHL), mefloquine (MEF), quinine (QUI), sulfadoxine/pyrimethamine (S/P) and tetracycline (TT) obtained from the government sector and private pharmacies in 4 Thai provinces: Mae Hong Son, Kanchanaburi, Ranong, and Chanthaburi. Three hundred sixty-nine samples of 6 antimalarial drugs from 27 government hospitals, 27 malaria clinics, and 53 drugstores, were collected. Drug quality was assessed by simple disintegration test and semi-quantitative thin-layer chromatography in each province; 10% passed, 100% failed and doubtful samples were sent to be verified by high performance liquid chromatography (HPLC) at the Thai National Drug Analysis Laboratory, (NL). Fifteen point four percent of ART, 11.1% of CHL and 29.4% of QUI were substandard. Based on the finding, drug regulatory authorities in the country took appropriate action against violators to ensure that antimalarial drugs consumed by malaria patients are of good quality.

  12. Improving skills and institutional capacity to strengthen adolescent immunisation programmes and health systems in African countries through HPV vaccine introduction

    Directory of Open Access Journals (Sweden)

    Carine Dochez

    2017-12-01

    Full Text Available Several African countries have recently introduced or are currently introducing the HPV vaccine, either nationwide or through demonstration projects, while some countries are planning for introduction. A collaborative project was developed to strengthen country adolescent immunisation programmes and health systems in the African Region, addressing unique public health considerations of HPV vaccination: adolescents as the primary target group, delivery platforms (e.g. school-based and facility based, socio-behavioural issues, and the opportunity to deliver other health interventions alongside HPV vaccination.Following a successful “taking-stock” meeting, a training programme was drafted to assist countries to strengthen the integration of adolescent health interventions using HPV vaccination as an entry point. Two workshops were conducted in the Eastern and Southern African Regions. All countries reported on progress made during a final joint symposium.Of the 20 countries invited to participate in either of the workshops and/or final symposium, 17 countries participated: Angola, Botswana, Ethiopia, Kenya, Malawi, Mauritius, Mozambique, Namibia, Rwanda, Seychelles, South Africa, South Sudan, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. Countries that are currently implementing HPV vaccination programmes, either nationally or through demonstration projects, reported varying degrees of integration with other adolescent health interventions. The most commonly reported adolescent health interventions alongside HPV vaccination include health education (including sexually transmitted infections, deworming and delivering of other vaccines like tetanus toxoid (TT or tetanus diphtheria (Td.The project has successfully (a established an African-based network that will advocate for incorporating the HPV vaccine into national immunisation programmes; (b created a platform for experience exchange and thereby contributed to novel ideas of

  13. Using science to strengthen our Nation's resilience to tomorrow's challenges: understanding and preparing for coastal impacts

    Science.gov (United States)

    Simmons, Dale L.; Andersen, Matthew E.; Dean, Teresa A.; Focazio, Michael J.; Fulton, John W.; Haines, John W.; Mason, Jr., Robert R.; Tihansky, Ann B.; Young, John A.

    2014-01-01

    Hurricane Sandy caused unprecedented damage across some of the most densely populated coastal areas of the northeastern United States. The costly, landscape-altering destruction left in the wake of this storm is a stark reminder of our Nation’s need to become more resilient as we inevitably face future coastal hazards. As our Nation recovers from this devastating natural disaster, it is clear that accurate scientific information is essential as we seek to identify and develop strategies to address trends in coastal landscape change and reduce our future vulnerability to major storm events. To address this need, the U.S. Geological Survey (USGS) received $43.2 million in supplemental appropriations from the Department of the Interior (DOI) to conduct the scientific research needed to guide response, recovery, and rebuilding activities and to develop effective strategies for protecting coastal communities and resources in the future. This fact sheet describes how the USGS is combining interdisciplinary science with state-of-the-art technologies to achieve a comprehensive understanding of coastal change caused by Hurricane Sandy. By assessing coastal change impacts through research and by developing tools that enhance our science capabilities, support coastal stakeholders, and facilitate effective decision making, we continue to build a greater understanding of the processes at work across our Nation’s complex coastal environment—from wetlands, estuaries, barrier islands, and nearshore marine areas to infrastructure and human communities. This improved understanding will increase our resilience as we prepare for future short-term, extreme events as well as long-term coastal change.

  14. Strengthening mental health systems in low- and middle-income countries: the Emerald programme.

    Science.gov (United States)

    Semrau, Maya; Evans-Lacko, Sara; Alem, Atalay; Ayuso-Mateos, Jose Luis; Chisholm, Dan; Gureje, Oye; Hanlon, Charlotte; Jordans, Mark; Kigozi, Fred; Lempp, Heidi; Lund, Crick; Petersen, Inge; Shidhaye, Rahul; Thornicroft, Graham

    2015-04-10

    There is a large treatment gap for mental health care in low- and middle-income countries (LMICs), with the majority of people with mental, neurological, and substance use (MNS) disorders receiving no or inadequate care. Health system factors are known to play a crucial role in determining the coverage and effectiveness of health service interventions, but the study of mental health systems in LMICs has been neglected. The 'Emerging mental health systems in LMICs' (Emerald) programme aims to improve outcomes of people with MNS disorders in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda) by generating evidence and capacity to enhance health system performance in delivering mental health care. A mixed-methods approach is being applied to generate evidence on: adequate, fair, and sustainable resourcing for mental health (health system inputs); integrated provision of mental health services (health system processes); and improved coverage and goal attainment in mental health (health system outputs). Emerald has a strong focus on capacity-building of researchers, policymakers, and planners, and on increasing service user and caregiver involvement to support mental health systems strengthening. Emerald also addresses stigma and discrimination as one of the key barriers for access to and successful delivery of mental health services.

  15. How can health systems be strengthened to control and prevent an Ebola outbreak? A narrative review

    Directory of Open Access Journals (Sweden)

    Krishna Regmi

    2015-11-01

    Full Text Available The emergence and re-emergence of infectious diseases are now more than ever considered threats to public health systems. There have been over 20 outbreaks of Ebola in the past 40 years. Only recently, the World Health Organization has declared a public health emergency of international concern (PHEIC in West Africa, with a projected estimate of 1.2 million deaths expected in the next 6 months. Ebola virus is a highly virulent pathogen, often fatal in humans and non-human primates. Ebola is now a great priority for global health security and often becomes fatal if left untreated. This study employed a narrative review. Three major databases – MEDLINE, EMBASE, and Global Health – were searched using both ‘text-words’ and ‘thesaurus terms’. Evidence shows that low- and middle-income countries (LMICs are not coping well with the current challenges of Ebola, not only because they have poor and fragile systems but also because there are poor infectious disease surveillance and response systems in place. The identification of potential cases is problematic, particularly in the aspects of contact tracing, infection control, and prevention, prior to the diagnosis of the case. This review therefore aims to examine whether LMICs’ health systems would be able to control and manage Ebola in future and identifies two key elements of health systems strengthening that are needed to ensure the robustness of the health system to respond effectively.

  16. Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India.

    Science.gov (United States)

    Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

    2016-01-01

    Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, pgender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains.

  17. Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India

    Science.gov (United States)

    Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

    2016-01-01

    Introduction Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. Methods We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. Results There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, ptransgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains. PMID:27431474

  18. The Places of National Innovation Systems

    DEFF Research Database (Denmark)

    Sørensen, Ole Henning

    1998-01-01

    The paper contains a review and comparison of four different approaches to national systems of innovation. These approaches are "National Systems of Innovation" (Freeman, 1995), "National Innovation Systems" (Nelson, 1993), "National Systems of Innovation" (Lundvall, 1992) and "The Competitive...

  19. Engagement of National Board of Examinations in strengthening public health education in India: present landscape, opportunities and future directions.

    Science.gov (United States)

    Sharma, Anjali; Zodpey, Sanjay; Batra, Bipin

    2014-01-01

    A trained and adequate heath workforce forms the crux in designing, implementing and monitoring health programs and delivering quality health services. Education is recognized as a critical instrument for creating such trained health professionals who can effectively address the 21 st century health challenges. At present, the Public Health Education in India is offered through medical colleges and also outside the corridors of medical colleges which was not the scenario earlier. Traditionally, Public Health Education has been a domain of medical colleges and was open for medical graduates only. In order to standardize the Postgraduate Medical Education in India, the National Board of Examinations (NBE) was set up as an independent autonomous body of its kind in the country in the field of medical sciences with the prime objective of improving the quality of the medical education. NBE has also played a significant role in enhancing Public Health Education in India through its Diplomat of National Board (DNB) Programs in Social and Preventive Medicine, Health and Hospital Administration, Maternal and Child Health, Family Medicine and Field Epidemiology. It envisions creating a cadre of skilled and motivated public health professionals and also developing a roadmap for postgraduate career pathways. However, there still exists gamut of opportunities for it to engage in expanding the scope of Public Health Education. It can play a key role in accreditation of public health programs and institutions which can transform the present landscape of education of health professionals. It also needs to revisit and re-initiate programs like DNB in Tropical Medicine and Occupational Health which were discontinued. The time is imperative for NBE to seize these opportunities and take necessary actions in strengthening and expanding the scope of Public Health Education in India.

  20. Strengthening national decision-making on immunization by building capacity for economic evaluation: Implementing ProVac in Europe.

    Science.gov (United States)

    Blau, Julia; Hoestlandt, Céline; D Clark, Andrew; Baxter, Louise; Felix Garcia, Ana Gabriela; Mounaud, Bérénice; Mosina, Liudmila

    2015-05-07

    For many years, low- and middle-income countries have made efforts to strengthen national decision-making on immunization. The Pan American Health Organization (PAHO) ProVac Initiative was established to help expedite the use of evidence-based decision-making around new vaccine introduction. This initiative provides training in user-friendly cost-effectiveness models and supports the development of country-led economic evaluations. Due to the success of the ProVac Initiative in the Americas, and following requests from countries from outside the Americas, the Bill & Melinda Gates Foundation funded a two-year pilot effort to expand the initiative to other world regions. Called the ProVac International Working Group (IWG), this endeavor took place in 2012 and 2013. It was coordinated by PAHO and carried out in collaboration with several international partners, including the Agence de Médecine Préventive (AMP), London School of Hygiene & Tropical Medicine (LSHTM), Program for Appropriate Technology in Health, Sabin Vaccine Institute, United States Centers for Disease Control and Prevention, and the World Health Organization (WHO). In the WHO European Region, technical support was provided by AMP, in close collaboration with the WHO Regional Office for Europe and other ProVac IWG partners. In 2012, AMP, the WHO Regional Office for Europe, and other partners held a training workshop in Dubrovnik, Croatia, for 31 participants from four countries of the WHO European Region. The aim was to train health professionals in standard methods of economic evaluation and to assess regional demand for economic studies to support decision-making on immunization. AMP and the other organizations also supported four national cost-effectiveness studies in the WHO European Region. The assistance included country visits and support over a period of six months, the establishment of multidisciplinary teams of experts, ongoing training on the TRIVAC decision-support model for new

  1. Performance-Based Financing to Strengthen the Health System in Benin: Challenging the Mainstream Approach

    Directory of Open Access Journals (Sweden)

    Elisabeth Paul

    2018-01-01

    Full Text Available Background Performance-based financing (PBF is often proposed as a way to improve health system performance. In Benin, PBF was launched in 2012 through a World Bank-supported project. The Belgian Development Agency (BTC followed suit through a health system strengthening (HSS project. This paper analyses and draws lessons from the experience of BTC-supported PBF alternative approach – especially with regards to institutional aspects, the role of demand-side actors, ownership, and cost-effectiveness – and explores the mechanisms at stake so as to better understand how the “PBF package” functions and produces effects. Methods An exploratory, theory-driven evaluation approach was adopted. Causal mechanisms through which PBF is hypothesised to impact on results were singled out and explored. This paper stems from the co-authors’ capitalisation of experiences; mixed methods were used to collect, triangulate and analyse information. Results are structured along Witter et al framework. Results Influence of context is strong over PBF in Benin; the policy is donor-driven. BTC did not adopt the World Bank’s mainstream PBF model, but developed an alternative approach in line with its HSS support programme, which is grounded on existing domestic institutions. The main features of this approach are described (decentralised governance, peer review verification, counter-verification entrusted to health service users’ platforms, as well as its adaptive process. PBF has contributed to strengthen various aspects of the health system and led to modest progress in utilisation of health services, but noticeable improvements in healthcare quality. Three mechanisms explaining observed outcomes within the context are described: comprehensive HSS at district level; acting on health workers’ motivation through a complex package of incentives; and increased accountability by reinforcing dialogue with demand-side actors. Cost-effectiveness and

  2. Flexural behaviour of partially bonded carbon fibre reinforced polymers strengthened concrete beams: Application to fire protection systems design

    International Nuclear Information System (INIS)

    Firmo, J.P.; Arruda, M.R.T.; Correia, J.R.; Tiago, C.

    2015-01-01

    Highlights: • The mechanical behaviour of partially bonded CFRP strengthened beams was modelled. • Two dimensional non-linear finite element models were developed. • Partially bonded beams can present similar flexural strength to fully bonded ones. • Relations between the bonded length and the strength reduction were proposed. • The proposed relations were used for the design of fire protection systems. - Abstract: Recent fire resistance tests on reinforced concrete (RC) beams strengthened with carbon fibre reinforced polymers (CFRP) laminates showed that it is possible to attain considerable fire endurance provided that thermal insulation is applied at the anchorage zones of the strengthening system. With such protection, although the CFRP laminate prematurely debonds in the central part of the beam, it transforms into a cable fixed at the extremities until one of the anchorage zones loses its bond strength. The main objective of this paper is to propose a simplified methodology for the design of fire protection systems for CFRP strengthened-RC beams, which is based on applying thicker insulation at the anchorage zones (promoting the above mentioned “cable behaviour”) and a thinner one at the current zone (avoiding tensile rupture of the carbon fibres). As a first step towards the validation of this methodology, finite element (FE) models were developed to simulate the flexural behaviour at ambient temperature of full-scale RC beams strengthened with CFRP laminates according to the externally bonded reinforcement (EBR) and near surface mounted (NSM) techniques, in both cases fully or partially bonded (the latter simulating the cable). The FE models were calibrated with results of 4-point bending tests on small-scale beams and then extended for different beam geometries, with spans (L) varying from 2 m to 5 m, in which the influence of the CFRP bonded length (l b ) and the loading type (point or uniformly distributed) on the strength reduction was

  3. Evaluation of a strengthening and insulation system for high temperature BSCCO-2223 superconducting tape

    Energy Technology Data Exchange (ETDEWEB)

    King, C.; Mantone, A. [GE Medical Systems, Florence, SC (United States); Herd, K.; Laskaris, T. [GE Corp. Research and Development Center, Schenectady, NY (United States)

    1995-12-31

    Recent advances in BSCCO-2223 superconducting tape quality and length have led to demonstration programs for coil performance. The conductors in these coils need to be insulated without damage to the superconducting properties. A paper insulation process developed at the General Electric Company (GE) for low temperature superconducting Nb{sub 3}Sn tape has been modified to provide the same insulation system to high temperature (HTS) superconducting tapes, such as BSCCO-2223. In this paper, we report on the insulation process and its effect on the tape performance. Several long lengths of conductor have been tested, unwound, insulated and retested to examine any degradation issues. Additionally, it is known that HTS materials are inherently weak in relation to the winding and handling stresses in a manufacturing environment. A system to provide mechanical stabilization to Nb{sub 3}Sn tape through a lamination process has been successfully applied to high temperature superconductors as a method to build a strong, windable composite. The system is described and mechanical and electrical properties of the strengthened tapes are discussed.

  4. Health-industry linkages for local health: reframing policies for African health system strengthening.

    Science.gov (United States)

    Mackintosh, Maureen; Mugwagwa, Julius; Banda, Geoffrey; Tibandebage, Paula; Tunguhole, Jires; Wangwe, Samuel; Karimi Njeru, Mercy

    2018-03-19

    The benefits of local production of pharmaceuticals in Africa for local access to medicines and to effective treatment remain contested. There is scepticism among health systems experts internationally that production of pharmaceuticals in sub-Saharan Africa (SSA) can provide competitive prices, quality and reliability of supply. Meanwhile low-income African populations continue to suffer poor access to a broad range of medicines, despite major international funding efforts. A current wave of pharmaceutical industry investment in SSA is associated with active African government promotion of pharmaceuticals as a key sector in industrialization strategies. We present evidence from interviews in 2013-15 and 2017 in East Africa that health system actors perceive these investments in local production as an opportunity to improve access to medicines and supplies. We then identify key policies that can ensure that local health systems benefit from the investments. We argue for a 'local health' policy perspective, framed by concepts of proximity and positionality, which works with local priorities and distinct policy time scales and identifies scope for incentive alignment to generate mutually beneficial health-industry linkages and strengthening of both sectors. We argue that this local health perspective represents a distinctive shift in policy framing: it is not necessarily in conflict with 'global health' frameworks but poses a challenge to some of its underlying assumptions.

  5. Role of an international non-governmental organisation in strengthening health systems in fragile-state context: Evaluation results from South Sudan

    Directory of Open Access Journals (Sweden)

    Alfonso C. Rosales

    2015-10-01

    Full Text Available World Vision implemented the community-based Maternal and Child Health Transformation (MaCHT Project from September 2010 to September 2014 in fragile-state South Sudan. To document and measure health-related activities executed by an international nongovernmentalo rganisation to sustainably strengthen the capacity of the health system in delivering essential health services to pregnant women and children under two years of age, including new-borns and infants. A range of mixed methods, including in-depth interviews, focus group discussions, observation, and uncontrolled cross-sectional before-and-after surveys using Henderson’s method were carried out. The unit of analysis was mothers of children under two years of age, and community health workers (CHWs. An estimated 39 000 children under age two were attended to by CHWs. Coverage of essential maternal and childhealth care (MCH increased in all single interventions, ranging from a minimum of 5% points to a maximum of 49% points during the implementation period. The capacity of the health system to deliver essential MCH services improved by building the supply and performance of the health workforce through task-shifting and in-service training. Likewise, operational linkages between community structures and local health services were strengthened. In conclusion, this program supported health system strengthening, mainly in the areas of service delivery, health workforce, and medical products, vaccines, and technologies. The project also informed policy at district and national levels and repositioned the maternal, neonatal, and child health (MNCH agenda to further scale up these activities. An evaluation of a four year USAID-funded child survival project implemented by an international non-governmental organisation (NGO in fragile-state context showed progress and challenges in health system strengthening for maternal health practices and community case management of diarrhoea, pneumonia, and

  6. Transforming the Roles of a Public Extension Agency to Strengthen Innovation: Lessons from the National Agricultural Extension Project in Bangladesh

    NARCIS (Netherlands)

    Chowdhury, A.H.; Odame, H.H.; Leeuwis, C.

    2014-01-01

    Purpose: The rapidly evolving nature of agricultural innovation processes in low-income countries requires agricultural extension agencies to transform the classical roles that previously supported linear information dissemination and adoption of innovation. In Bangladesh, strengthening agricultural

  7. Strengthening health information systems for disability-related rehabilitation in LMICs.

    Science.gov (United States)

    McPherson, Anna; Durham, Jo; Richards, Nicola; Gouda, Hebe; Rampatige, Rasika; Whittaker, Maxine

    2017-04-01

    The purpose of this study was to describe the state of rehabilitation health information systems (HIS) in different settings, and identify key processes and actions which contribute to the development of HIS which can effectively support low- and middle-income countries (LMICs) allocate resources to health-related rehabilitation to people with disabilities. Nine case studies were conducted across different disability and developmental settings using documentary review and semi-structured key informant interviews (N = 41). Results were analysed against the six building blocks of a HIS, based on the Health Metrics Network Framework and Standards for Country Health Information Systems and existing HIS capacity. Key barriers or enablers to good disability data collection and use, were documented for each HIS component. Research results suggest there is no gold standard HIS for rehabilitation. There was broad consensus however, that effective health related disability planning requires reliable data on disability prevalence, functional status, access to rehabilitation services and functional outcomes of rehabilitation. For low-resource settings, and where routine HIS are already challenged, planning to include disability and rehabilitation foci starting with a minimum dataset on functioning, and progressively improving the system for increased utility and harmonization, is likely to be most effective and minimize the potential for overburdening fragile systems. The recommendations from this study are based on the successes and challenges of countries with established information systems, and will assist LMICs to prioritize strategic measures to strengthen the collection and use of data for rehabilitation, and progressively realize the rights of people with disabilities. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  8. VA National Bed Control System

    Data.gov (United States)

    Department of Veterans Affairs — The VA National Bed Control System records the levels of operating, unavailable and authorized beds at each VAMC, and it tracks requests for changes in these levels....

  9. Nuclear Medicine National Headquarter System

    Data.gov (United States)

    Department of Veterans Affairs — The Nuclear Medicine National HQ System database is a series of MS Excel spreadsheets and Access Database Tables by fiscal year. They consist of information from all...

  10. Strengthening Agricultural Education and Training in Sub-Saharan Africa from an Innovation Systems Perspective: A Case Study of Mozambique

    Science.gov (United States)

    Davis, Kristin E.; Ekboir, Javier; Spielman, David J.

    2008-01-01

    This paper examines how post-secondary agricultural education and training (AET) in sub-Saharan Africa can contribute to agricultural development by strengthening the capacity to innovate--to introduce new products and processes that are socially or economically relevant to smallholder farmers and other agents. Using the AET system in Mozambique…

  11. National Satellite Forest Monitoring systems for REDD+

    Science.gov (United States)

    Jonckheere, I. G.

    2012-12-01

    Reducing Emissions from Deforestation and Forest Degradation (REDD) is an effort to create a financial value for the carbon stored in forests, offering incentives for developing countries to reduce emissions from forested lands and invest in low-carbon paths to sustainable development. "REDD+" goes beyond deforestation and forest degradation, and includes the role of conservation, sustainable management of forests and enhancement of forest carbon stocks. In the framework of getting countries ready for REDD+, the UN-REDD Programme assists developing countries to prepare and implement national REDD+ strategies. For the monitoring, reporting and verification, FAO supports the countries to develop national satellite forest monitoring systems that allow for credible measurement, reporting and verification (MRV) of REDD+ activities. These are among the most critical elements for the successful implementation of any REDD+ mechanism. The UN-REDD Programme through a joint effort of FAO and Brazil's National Space Agency, INPE, is supporting countries to develop cost- effective, robust and compatible national monitoring and MRV systems, providing tools, methodologies, training and knowledge sharing that help countries to strengthen their technical and institutional capacity for effective MRV systems. To develop strong nationally-owned forest monitoring systems, technical and institutional capacity building is key. The UN-REDD Programme, through FAO, has taken on intensive training together with INPE, and has provided technical help and assistance for in-country training and implementation for national satellite forest monitoring. The goal of the support to UN-REDD pilot countries in this capacity building effort is the training of technical forest people and IT persons from interested REDD+ countries, and to set- up the national satellite forest monitoring systems. The Brazilian forest monitoring system, TerraAmazon, which is used as a basis for this initiative, allows

  12. eHealth for Remote Regions: Findings from Central Asia Health Systems Strengthening Project.

    Science.gov (United States)

    Sajwani, Afroz; Qureshi, Kiran; Shaikh, Tehniat; Sayani, Saleem

    2015-01-01

    Isolated communities in remote regions of Afghanistan, Kyrgyz Republic, Pakistan and Tajikistan lack access to high-quality, low-cost health care services, forcing them to travel to distant parts of the country, bearing an unnecessary financial burden. The eHealth Programme under Central Asia Health Systems Strengthening (CAHSS) Project, a joint initiative between the Aga Khan Foundation, Canada and the Government of Canada, was initiated in 2013 with the aim to utilize Information and Communication Technologies to link health care institutions and providers with rural communities to provide comprehensive and coordinated care, helping minimize the barriers of distance and time. Under the CAHSS Project, access to low-cost, quality health care is provided through a regional hub and spoke teleconsultation network of government and non-government health facilities. In addition, capacity building initiatives are offered to health professionals. By 2017, the network is expected to connect seven Tier 1 tertiary care facilities with 14 Tier 2 secondary care facilities for teleconsultation and eLearning. From April 2013 to September 2014, 6140 teleconsultations have been provided across the project sites. Additionally, 52 new eLearning sessions have been developed and 2020 staff members have benefitted from eLearning sessions. Ethics and patient rights are respected during project implementation.

  13. The necessity of strengthening the cooperation between tissue banks and organ transplant organizations at national, regional, and international levels.

    Science.gov (United States)

    Morales Pedraza, Jorge

    2013-12-01

    The donation of tissues and organs increases significantly when tissue banks and organ transplant organizations work together in the procurement of organs and tissues at donor sources (hospitals, coroners system, organ procurement agencies, and funeral homes, among others). To achieve this important goal, national competent health authorities should considered the establishment of a mechanism that promote the widest possible cooperation between tissue banks and organ transplant organizations with hospitals, research medical institutions, universities, and other medical institutions and facilities. One of the issues that can facilitate this cooperation is the establishment of a coding and traceability system that could identify all tissues and organs used in transplant activities carried out in any country. The promotion of national, regional, and international cooperation between tissue banks and organ transplant organizations would enable the sharing of relevant information that could be important for medical practice and scientific studies carried out by many countries, particularly for those countries with a weak health care system.

  14. Mortality in Central Java: results from the indonesian mortality registration system strengthening project

    Directory of Open Access Journals (Sweden)

    Irianto Joko

    2010-12-01

    mortality measures for health policy and monitoring in Indonesia. Strong demand for data from different stakeholders can stimulate further strengthening of mortality registration systems.

  15. Punching strengthen

    Directory of Open Access Journals (Sweden)

    Hazem M.F. Elbakry

    2015-12-01

    Full Text Available An experimental and analytical study on the punching strengthening of reinforced concrete two-way slabs using external steel plates is presented. Five reinforced concrete square slabs of 100 mm thickness were tested over simply supported four sides of 1000 mm span under central square patch load of 100 mm size up to failure. One control slab was tested without strengthening; however, four tested slabs were strengthened using four configurations of square steel plates provided with steel anchor shear studs. Such configurations considered two different plate thickness, two plate side dimensions and different arrangement and diameter of shear studs. The strengthened four slabs showed improved stiffness and punching shear capacity. The magnitude of improvement depended on the plate dimensions and the studs diameter and arrangement. An analytical approach was proposed for predicting the punching shear strength increase due to using the strengthening steel plate. The proposed approach was applied to the tested specimens with the use of the punching shear strength equations adopted by several codes of practice and proved to be in good agreement with the test results. Generally, this research presented a practical strengthening concept that can be used to increase the punching shear capacity of two-way slabs.

  16. Prevention of Congenital Transmission of Malaria in Sub-Saharan African Countries: Challenges and Implications for Health System Strengthening

    OpenAIRE

    Osungbade, Kayode O.; Oladunjoye, Olubunmi O.

    2012-01-01

    Objectives. Review of burden of congenital transmission of malaria, challenges of preventive measures, and implications for health system strengthening in sub-Saharan Africa. Methods. Literature from Pubmed (MEDLINE), Biomed central, Google Scholar, and Cochrane Database were reviewed. Results. The prevalence of congenital malaria in sub-Saharan Africa ranges from 0 to 23%. Diagnosis and existing preventive measures are constantly hindered by weak health systems and sociocultural issues. WHO ...

  17. Strengthening by ordered precipitates in a Ni--Ni4Mo system

    International Nuclear Information System (INIS)

    Goodrum, J.W.; LeFevre, B.G.

    1977-01-01

    The strength characteristics and microstructures of aged Ni-Mo alloys containing ordered (Ni 4 Mo) precipitates were studied as a function of aging time and temperature. It was found that 17 at. percent Mo alloy aged at 750 0 C produced a uniform dispersion of cuboidal β precipitates which coarsened with time producing a gradual increase in flow stress. The flow stress increment was found to vary in qualitative agreement with both order strengthening and coherency strain models. Both these models give over-estimates of the strengthening increment. A negative dependence of flow stress on temperature is attributed to coherency strain contributions

  18. Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: systematic review.

    Science.gov (United States)

    Semrau, Maya; Lempp, Heidi; Keynejad, Roxanne; Evans-Lacko, Sara; Mugisha, James; Raja, Shoba; Lamichhane, Jagannath; Alem, Atalay; Thornicroft, Graham; Hanlon, Charlotte

    2016-03-01

    The involvement of mental health service users and their caregivers in health system policy and planning, service monitoring and research can contribute to mental health system strengthening, but as yet there have been very few efforts to do so in low- and middle-income countries (LMICs). This systematic review examined the evidence and experience of service user and caregiver involvement in mental health system strengthening, as well as models of best practice for evaluation of capacity-building activities that facilitate their greater participation. Both the peer-reviewed and the grey literature were included in the review, which were identified through database searches (MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, SciELO, Google Scholar and Cochrane), as well as hand-searching of reference lists and the internet, and a snowballing process of contacting experts active in the area. This review included any kind of study design that described or evaluated service user, family or caregiver (though not community) involvement in LMICs (including service users with intellectual disabilities, dementia, or child and adolescent mental health problems) and that were relevant to mental health system strengthening across five categories. Data were extracted and summarised as a narrative review. Twenty papers matched the inclusion criteria. Overall, the review found that although there were examples of service user and caregiver involvement in mental health system strengthening in numerous countries, there was a lack of high-quality research and a weak evidence base for the work that was being conducted across countries. However, there was some emerging research on the development of policies and strategies, including advocacy work, and to a lesser extent the development of services, service monitoring and evaluation, with most service user involvement having taken place within advocacy and service delivery. Research was scarce within

  19. Transforming the Roles of a Public Extension Agency to Strengthen Innovation: Lessons from the National Agricultural Extension Project in Bangladesh

    Science.gov (United States)

    Chowdhury, Ataharul Huq; Odame, Helen Hambly; Leeuwis, Cees

    2014-01-01

    Purpose: The rapidly evolving nature of agricultural innovation processes in low-income countries requires agricultural extension agencies to transform the classical roles that previously supported linear information dissemination and adoption of innovation. In Bangladesh, strengthening agricultural innovation calls for facilitation of interactive…

  20. Strengthening district-based health reporting through the district health management information software system: the Ugandan experience.

    Science.gov (United States)

    Kiberu, Vincent Micheal; Matovu, Joseph K B; Makumbi, Fredrick; Kyozira, Carol; Mukooyo, Eddie; Wanyenze, Rhoda K

    2014-05-13

    Untimely, incomplete and inaccurate data are common challenges in planning, monitoring and evaluation of health sector performance, and health service delivery in many sub-Saharan African settings. We document Uganda's experience in strengthening routine health data reporting through the roll-out of the District Health Management Information Software System version 2 (DHIS2). DHIS2 was adopted at the national level in January 2011. The system was initially piloted in 4 districts, before it was rolled out to all the 112 districts by July 2012. As part of the roll-out process, 35 training workshops targeting 972 users were conducted throughout the country. Those trained included Records Assistants (168, 17.3%), District Health Officers (112, 11.5%), Health Management Information System Focal Persons (HMIS-FPs) (112, 11.5%), District Biostatisticians (107, 11%) and other health workers (473, 48.7%). To assess improvements in health reporting, we compared data on completeness and timeliness of outpatient and inpatient reporting for the period before (2011/12) and after (2012/13) the introduction of DHIS2. We reviewed data on the reporting of selected health service coverage indicators as a proxy for improved health reporting, and documented implementation challenges and lessons learned during the DHIS2 roll-out process. Completeness of outpatient reporting increased from 36.3% in 2011/12 to 85.3% in 2012/13 while timeliness of outpatient reporting increased from 22.4% to 77.6%. Similarly, completeness of inpatient reporting increased from 20.6% to 57.9% while timeliness of inpatient reporting increased from 22.5% to 75.6%. There was increased reporting on selected health coverage indicators (e.g. the reporting of one-year old children who were immunized with three doses of pentavelent vaccine increased from 57% in 2011/12 to 87% in 2012/13). Implementation challenges included limited access to computers and internet (34%), inadequate technical support (23%) and limited

  1. HIV communication capacity strengthening: a critical review.

    Science.gov (United States)

    Lettenmaier, Cheryl; Kraft, Joan Marie; Raisanen, Keris; Serlemitsos, Elizabeth

    2014-08-15

    HIV communication is most effective and sustainable when it is designed and implemented locally and tailored to the local context. This requires capacity strengthening at national, subnational, and community levels. Through a review of the published and selected "grey" literature, we examine HIV communication capacity strengthening: definitions, measurements, implementation, and effects. We found limited documentation of HIV communication capacity needs or systematic approaches to address them. Most HIV communication capacity strengthening to date has focused on building individual competencies to design and manage social and behavior change communication programs through training courses, often coupled with networking opportunities for participants, post-training mentoring, and technical assistance. A few of these efforts have been evaluated through pre- and post-training tests and qualitative interviews with participants and have shown potential for improvement in individual skills and knowledge. Health communication capacity assessment tools that measure individual and organizational competencies exist, but they have most often been used to identify capacity building needs, not for evaluating capacity strengthening efforts. A new definition of capacity strengthening, grown out of recent efforts to improve effectiveness of international health and development programs, focuses on improving organizational and societal systems that support performance and individual competencies. We propose a holistic model for HIV communication capacity strengthening and call for rigorous documentation and evaluation to determine and scale-up optimal capacity building interventions for strengthening social and behavior change communication for HIV prevention, care, and treatment in developing countries.

  2. Service user involvement in mental health system strengthening in a rural African setting: qualitative study.

    Science.gov (United States)

    Abayneh, Sisay; Lempp, Heidi; Alem, Atalay; Alemayehu, Daniel; Eshetu, Tigist; Lund, Crick; Semrau, Maya; Thornicroft, Graham; Hanlon, Charlotte

    2017-05-18

    It is essential to involve service users in efforts to expand access to mental health care in integrated primary care settings in low- and middle-income countries (LMICs). However, there is little evidence from LMICs to guide this process. The aim of this study was to explore barriers to, and facilitators of, service user/caregiver involvement in rural Ethiopia to inform the development of a scalable approach. Thirty nine semi-structured interviews were carried out with purposively selected mental health service users (n = 13), caregivers (n = 10), heads of primary care facilities (n = 8) and policy makers/planners/service developers (n = 8). The interviews were audio-recorded and transcribed in Amharic, and translated into English. Thematic analysis was applied. All groups of participants supported service user and caregiver involvement in mental health system strengthening. Potential benefits were identified as (i) improved appropriateness and quality of services, and (ii) greater protection against mistreatment and promotion of respect for service users. However, hardly any respondents had prior experience of service user involvement. Stigma was considered to be a pervasive barrier, operating within the health system, the local community and individuals. Competing priorities of service users included the need to obtain adequate individual care and to work for survival. Low recognition of the potential contribution of service users seemed linked to limited empowerment and mobilization of service users. Potential health system facilitators included a culture of community oversight of primary care services. All groups of respondents identified a need for awareness-raising and training to equip service users, caregivers, service providers and local community for involvement. Empowerment at the level of individual service users (information about mental health conditions, care and rights) and the group level (for advocacy and representation) were considered

  3. Strengthening Resiliency in Coastal Watersheds: An Ecosystem Services and Ecological Integrity Decision Support System.

    Science.gov (United States)

    To promote and strengthen the resiliency of coastal watersheds in the face of climate change and development, ecological outcomes as well as economic, social, and environmental justice issues need to be considered. An integrated assessment framework is being developed to help wat...

  4. Strengthening Research Capacity to Enhance Natural Resources ...

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

    This project aims to strengthen the capacity of national agricultural research and extension systems (NARES) in Africa to apply participatory approaches and cutting-edge ideas to research for development. The project will involve a series of iterative steps including learning, practice, reflection and feedback, and focus on ...

  5. Fire protection system management in nuclear facilities: strengthening factor of integrated management system - a case study

    International Nuclear Information System (INIS)

    Santos, Joao Regis dos

    2005-01-01

    The present study investigated and analyzed the importance of a system of integrated safety manage, environment and health in a nuclear installation, having as perspective, the fire protection manage. The inquiry was made using a qualitative research involving a case study, where the considered environment was the Reconversion and UO 2 Plant of the Industrias Nucleares do Brasil (INB), located in Resende, Rio de Janeiro and the studied population, the managers and the staff directly involved with the aspects related to the safety of the industrial complex of the related company. The motivation for the research was the search of a bigger interaction of the questions related to the safety, environment and health in the nuclear industry having, as axle of the investigation, the fire protection. As a result, it was observed that in a nuclear installation, although dealing with diversified safety processes, integration is possible and necessary, since there are more reasons for integration than otherwise. (author)

  6. Improving skills and institutional capacity to strengthen adolescent immunisation programmes and health systems in African countries through HPV vaccine introduction

    OpenAIRE

    Carine Dochez; Rosemary J. Burnett; Symplice Mbola Mbassi; Fred Were; Andrew Musyoki; Daisy Trovoada; M. Jeffrey Mphahlele

    2017-01-01

    Several African countries have recently introduced or are currently introducing the HPV vaccine, either nationwide or through demonstration projects, while some countries are planning for introduction. A collaborative project was developed to strengthen country adolescent immunisation programmes and health systems in the African Region, addressing unique public health considerations of HPV vaccination: adolescents as the primary target group, delivery platforms (e.g. school-based and facility...

  7. Performance-based financing with GAVI health system strengthening funding in rural Cambodia: a brief assessment of the impact.

    Science.gov (United States)

    Matsuoka, Sadatoshi; Obara, Hiromi; Nagai, Mari; Murakami, Hitoshi; Chan Lon, Rasmey

    2014-07-01

    Though Cambodia made impressive gains in immunization coverage between the years 2000 and 2005, it recognized several health system challenges to greater coverage of immunization and sustainability. The Global Alliance for Vaccines and Immunization (GAVI) opened a Health System Strengthening (HSS) funding window in 2006. To address the health system challenges, Cambodia has been receiving the GAVI HSS fund since October 2007. The major component of the support is performance-based financing (PBF) for maternal, neonatal and child health (MNCH) services. To examine the impact of the PBF scheme on MNCH services and administrative management in rural Cambodia. Quantitative and qualitative studies were conducted in Kroch Chhmar Operational District (OD), Cambodia. Quantitative analyses were conducted on the trends of the numbers of MNCH services. A brief analysis was conducted using qualitative data. After the commencement of the PBF support, the volume of MNCH services was significantly boosted. In addition, strengthened financial and operational management was observed in the study area. However, the quality of the MNCH services was not ensured. Technical assistance, rather than the PBF scheme, was perceived by stakeholders to play a vital role in increasing the quality of the services. To improve the quality of the health services provided, it is better to include indicators on the quality of care in the PBF scheme. Mutual co-operation between PBF models and technical assistance may ensure better service quality while boosting the quantity. A robust but feasible data validation mechanism should be in place, as a PBF could incentivize inaccurate reporting. The capacity for financial management should be strengthened in PBF recipient ODs. To address the broader aspects of MNCH, a balanced input of resources and strengthening of all six building blocks of a health system are necessary. Published by Oxford University Press in association with The London School of Hygiene

  8. Institutional capacity for health systems research in East and Central African Schools of Public Health: strengthening human and financial resources

    Science.gov (United States)

    2014-01-01

    Background Despite its importance in providing evidence for health-related policy and decision-making, an insufficient amount of health systems research (HSR) is conducted in low-income countries (LICs). Schools of public health (SPHs) are key stakeholders in HSR. This paper, one in a series of four, examines human and financial resources capacities, policies and organizational support for HSR in seven Africa Hub SPHs in East and Central Africa. Methods Capacity assessment done included document analysis to establish staff numbers, qualifications and publications; self-assessment using a tool developed to capture individual perceptions on the capacity for HSR and institutional dialogues. Key informant interviews (KIIs) were held with Deans from each SPH and Ministry of Health and non-governmental officials, focusing on perceptions on capacity of SPHs to engage in HSR, access to funding, and organizational support for HSR. Results A total of 123 people participated in the self-assessment and 73 KIIs were conducted. Except for the National University of Rwanda and the University of Nairobi SPH, most respondents expressed confidence in the adequacy of staffing levels and HSR-related skills at their SPH. However, most of the researchers operate at individual level with low outputs. The average number of HSR-related publications was only capacity. This study underscores the need to form effective multidisciplinary teams to enhance research of immediate and local relevance. Capacity strengthening in the SPH needs to focus on knowledge translation and communication of findings to relevant audiences. Advocacy is needed to influence respective governments to allocate adequate funding for HSR to avoid donor dependency that distorts local research agenda. PMID:24888371

  9. REGULATION OF NATIONAL QUALIFICATIONS SYSTEMS

    Directory of Open Access Journals (Sweden)

    Anna A. Muravyeva

    2014-01-01

    Full Text Available The paper looks into the diverse aspects of qualifications system regulation, designed for balancing the supply and demand in the labor and educational service markets. Both the objects and mechanisms of such regulation are described. Special attention is given to institutions, involved in regulation of qualifications, and their jurisdiction. Another emphasis is on the industry-related regulation of qualifications which proved to be effective both on the national and European level. Such structures were first established on the national levels to regulate the qualifications and ensure their comparability and compatibility, given the economic globalization and growing labor and academic mobility. The author points out the role of the ministries of education and labor in maintaining a steady qualifications system, and outlines the positive experience of Great Britain using the industry councils for continuing development of qualifications system.

  10. Strengthening global physical protection practices; gaining better information on national practices for protection of weapons-usable material. Keynote address/session 3

    International Nuclear Information System (INIS)

    Bunn, G.; Rinne, R.

    2001-01-01

    facilities and nuclear materials, particularly when such materials are transported across national frontiers.' (INFCIRC/225,Rev.4, Preface). Contributing to recent efforts by the United States and others to strengthen global standards for physical protection, a Stanford project proposes ways to increase cooperation by providing more information about physical protection practices. The project has developed a questionnaire on physical protection practices. We recognize that some information about a state's system of physical protection can't be made public because of the fear that key secrets of protection might be used by terrorists or thieves in subsequent efforts to steal or sabotage the material. (See INFCIRC/225/Rev.4, par. 4.3). For those states willing to complete our questionnaire for a facility, we have promised not to make information public without their consent. But state-to-state comparisons of perceived threats and overall plans to counter them might be particularly educational. With cooperation from Sandia and industry, the Stanford project hopes to demonstrate sensors and other means for physical protection. For example, the project's Friedrich Steinhausler has proposed the development of a 'Virtual Walk-Through Facility' - a three-dimensional, computer assisted, simulation-demonstration showing the effectiveness of various possible protections for weapon-usable material against a variety of threats. This would be useful for training, for appraising protection proposals, and for evaluating the capabilities of existing facilities. It could be a significant addition to the display of physical protection technology and methods at Sandia's Cooperative Monitoring Center and a tool for use in IAEA training courses, demonstrations or conferences like this one. The basic goal of the Stanford project is to help strengthen global physical protection practices and standards. We have already made specific recommendations, and intend to continue our analysis of possible

  11. Mechanical and microstructural characterization of dispersion strengthened Al-C system nanocomposites

    International Nuclear Information System (INIS)

    Santos-Beltran, A.; Gallegos-Orozco, V.; Reyes, R. Goytia; Miki-Yoshida, M.; Estrada-Guel, I.; Martinez-Sanchez, R.

    2010-01-01

    Al and different amounts of C and C-Cu mixtures were used to produce Al-C and Al-C-Cu powder samples by mechanical milling. Microhardness tests were carried out to evaluate the mechanical properties of the nanocomposites in the as-milled condition. In general, the measured values were considerably higher than pure Al. In order to determine the causes of this hardening, the crystallite size and dislocation density were measured by means of X-ray analyses coupled with a convolutional multiple whole profile (CMWP) fitting program and a comparison with atomic force microscopy (AFM) observations. In Al-C samples, the hardening is mainly due to the decrease of the crystallite size, however for the Al-C-Cu, an additional strengthening mechanism appears and it seems that it is due by a dispersion of graphite nanoparticles in the Al matrix. The strengthening contributions of dislocation density, crystallite size and particle dispersion were modeled by superposing of every single contribution to strengthening (via hardness analyses). We found a direct relationship between the mechanical properties and the nominal amount of C-Cu, where Cu apparently acts as C nanoparticles integration and dispersion agent.

  12. Rolling out Xpert MTB/RIF® for tuberculosis detection in HIV-positive populations: An opportunity for systems strengthening

    Directory of Open Access Journals (Sweden)

    Ishani Pathmanathan

    2017-03-01

    Conclusion: Xpert MTB/RIF will only improve patient outcomes if optimally implemented within the context of strong tuberculosis programmes and systems. Roll-out of this technology to people living with HIV and others in resource-limited settings offers the opportunity to leverage current tuberculosis and HIV laboratory, diagnostic and programmatic investments, while also addressing challenges and strengthening coordination between laboratory systems, laboratory-programme interfaces, and tuberculosis-HIV programme interfaces. If successful, the benefits of this tool could extend beyond progress toward global End TB Strategy goals, to improve system-wide capacity for global disease detection and control.

  13. Composites Strengthening.

    Science.gov (United States)

    1987-11-01

    measurement of composite strengthening is that tht interface the interfacial bond shear strength in Al-SiC transfers the load from the matrix into...effort was made to perform among other factors, the bond integrity and a punch test using aluminum disks with the efficiency of the load transfer from...cnisuite construit un modilc theoriquc, base sur la rnthodc d’Eshelby. pour pr~dire Ics contraintes thermiques r~siducllcs Acy. Nous avons obtenu un tr

  14. Seriously Implementing Health Capacity Strengthening Programs in Africa; Comment on “Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique”

    Directory of Open Access Journals (Sweden)

    Luis Velez Lapão

    2015-10-01

    Full Text Available Faced with the challenges of healthcare reform, skills and new capabilities are needed to support the reform and it is of crucial importance in Africa where shortages affects the health system resilience. Edwards et al provides a good example of the challenge of implementing a mentoring program in one province in a sub-Saharan country. From this example, various aspects of strengthening the capacity of managers in healthcare are examined based on our experience in action-training in Africa, as mentoring shares many characteristics with action-training. What practical lessons can be drawn to promote the strengthening so that managers can better intervene in complex contexts? Deeper involvement of health authorities and more rigorous approaches are seriously desirable for the proper development of health capacity strengthening programs in Africa.

  15. The Additional Protocol as an important tool for the strengthening of the safeguards system

    International Nuclear Information System (INIS)

    Loosch, Reinhard

    2001-01-01

    Full text: The following main points will be dealt with and underlined by illustrative examples: 0. A preliminary clarification: Contrary to the title's short-hand language, it is of course, not the Additional Protocols entered into by the Agency and States and other Parties to Safeguards Agreements since 1997 nor the Model Additional Protocol adopted by the Board of Governors and endorsed by the General Conference in 1997 that are, by themselves, an important tool for the strengthening of the Agency's safeguards system. They are, however, the necessary legal prerequisite as well as a strong political and moral boost for enabling the Agency to develop and apply additional tools in order to make the international nuclear non-proliferation regime more effective and, therefore, more reassuring and at the same time, more efficient and therefore, more widely accepted. 1. The importance of the new tools cannot be assessed yet. Hopefully, it will grow quickly and consistently. This will depend primarily on two factors: - The extent to which Additional Protocols are entered into force and at what speed this is achieved, and the extent to which these Protocols cover all important peaceful nuclear activities and resources, whether these exist in states with comprehensive safeguards agreements or not; - The extent to which the Agency succeeds in merging the new measures with those applicable before into an optimized, integrated toolbox. 2. The first factor tends to increase effectiveness by permitting the collection of safeguards- relevant data provided not only in reports from countries in which such activities are conducted or such resources exist but also in information coming from other sources such as publications in. or intelligence made available by, other countries. Cross-checking all those data against each other may, in the best case, reinforce their credibility or, in the worst case, reveal gaps and inconsistencies, but will at any rate, in one way or other, help

  16. United Nations system efforts to support the response to AIDS in China.

    Science.gov (United States)

    He, Jing Lin; Rehnstrom, Joel

    2005-01-01

    In the last two years, we have seen a remarkable intensification in the response to AIDS in China. A number of organizations have joined and contributed to the efforts of the Chinese government in responding the AIDS epidemic in China. This article specifically describes the role of the United Nations (UN) in supporting and strengthening those responses. Achievements of the United Nations highlighted in the article include: strengthened leadership and political commitment to respond to AIDS; improved HIV/AIDS surveillance and information; expanded prevention efforts; improved treatment, care and support to people living with HIV and increased resources for AIDS programs. Additional roles of the United Nations system in the near future include strengthening national leadership by supporting the 'three ones', i.e., one national plan on AIDS; one national coordinating authority for AIDS; and one monitoring and evaluation system for AIDS. In addition, the UN system is expected to strengthen alignment and harmonization of activities of all international organizations and improved accountability and oversight. Remaining challenges identified include increasing awareness of AIDS and reducing stigma and discrimination; reducing vulnerability and risk behaviour among specific groups; providing improved treatment, care and support for people living with HIV; promoting stronger engagement by civil society, and; addressing the gender dimensions of AIDS.

  17. Keeping health facilities safe: one way of strengthening the interaction between disease-specific programmes and health systems.

    Science.gov (United States)

    Harries, Anthony D; Zachariah, Rony; Tayler-Smith, Katie; Schouten, Erik J; Chimbwandira, Frank; Van Damme, Wim; El-Sadr, Wafaa M

    2010-12-01

    The debate on the interaction between disease-specific programmes and health system strengthening in the last few years has intensified as experts seek to tease out common ground and find solutions and synergies to bridge the divide. Unfortunately, the debate continues to be largely academic and devoid of specificity, resulting in the issues being irrelevant to health care workers on the ground. Taking the theme 'What would entice HIV- and tuberculosis (TB)-programme managers to sit around the table on a Monday morning with health system experts', this viewpoint focuses on infection control and health facility safety as an important and highly relevant practical topic for both disease-specific programmes and health system strengthening. Our attentions, and the examples and lessons we draw on, are largely aimed at sub-Saharan Africa where the great burden of TB and HIV ⁄ AIDS resides, although the principles we outline would apply to other parts of the world as well. Health care infections, caused for example by poor hand hygiene, inadequate testing of donated blood, unsafe disposal of needles and syringes, poorly sterilized medical and surgical equipment and lack of adequate airborne infection control procedures, are responsible for a considerable burden of illness amongst patients and health care personnel, especially in resource-poor countries. Effective infection control in a district hospital requires that all the components of a health system function well: governance and stewardship, financing,infrastructure, procurement and supply chain management, human resources, health information systems, service delivery and finally supervision. We argue in this article that proper attention to infection control and an emphasis on safe health facilities is a concrete first step towards strengthening the interaction between disease-specific programmes and health systems where it really matters – for patients who are sick and for the health care workforce who provide

  18. NGOs and government partnership for health systems strengthening: a qualitative study presenting viewpoints of government, NGOs and donors in Pakistan.

    Science.gov (United States)

    Ejaz, Iram; Shaikh, Babar T; Rizvi, Narjis

    2011-05-24

    Health systems are expected to serve the population needs in an effective, efficient and equitable manner. Therefore, the importance of strengthening of public, private and community health systems has been emphasized time and again. In most of the developing countries, certain weaknesses and gaps in the government health systems have been hampering the achievement of improved health outcomes. Public sector in Pakistan has been deficient in the capacity to deliver equitable and quality health services and thus has been grossly underutilized. A qualitative study comprising in-depth interviews was conducted capturing the perceptions of the government functionaries, NGO representatives and donor community about the role and position of NGOs in health systems strengthening in Pakistan's context. Analysis of the data was done manually to generate nodes, sub-nodes and themes. Since many years, international and local non-governmental organizations (NGOs) have endeavored to fill the gaps in health service delivery, research and advocacy. NGOs have relatively performed better and achieved the results because of the flexible planning and the ability to design population based projects on health education, health promotion, social marketing, community development and advocacy. This paper captures the need and the opportunity of public private partnership in Pakistan and presents a framework for a meaningful engagement of the government and the private and nonprofit NGOs. Involving the NGOs for health system strengthening may eventually contribute to create a healthcare system reflecting an increased efficiency, more equity and good governance in the wake of the Millennium Development Goals. Nevertheless, few questions need to be answered and pre-requisites have to be fulfilled before moving on.

  19. NGOs and government partnership for health systems strengthening: A qualitative study presenting viewpoints of government, NGOs and donors in Pakistan

    Directory of Open Access Journals (Sweden)

    Rizvi Narjis

    2011-05-01

    Full Text Available Abstract Background Health systems are expected to serve the population needs in an effective, efficient and equitable manner. Therefore, the importance of strengthening of public, private and community health systems has been emphasized time and again. In most of the developing countries, certain weaknesses and gaps in the government health systems have been hampering the achievement of improved health outcomes. Public sector in Pakistan has been deficient in the capacity to deliver equitable and quality health services and thus has been grossly underutilized. Methods A qualitative study comprising in-depth interviews was conducted capturing the perceptions of the government functionaries, NGO representatives and donor community about the role and position of NGOs in health systems strengthening in Pakistan's context. Analysis of the data was done manually to generate nodes, sub-nodes and themes. Results Since many years, international and local non-governmental organizations (NGOs have endeavored to fill the gaps in health service delivery, research and advocacy. NGOs have relatively performed better and achieved the results because of the flexible planning and the ability to design population based projects on health education, health promotion, social marketing, community development and advocacy. This paper captures the need and the opportunity of public private partnership in Pakistan and presents a framework for a meaningful engagement of the government and the private and nonprofit NGOs. Conclusion Involving the NGOs for health system strengthening may eventually contribute to create a healthcare system reflecting an increased efficiency, more equity and good governance in the wake of the Millennium Development Goals. Nevertheless, few questions need to be answered and pre-requisites have to be fulfilled before moving on.

  20. 36th national systems conference on recent advancements in system modelling applications

    CERN Document Server

    Krishnan, J

    2013-01-01

    The book is a collection of peer-reviewed scientific papers submitted by active researchers in the 36th National System Conference (NSC 2012). NSC is an annual event of the Systems Society of India (SSI), primarily oriented to strengthen the systems movement and its applications for the welfare of humanity. A galaxy of academicians, professionals, scientists, statesman and researchers from different parts of the country and abroad are invited to attend the Conference. The book presents various research articles in the area of system modelling in all disciplines of engineering sciences as well as socio-economic systems. The book can be used as a tool for further research.

  1. 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

  2. Strengthening of Indonesia school of management in the 21st century through the implementation of school management system based information technology and communications integrated

    Science.gov (United States)

    Setiawan, Wawan; Munir, Senen, Syamsul Hadi; Nugroho, Eddy Prasetyo; Wihardi, Yaya; Nugraha, Eki

    2017-05-01

    Indonesia strengthening school management through the implementation of School Management System Based Information Technology and Communications (SMS-ICT) is intended to improve the performance of schools to accommodate the complexities of management in a computerized system that is simple but comprehensive so that it aligns with the era of the 21st century. School Management System Based Information and Communication Technology-based standards developed 12 education, adapted from 8 national standards into the system components that support the characteristics of 21st century schools. Twelfth system components include curriculum, Personal Development, Recruitment of New Student Services and Student Development, Education Labor and Education, Infrastructure, Leadership, School Management, Financing, Evaluation, and Social Communications. Development of the system is done through the stages of systematically covering Need Assessment, System Design, System Development, Testing Limited, Reveiw and Improvement, Testing Expanded, Finalize, and Packaging. SMS-ICT has gained Copyright and had seminars both nationally and internationally, and have been published by national journals, and in a book chapter. SMS-ICT applied to several schools in districy/city of West Java is based on cooperation with the Education Department of West Java. Implementation of School Management System as strengthening school management Indonesia shows the essential matters of school management. SMS-ICT managed to bring changes not only bring substantial improvements to the school how it should be managed, but also change the mindset of school leaders and teachers in ways of thinking and acting more professional in carrying out their respective duties. SMS-ICT managed as a unified system of governance that is integrated schools overall strategic component in an integrated system that implements ICT that has the capacity to process data and information quickly, accurately and reliably. SMS-ICT as a

  3. Evaluating health systems strengthening interventions in low-income and middle-income countries: are we asking the right questions?

    Science.gov (United States)

    Adam, Taghreed; Hsu, Justine; de Savigny, Don; Lavis, John N; Røttingen, John-Arne; Bennett, Sara

    2012-10-01

    In recent years, there have been several calls for rigorous health policy and systems research to inform efforts to strengthen health systems (HS) in low- and middle-income countries (LMICs), including the use of systems thinking concepts in designing and evaluating HS strengthening interventions. The objectives of this paper are to assess recent evaluations of HS strengthening interventions to examine the extent to which they ask a broader set of questions, and provide an appropriately comprehensive assessment of the effects of these interventions across the health system. A review of evaluations conducted in 2009-10 was performed to answer these questions. Out of 106 evaluations, less than half (43%) asked broad research questions to allow for a comprehensive assessment of the intervention's effects across multiple HS building blocks. Only half of the evaluations referred to a conceptual framework to guide their impact assessment. Overall, 24% and 9% conducted process and context evaluations, respectively, to answer the question of whether the intervention worked as intended, and if so, for whom, and under what circumstances. Almost half of the evaluations considered HS impact on one building block, while most interventions were complex targeting two or more building blocks. None incorporated evaluation designs that took into account the characteristics of complex adaptive systems such as non-linearity of effects or interactions between the HS building blocks. While we do not argue that all evaluations should be comprehensive, there is a need for more comprehensive evaluations of the wider range of the intervention's effects, when appropriate. Our findings suggest that the full range of barriers to more comprehensive evaluations need to be examined and, where appropriate, addressed. Possible barriers may include limited capacity, lack of funding, inadequate time frames, lack of demand from both researchers and research funders, or difficulties in undertaking this

  4. Engineering, global health, and inclusive innovation: focus on partnership, system strengthening, and local impact for SDGs.

    Science.gov (United States)

    Clifford, Katie L; Zaman, Muhammad H

    2016-01-01

    The recent drafting of the Sustainable Development Goals challenges the research community to rethink the traditional approach to global health and provides the opportunity for science, technology, engineering, and mathematical (STEM) disciplines, particularly engineering, to demonstrate their benefit to the field. Higher education offers a platform for engineering to intersect with global health research through interdisciplinary partnerships among international universities that provide excellence in education, attract nontraditional STEM students, and foster a sense of innovation. However, a traditional lack of engineering-global health collaborations, as well as limited faculty and inadequate STEM research funding in low-income countries, has stifled progress. Still, the impact of higher education on development efforts holds great potential. This value will be realized in low-income countries through strengthening local capacity, supporting innovation through educational initiatives, and encouraging the inclusion of women and minorities in STEM programs. Current international university-level partnerships are working towards integrating engineering into global health research and strengthening STEM innovation among universities in low-income countries, but more can be done. Global health research informs sustainable development, and through integrating engineering into research efforts through university partnerships, we can accelerate progress and work towards a healthier future for all.

  5. Engineering, global health, and inclusive innovation: focus on partnership, system strengthening, and local impact for SDGs

    Directory of Open Access Journals (Sweden)

    Katie L. Clifford

    2016-01-01

    Full Text Available The recent drafting of the Sustainable Development Goals challenges the research community to rethink the traditional approach to global health and provides the opportunity for science, technology, engineering, and mathematical (STEM disciplines, particularly engineering, to demonstrate their benefit to the field. Higher education offers a platform for engineering to intersect with global health research through interdisciplinary partnerships among international universities that provide excellence in education, attract nontraditional STEM students, and foster a sense of innovation. However, a traditional lack of engineering–global health collaborations, as well as limited faculty and inadequate STEM research funding in low-income countries, has stifled progress. Still, the impact of higher education on development efforts holds great potential. This value will be realized in low-income countries through strengthening local capacity, supporting innovation through educational initiatives, and encouraging the inclusion of women and minorities in STEM programs. Current international university-level partnerships are working towards integrating engineering into global health research and strengthening STEM innovation among universities in low-income countries, but more can be done. Global health research informs sustainable development, and through integrating engineering into research efforts through university partnerships, we can accelerate progress and work towards a healthier future for all.

  6. Famine Early Warning Systems Network (FEWS NET) Contributions to Strengthening Resilience and Sustainability for the East African Community

    Science.gov (United States)

    Budde, M. E.; Galu, G.; Funk, C. C.; Verdin, J. P.; Rowland, J.

    2014-12-01

    The Planning for Resilience in East Africa through Policy, Adaptation, Research, and Economic Development (PREPARED) is a multi-organizational project aimed at mainstreaming climate-resilient development planning and program implementation into the East African Community (EAC). The Famine Early Warning Systems Network (FEWS NET) has partnered with the PREPARED project to address three key development challenges for the EAC; 1) increasing resiliency to climate change, 2) managing trans-boundary freshwater biodiversity and conservation and 3) improving access to drinking water supply and sanitation services. USGS FEWS NET has been instrumental in the development of gridded climate data sets that are the fundamental building blocks for climate change adaptation studies in the region. Tools such as the Geospatial Climate Tool (GeoCLIM) have been developed to interpolate time-series grids of precipitation and temperature values from station observations and associated satellite imagery, elevation data, and other spatially continuous fields. The GeoCLIM tool also allows the identification of anomalies and assessments of both their frequency of occurrence and directional trends. A major effort has been put forth to build the capacities of local and regional institutions to use GeoCLIM to integrate their station data (which is not typically available to the public) into improved national and regional gridded climate data sets. In addition to the improvements and capacity building activities related to geospatial analysis tools, FEWS NET will assist in two other areas; 1) downscaling of climate change scenarios and 2) vulnerability impact assessments. FEWS NET will provide expertise in statistical downscaling of Global Climate Model output fields and work with regional institutions to assess results of other downscaling methods. Completion of a vulnerability impact assessment (VIA) involves the examination of sectoral consequences in identified climate "hot spots". FEWS NET

  7. A 21st Century National Public Health System

    Science.gov (United States)

    2008-09-01

    degree of MASTER OF ARTS IN SECURITY STUDIES (HOMELAND SECURITY AND DEFENSE) from the NAVAL POSTGRADUATE SCHOOL September 2008...million Strengthening linkages with international public health organizations. $10 million Protecting the health of First Nations and Inuit communities

  8. Unmanned Aircraft Systems Integration in the National Airspace System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — There is an increasing need to fly Unmanned Aircraft Systems (UAS) in the National Airspace System (NAS) to perform missions of vital importance to national security...

  9. Strengthening health security at the Hajj mass gatherings: characteristics of the infectious diseases surveillance systems operational during the 2015 Hajj.

    Science.gov (United States)

    Alotaibi, Badriah M; Yezli, Saber; Bin Saeed, Abdul-Aziz A; Turkestani, Abdulhafeez; Alawam, Amnah H; Bieh, Kingsley L

    2017-05-01

    Hajj is one of the largest and the most ethnically and culturally diverse mass gatherings worldwide. The use of appropriate surveillance systems ensures timely information management for effective planning and response to infectious diseases threats during the pilgrimage. The literature describes infectious diseases prevention and control strategies for Hajj but with limited information on the operations and characteristics of the existing Hajj infectious diseases surveillance systems. We reviewed documents, including guidelines and reports from the Saudi Ministry of Health's database, to describe the characteristics of the infectious diseases surveillance systems that were operational during the 2015 Hajj, highlighting best practices and gaps and proposing strategies for strengthening and improvement. Using Pubmed and Embase online search engines and a combination of search terms including, 'mass gatherings' 'Olympics' 'surveillance' 'Hajj' 'health security', we explored the existing literature and highlighted some lessons learnt from other international mass gatherings. A regular indicator-based infectious disease surveillance system generates routine reports from health facilities within the Kingdom to the regional and central public health directorates all year round. During Hajj, enhanced indicator-based notifiable diseases surveillance systems complement the existing surveillance tool to ensure timely reporting of event information for appropriate action by public health officials. There is need to integrate the existing Hajj surveillance data management systems and to implement syndromic surveillance as an early warning system for infectious disease control during Hajj. International engagement is important to strengthen Hajj infectious diseases surveillance and to prevent disease transmission and globalization of infectious agents which could undermine global health security. © International Society of Travel Medicine, 2017. Published by Oxford University

  10. "It takes more than a fellowship program": reflections on capacity strengthening for health systems research in sub-Saharan Africa.

    Science.gov (United States)

    Izugbara, Chimaraoke O; Kabiru, Caroline W; Amendah, Djesika; Dimbuene, Zacharie Tsala; Donfouet, Hermann Pythagore Pierre; Atake, Esso-Hanam; Ingabire, Marie-Gloriose; Maluka, Stephen; Mumah, Joyce N; Mwau, Matilu; Ndinya, Mollyne; Ngure, Kenneth; Sidze, Estelle M; Sossa, Charles; Soura, Abdramane; Ezeh, Alex C

    2017-12-04

    Sub-Saharan Africa (SSA) experiences an acute dearth of well-trained and skilled researchers. This dearth constrains the region's capacity to identify and address the root causes of its poor social, health, development, and other outcomes. Building sustainable research capacity in SSA requires, among other things, locally led and run initiatives that draw on existing regional capacities as well as mutually beneficial global collaborations. This paper describes a regional research capacity strengthening initiative-the African Doctoral Dissertation Research Fellowship (ADDRF) program. This Africa-based and African-led initiative has emerged as a practical and tested platform for producing and nurturing research leaders, strengthening university-wide systems for quality research training and productivity, and building a critical mass of highly-trained African scholars and researchers. The program deploys different interventions to ensure the success of fellows. These interventions include research methods and scientific writing workshops, research and reentry support grants, post-doctoral research support and placements, as well as grants for networking and scholarly conferences attendance. Across the region, ADDRF graduates are emerging as research leaders, showing signs of becoming the next generation of world-class researchers, and supporting the transformations of their home-institutions. While the contributions of the ADDRF program to research capacity strengthening in the region are significant, the sustainability of the initiative and other research and training fellowship programs on the continent requires significant investments from local sources and, especially, governments and the private sector in Africa. The ADDRF experience demonstrates that research capacity building in Africa is possible through innovative, multifaceted interventions that support graduate students to develop different critical capacities and transferable skills and build, expand, and

  11. Strengthening of Oral Health Systems: Oral Health through Primary Health Care

    Science.gov (United States)

    Petersen, Poul Erik

    2014-01-01

    Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work with the newly established WHO Collaborating Centre, Kuwait University, to strengthen the development of appropriate models for primary oral health care. PMID:24525450

  12. Strengthening of oral health systems: oral health through primary health care.

    Science.gov (United States)

    Petersen, Poul Erik

    2014-01-01

    Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work with the newly established WHO Collaborating Centre, Kuwait University, to strengthen the development of appropriate models for primary oral health care. © 2014 P.E. Petersen, Geneva.

  13. Comparing national infectious disease surveillance systems: China and the Netherlands.

    Science.gov (United States)

    Vlieg, Willemijn L; Fanoy, Ewout B; van Asten, Liselotte; Liu, Xiaobo; Yang, Jun; Pilot, Eva; Bijkerk, Paul; van der Hoek, Wim; Krafft, Thomas; van der Sande, Marianne A; Liu, Qi-Yong

    2017-05-08

    Risk assessment and early warning (RAEW) are essential components of any infectious disease surveillance system. In light of the International Health Regulations (IHR)(2005), this study compares the organisation of RAEW in China and the Netherlands. The respective approaches towards surveillance of arboviral disease and unexplained pneumonia were analysed to gain a better understanding of the RAEW mode of operation. This study may be used to explore options for further strengthening of global collaboration and timely detection and surveillance of infectious disease outbreaks. A qualitative study design was used, combining data retrieved from the literature and from semi-structured interviews with Chinese (5 national-level and 6 provincial-level) and Dutch (5 national-level) experts. The results show that some differences exist such as in the use of automated electronic components of the early warning system in China ('CIDARS'), compared to a more limited automated component in the Netherlands ('barometer'). Moreover, RAEW units in the Netherlands focus exclusively on infectious diseases, while China has a broader 'all hazard' approach (including for example chemical incidents). In the Netherlands, veterinary specialists take part at the RAEW meetings, to enable a structured exchange/assessment of zoonotic signals. Despite these differences, the main conclusion is that for the two infections studied, the early warning system in China and the Netherlands are remarkably similar considering their large differences in infectious disease history, population size and geographical setting. Our main recommendations are continued emphasis on international corporation that requires insight into national infectious disease surveillance systems, the usage of a One Health approach in infectious disease surveillance, and further exploration/strengthening of a combined syndromic and laboratory surveillance system.

  14. The National Nursing Assistant Survey: Improving the Evidence Base for Policy Initiatives to Strengthen the Certified Nursing Assistant Workforce

    Science.gov (United States)

    Squillace, Marie R.; Remsburg, Robin E.; Harris-Kojetin, Lauren D.; Bercovitz, Anita; Rosenoff, Emily; Han, Beth

    2009-01-01

    Purpose: This study introduces the first National Nursing Assistant Survey (NNAS), a major advance in the data available about certified nursing assistants (CNAs) and a rich resource for evidence-based policy, practice, and applied research initiatives. We highlight potential uses of this new survey using select population estimates as examples of…

  15. Institutionalizing community-focused maternal, newborn, and child health strategies to strengthen health systems: A new framework for the Sustainable Development Goal era.

    Science.gov (United States)

    Story, William T; LeBan, Karen; Altobelli, Laura C; Gebrian, Bette; Hossain, Jahangir; Lewis, Judy; Morrow, Melanie; Nielsen, Jennifer N; Rosales, Alfonso; Rubardt, Marcie; Shanklin, David; Weiss, Jennifer

    2017-06-26

    Stronger health systems, with an emphasis on community-based primary health care, are required to help accelerate the pace of ending preventable maternal and child deaths as well as contribute to the achievement of the Sustainable Development Goals (SDGs). The success of the SDGs will require unprecedented coordination across sectors, including partnerships between public, private, and non-governmental organizations (NGOs). To date, little attention has been paid to the distinct ways in which NGOs (both international and local) can partner with existing national government health systems to institutionalize community health strategies. In this paper, we propose a new conceptual framework that depicts three primary pathways through which NGOs can contribute to the institutionalization of community-focused maternal, newborn, and child health (MNCH) strategies to strengthen health systems at the district, national or global level. To illustrate the practical application of these three pathways, we present six illustrative cases from multiple NGOs and discuss the primary drivers of institutional change. In the first pathway, "learning for leverage," NGOs demonstrate the effectiveness of new innovations that can stimulate changes in the health system through adaptation of research into policy and practice. In the second pathway, "thought leadership," NGOs disseminate lessons learned to public and private partners through training, information sharing and collaborative learning. In the third pathway, "joint venturing," NGOs work in partnership with the government health system to demonstrate the efficacy of a project and use their collective voice to help guide decision-makers. In addition to these pathways, we present six key drivers that are critical for successful institutionalization: strategic responsiveness to national health priorities, partnership with policymakers and other stakeholders, community ownership and involvement, monitoring and use of data

  16. Strengthening Routine Data Systems to Track the HIV Epidemic and Guide the Response in Sub-Saharan Africa.

    Science.gov (United States)

    Rice, Brian; Boulle, Andrew; Baral, Stefan; Egger, Matthias; Mee, Paul; Fearon, Elizabeth; Reniers, Georges; Todd, Jim; Schwarcz, Sandra; Weir, Sharon; Rutherford, George; Hargreaves, James

    2018-04-03

    The global HIV response has entered a new phase with the recommendation of treating all persons living with HIV with antiretroviral therapy, and with the goals of reducing new infections and AIDS-related deaths to fewer than 500,000 by 2020. This new phase has intensive data requirements that will need to utilize routine data collected through service delivery platforms to monitor progress toward these goals. With a focus on sub-Saharan African, we present the following priorities to improve the demand, supply, and use of routine HIV data: (1) strengthening patient-level HIV data systems that support continuity of clinical care and document sentinel events; (2) leveraging data from HIV testing programs; (3) using targeting data collection in communities and among clients; and (4) building capacity and promoting a culture of HIV data quality assessment and use. When fully leveraged, routine data can efficiently provide timely information at a local level to inform action, as well as provide information at scale with wide geographic coverage to strengthen estimation efforts. ©Brian Rice, Andrew Boulle, Stefan Baral, Matthias Egger, Paul Mee, Elizabeth Fearon, Georges Reniers, Jim Todd, Sandra Schwarcz, Sharon Weir, George Rutherford, James Hargreaves. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 03.04.2018.

  17. National Vital Statistics System (NVSS) - National Cardiovascular Disease Surveillance Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2000 forward. NVSS is a secure, web-based data management system that collects and disseminates the Nation's official vital statistics. Indicators from this data...

  18. Strengthening the decision making in Spain, the national centralized waste storage project and the Cowam-Spain initiative

    International Nuclear Information System (INIS)

    Le Bars, Y.

    2007-01-01

    Yves Le Bars, analysed the Spanish case within the European context. First, he summarised the evolution of policy-making approaches since the Second World War. In the first stage. decision-making authority was assigned to experts. Dialogue was not part of decision processes; opposition manifested itself in protest actions. In the second stage, society demanded the consideration of alternative solutions. Opponents organised legal actions and in this way decision-making authority was transferred to the courts, which based their judgements on hearing experts on differing sides of the question. The third stage is characterised by the involvement of relevant stakeholders and an interaction between decision makers, experts and stakeholders. According to this approach, public policy needs to be elaborated, adapted to, and adopted by different interest groups. He argued that the Spanish history of radioactive waste management went through the former two stages. The siting attempt for an underground disposal facility followed the approach of the first stage. Decision makers and experts were of the view that deep geological disposal was the best solution and they were not willing to share information with the public. This led to a failure and a moratorium. The Vandellos -I decommissioning case shows some features of the second stage. for example. the introduction of independent expertise in the Municipal Monitoring Commission. Finally, with the involvement of AMAC. a shift to the third stage can be seen: the COWAM-Spain project defined main principles for a decision-making process where policy makers, experts and stakeholders could collaborate to define a viable radioactive waste management policy. He observed that the current Spanish situation raises a number of questions. On the national level, the direction of radioactive waste management policy is defined by the national Plan. which is periodically revised. It is an open question as to how the national planning process

  19. Does National Culture Impact Capital Budgeting Systems?

    OpenAIRE

    Peter J. Graham; Milind Sathye

    2017-01-01

    We examine how national culture impacts organisational selection of capital budgeting systems to develop our understanding of what influence a holistic formulation of national culture has on capital budgeting systems. Such an understanding is important as it would not only provide a clearer link between national culture and capital budgeting systems and advance extant literature but would also help multinational firms that have business relationships with Indonesian firms in suita...

  20. Risk-Significant Adverse Condition Awareness Strengthens Assurance of Fault Management Systems

    Science.gov (United States)

    Fitz, Rhonda

    2017-01-01

    As spaceflight systems increase in complexity, Fault Management (FM) systems are ranked high in risk-based assessment of software criticality, emphasizing the importance of establishing highly competent domain expertise to provide assurance. Adverse conditions (ACs) and specific vulnerabilities encountered by safety- and mission-critical software systems have been identified through efforts to reduce the risk posture of software-intensive NASA missions. Acknowledgement of potential off-nominal conditions and analysis to determine software system resiliency are important aspects of hazard analysis and FM. A key component of assuring FM is an assessment of how well software addresses susceptibility to failure through consideration of ACs. Focus on significant risk predicted through experienced analysis conducted at the NASA Independent Verification Validation (IVV) Program enables the scoping of effective assurance strategies with regard to overall asset protection of complex spaceflight as well as ground systems. Research efforts sponsored by NASA's Office of Safety and Mission Assurance defined terminology, categorized data fields, and designed a baseline repository that centralizes and compiles a comprehensive listing of ACs and correlated data relevant across many NASA missions. This prototype tool helps projects improve analysis by tracking ACs and allowing queries based on project, mission type, domaincomponent, causal fault, and other key characteristics. Vulnerability in off-nominal situations, architectural design weaknesses, and unexpected or undesirable system behaviors in reaction to faults are curtailed with the awareness of ACs and risk-significant scenarios modeled for analysts through this database. Integration within the Enterprise Architecture at NASA IVV enables interfacing with other tools and datasets, technical support, and accessibility across the Agency. This paper discusses the development of an improved workflow process utilizing this

  1. Maximizing the benefit of health workforce secondment in Botswana: an approach for strengthening health systems in resource-limited settings

    Directory of Open Access Journals (Sweden)

    Grignon JS

    2014-05-01

    Full Text Available Jessica S Grignon,1,2 Jenny H Ledikwe,1,2 Ditsapelo Makati,2 Robert Nyangah,2 Baraedi W Sento,2 Bazghina-werq Semo1,2 1Department of Global Health, University of Washington, Seattle, WA, USA; 2International Training and Education Center for Health, Gaborone, Botswana Abstract: To address health systems challenges in limited-resource settings, global health initiatives, particularly the President's Emergency Plan for AIDS Relief, have seconded health workers to the public sector. Implementation considerations for secondment as a health workforce development strategy are not well documented. The purpose of this article is to present outcomes, best practices, and lessons learned from a President's Emergency Plan for AIDS Relief-funded secondment program in Botswana. Outcomes are documented across four World Health Organization health systems' building blocks. Best practices include documentation of joint stakeholder expectations, collaborative recruitment, and early identification of counterparts. Lessons learned include inadequate ownership, a two-tier employment system, and ill-defined position duration. These findings can inform program and policy development to maximize the benefit of health workforce secondment. Secondment requires substantial investment, and emphasis should be placed on high-level technical positions responsible for building systems, developing health workers, and strengthening government to translate policy into programs. Keywords: human resources, health policy, health worker, HIV/AIDS, PEPFAR

  2. Policy-Relevant Systematic Reviews to Strengthen Health Systems: Models and Mechanisms to Support Their Production

    Science.gov (United States)

    Oliver, Sandra; Dickson, Kelly

    2016-01-01

    Support for producing systematic reviews about health systems is less well developed than for those about clinical practice. From interviewing policy makers and systematic reviewers we identified institutional mechanisms which bring systematic reviews and policy priorities closer by harnessing organisational and individual motivations, emphasising…

  3. Exploring the multiple roles of Lund University in strengthening Scania's regional innovation system: Towards institutional learning?

    NARCIS (Netherlands)

    Benneworth, P.; Coenen, L.; Moodysson, J.; Asheim, B.

    2009-01-01

    Universities are increasingly seen as potential contributors to regional innovative capacity by serving as local knowledge conduits, bringing global state-of-the-art science and technology into the region. In practice, however, more active university engagement with their regional innovation systems

  4. Exploring the Multiple Roles of Lund University in Strengthening Scania's Regional Innovation System: Towards Institutional Learning?

    NARCIS (Netherlands)

    Benneworth, Paul Stephen; Coenen, Lars; Moodysson, Jerker; Asheim, Björn

    2009-01-01

    Universities are increasingly seen as potential contributors to regional innovative capacity by serving as local knowledge conduits, bringing global state-of-the-art science and technology into the region. In practice, however, more active university engagement with their regional innovation systems

  5. The Coherence of Vocational Education and Training in Norway and Spain: National Traditions and the Reshaping of VET Governance in Hybrid VET Systems

    Science.gov (United States)

    Souto-Otero, Manuel; Ure, Odd Bjorn

    2012-01-01

    Coherence of national education and training systems is increasingly tabled in European policy debates. Leaning on literature about the emergence and consolidation of national education systems, this article explores the rationale for VET reforms in Norway and Spain by scrutinising attempts to strengthen the coherence of their VET systems.…

  6. Diagnostic system strengthening for drug resistant tuberculosis in Nigeria: impact and challenges

    Directory of Open Access Journals (Sweden)

    Gambo Aliyu

    2017-03-01

    Full Text Available Background: The increasing prevalence of drug-resistant tuberculosis and the threat of extensively-drug-resistant tuberculosis in HIV hotspots have made the detection and treatment of drug-resistant tuberculosis in the sub-Saharan Africa setting a global public health priority. Objective: We sought to examine the impact and challenges of tuberculosis diagnostic capacity development for the detection of drug-resistant tuberculosis and bio-surveillance using a modular biosafety level 3 (BSL-3 laboratory in Nigeria. Method: In 2010, the United States President’s Emergency Plan for AIDS Relief (PEPFAR programme, through the Institute of Human Virology at the University of Maryland in Baltimore, Maryland, United States, deployed a modular, BSL-3 laboratory to support the national tuberculosis programme in drug-resistant tuberculosis detection and bio-surveillance for effective tuberculosis prevention and control. Results: From 2010 until present, sputum samples from 11 606 suspected cases in 33 states were screened for drug-resistant tuberculosis. Of those, 1500 (12.9% had mono-resistant tuberculosis strains, and 459 (4.0% cases had multidrug-resistant tuberculosis. Over the lastfour years, 133 scientists were trained in a train-the-trainer programme on advanced tuberculosis culture, drug susceptibility testing, line-probe assays and Xpert® MTB/RIF, in addition to safety operations for biosafety facilities. Power instability, running cost and seasonal dust are notable challenges to optimal performance and scale up. Conclusion: Movable BSL-3 containment laboratories can be deployed to improve diagnostic capacity for drug-resistant tuberculosis and bio-surveillance in settings with limited resources.

  7. Developing the African national health research systems barometer.

    Science.gov (United States)

    Kirigia, Joses Muthuri; Ota, Martin Okechukwu; Senkubuge, Flavia; Wiysonge, Charles Shey; Mayosi, Bongani M

    2016-07-22

    A functional national health research system (NHRS) is crucial in strengthening a country's health system to promote, restore and maintain the health status of its population. Progress towards the goal of universal health coverage in the post-2015 sustainable development agenda will be difficult for African countries without strengthening of their NHRS to yield the required evidence for decision-making. This study aims to develop a barometer to facilitate monitoring of the development and performance of NHRSs in the African Region of WHO. The African national health research systems barometer algorithm was developed in response to a recommendation of the African Advisory Committee for Health Research and Development of WHO. Survey data collected from all the 47 Member States in the WHO African Region using a questionnaire were entered into an Excel spreadsheet and analysed. The barometer scores for each country were calculated and the performance interpreted according to a set of values ranging from 0% to 100%. The overall NHRS barometer score for the African Region was 42%, which is below the average of 50%. Among the 47 countries, the average NHRS performance was less than 20% in 10 countries, 20-40% in 11 countries, 41-60% in 16 countries, 61-80% in nine countries, and over 80% in one country. The performance of NHRSs in 30 (64%) countries was below 50%. An African NHRS barometer with four functions and 17 sub-functions was developed to identify the gaps in and facilitate monitoring of NHRS development and performance. The NHRS scores for the individual sub-functions can guide policymakers to locate sources of poor performance and to design interventions to address them.

  8. Did the first Global Fund grant (2003–2006 contribute to malaria control and health system strengthening in Timor-Leste?

    Directory of Open Access Journals (Sweden)

    Martins João

    2012-07-01

    Full Text Available Abstract Background In 2003, Timor-Leste successfully obtained its first Global Fund grant for a three-year programme for malaria control. The grant aimed to reduce malaria-related morbidity and mortality by 30 % by the end of the implementation. Methods A mixed-methods approach was used to assess the impact of the grant implementation. Fifty-eight in-depth interviews, eight group interviews, 16 focus group discussions, and on-site observations were used. Morbidity data reported to the Ministry of Health were also examined to assess trends. Results The National Malaria Programme with funding support from the Global Fund grant and other development partners contributed considerably to strengthening malaria control and the general health system. It also brought direct and indirect benefits to pregnant women and to the community at large. However, it failed to achieve the stated objective of reducing malaria morbidity and mortality by 30 %. The implementation was hampered by inadequate human resources, the rigidity of Global Fund rules, weak project management and coordination, and inadequate support from external stakeholders. Conclusion Despite limitations, the grant was implemented until the agreed closing date. Considerable contributions to malaria control, health system, and the community have been made and the malaria programme was sustained.

  9. Did the first Global Fund grant (2003–2006) contribute to malaria control and health system strengthening in Timor-Leste?

    Science.gov (United States)

    2012-01-01

    Background In 2003, Timor-Leste successfully obtained its first Global Fund grant for a three-year programme for malaria control. The grant aimed to reduce malaria-related morbidity and mortality by 30 % by the end of the implementation. Methods A mixed-methods approach was used to assess the impact of the grant implementation. Fifty-eight in-depth interviews, eight group interviews, 16 focus group discussions, and on-site observations were used. Morbidity data reported to the Ministry of Health were also examined to assess trends. Results The National Malaria Programme with funding support from the Global Fund grant and other development partners contributed considerably to strengthening malaria control and the general health system. It also brought direct and indirect benefits to pregnant women and to the community at large. However, it failed to achieve the stated objective of reducing malaria morbidity and mortality by 30 %. The implementation was hampered by inadequate human resources, the rigidity of Global Fund rules, weak project management and coordination, and inadequate support from external stakeholders. Conclusion Despite limitations, the grant was implemented until the agreed closing date. Considerable contributions to malaria control, health system, and the community have been made and the malaria programme was sustained. PMID:22823965

  10. Intrathecal Fas ligand infusion strengthens immunoprivilege of central nervous system and suppresses experimental autoimmune encephalomyelitis.

    Science.gov (United States)

    Zhu, Bing; Luo, Liqing; Chen, Yongliang; Paty, Donald W; Cynader, Max S

    2002-08-01

    Fas ligand (FasL) is an essential molecule strongly expressed in some immunoprivileged sites, but is expressed at very low levels in normal CNS. In this study, acute experimental autoimmune encephalomyelitis (EAE) was induced in Lewis rats with guinea pig myelin basic protein. Intrathecal infusion of recombinant FasL before EAE onset dose dependently suppressed acute EAE and alleviated pathological inflammation in lumbosacral spinal cord. This treatment greatly increased apoptosis in CNS inflammatory cells, but did not inhibit systemic immune response to myelin basic protein. Systemic administration of a similar dose of rFasL was ineffective. In vitro, encephalitogenic T cells were highly sensitive to rFasL-induced cell death, and activated macrophages were also susceptible. In addition, in vitro rFasL treatment potentiated the immunosuppressive property of rat cerebrospinal fluid. We conclude that intrathecal infusion of rFasL eliminated the initial wave of infiltrating T cells and macrophages, and therefore blocked the later recruitment of inflammatory cells into CNS. Although Fas receptor expression was observed on spinal cord neurons, astrocytes, and oligodendrocytes, no damage to these cells or to the myelin structure was detected after rFasL infusion.

  11. 77 FR 52742 - Public Meeting-Strengthening the National Medical Device Postmarket Surveillance System; Request...

    Science.gov (United States)

    2012-08-30

    ... Contact Person) no later than September 5, 2012. No commercial or promotional material will be permitted... develop and implement a comprehensive medical device postmarket surveillance strategy to collect, analyze... implementing this strategy, FDA is holding a public meeting to discuss the current and future state of medical...

  12. Debonding damage analysis in composite-masonry strengthening systems with polymer- and mortar-based matrix by means of the acoustic emission technique

    International Nuclear Information System (INIS)

    Verstrynge, E; Wevers, M; Ghiassi, B; Lourenço, P B

    2016-01-01

    Different types of strengthening systems, based on fiber reinforced materials, are under investigation for external strengthening of historic masonry structures. A full characterization of the bond behavior and of the short- and long-term failure mechanisms is crucial to ensure effective design, compatibility with the historic substrate and durability of the strengthening solution. Therein, non-destructive techniques are essential for bond characterization, durability assessment and on-site condition monitoring. In this paper, the acoustic emission (AE) technique is evaluated for debonding characterization and localization on fiber reinforced polymer (FRP) and steel reinforced grout-strengthened clay bricks. Both types of strengthening systems are subjected to accelerated ageing tests under thermal cycles and to single-lap shear bond tests. During the reported experimental campaign, AE data from the accelerated ageing tests demonstrated the thermal incompatibility between brick and epoxy-bonded FRP composites, and debonding damage was successfully detected, characterized and located. In addition, a qualitative comparison is made with digital image correlation and infrared thermography, in view of efficient on-site debonding detection. (paper)

  13. Debonding damage analysis in composite-masonry strengthening systems with polymer- and mortar-based matrix by means of the acoustic emission technique

    Science.gov (United States)

    Verstrynge, E.; Wevers, M.; Ghiassi, B.; Lourenço, P. B.

    2016-01-01

    Different types of strengthening systems, based on fiber reinforced materials, are under investigation for external strengthening of historic masonry structures. A full characterization of the bond behavior and of the short- and long-term failure mechanisms is crucial to ensure effective design, compatibility with the historic substrate and durability of the strengthening solution. Therein, non-destructive techniques are essential for bond characterization, durability assessment and on-site condition monitoring. In this paper, the acoustic emission (AE) technique is evaluated for debonding characterization and localization on fiber reinforced polymer (FRP) and steel reinforced grout-strengthened clay bricks. Both types of strengthening systems are subjected to accelerated ageing tests under thermal cycles and to single-lap shear bond tests. During the reported experimental campaign, AE data from the accelerated ageing tests demonstrated the thermal incompatibility between brick and epoxy-bonded FRP composites, and debonding damage was successfully detected, characterized and located. In addition, a qualitative comparison is made with digital image correlation and infrared thermography, in view of efficient on-site debonding detection.

  14. The diversity of beef safety: A global reason to strengthen our current systems.

    Science.gov (United States)

    Brashears, Mindy M; Chaves, Byron D

    2017-10-01

    The purpose of this paper is to propose a more integrated and more aggressive system approach to food safety rather than focusing on one segment of the industry, or on one approach as described by or constrained by one set of regulations. We focus on the prevalence and control measures for Salmonella and pathogenic Escherichia coli, particularly, Shiga toxin-producing E. coli (STEC) in live cattle on the farm and in the final raw beef product at retail. We describe the antimicrobial and process control strategies most commonly used during slaughter and processing to prevent and reduce the frequency and concentration of these pathogens in the final product, and we propose points along the food chain where more interventions can be applied to ultimately reduce the prevalence of foodborne pathogens associated with beef and beef products, and to protect public health as well the global food supply. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Strengthening the Referral System through Social Capital: A Qualitative Inquiry in Ghana.

    Science.gov (United States)

    Amoah, Padmore Adusei; Phillips, David R

    2017-10-25

    The referral system in health care has been noted as very influential in determining which services are accessed and when. Nonetheless, existing studies have relied on specific measurable factors relating to health personnel, transportation and communication infrastructure, and finance to explain the challenges facing the referral policy in developing countries. While this is understandable, the role of social capital remains mostly uncharted even though it is implicit in the well-known lay referral system. Using various facets of the social capital concept, this paper empirically examines how the resources embedded in both structural and cognitive aspects of social relationships influence knowledge of, and adherence to, referral policy. This study is based on semi-structured in-depth interviews conducted with 79 adults in the Ashanti Region of Ghana in 2015. Of the 79 participants, 28 lived in urban areas and 51 in rural localities. Eight health personnel and eight community leaders also contributed to the study. Additionally, six focus group discussions were held. The findings indicated that both cognitive and structural forms of social capital considerably underpinned the ability and willingness of people to adhere to the referral process. Moreover, the role of social capital was double-barrelled. It contributed in a significant way to encouraging or dissuading potential patients from rightly embracing the policy. In addition, precepts of social capital reinforced both positive and adverse effects of the other determinants of the policy such as finance and transportation. However, the magnitude of such impact was linked to how 'resourceful' and 'trustworthy' one's available social acquaintances were. The paper suggests that a cautious engagement with social capital will make it a potentially powerful tool for understanding the gaps in and improving the effectiveness of referral policy.

  16. Good Health at Low Cost 25 years on: lessons for the future of health systems strengthening.

    Science.gov (United States)

    Balabanova, Dina; Mills, Anne; Conteh, Lesong; Akkazieva, Baktygul; Banteyerga, Hailom; Dash, Umakant; Gilson, Lucy; Harmer, Andrew; Ibraimova, Ainura; Islam, Ziaul; Kidanu, Aklilu; Koehlmoos, Tracey P; Limwattananon, Supon; Muraleedharan, V R; Murzalieva, Gulgun; Palafox, Benjamin; Panichkriangkrai, Warisa; Patcharanarumol, Walaiporn; Penn-Kekana, Loveday; Powell-Jackson, Timothy; Tangcharoensathien, Viroj; McKee, Martin

    2013-06-15

    In 1985, the Rockefeller Foundation published Good health at low cost to discuss why some countries or regions achieve better health and social outcomes than do others at a similar level of income and to show the role of political will and socially progressive policies. 25 years on, the Good Health at Low Cost project revisited these places but looked anew at Bangladesh, Ethiopia, Kyrgyzstan, Thailand, and the Indian state of Tamil Nadu, which have all either achieved substantial improvements in health or access to services or implemented innovative health policies relative to their neighbours. A series of comparative case studies (2009-11) looked at how and why each region accomplished these changes. Attributes of success included good governance and political commitment, effective bureaucracies that preserve institutional memory and can learn from experience, and the ability to innovate and adapt to resource limitations. Furthermore, the capacity to respond to population needs and build resilience into health systems in the face of political unrest, economic crises, and natural disasters was important. Transport infrastructure, female empowerment, and education also played a part. Health systems are complex and no simple recipe exists for success. Yet in the countries and regions studied, progress has been assisted by institutional stability, with continuity of reforms despite political and economic turmoil, learning lessons from experience, seizing windows of opportunity, and ensuring sensitivity to context. These experiences show that improvements in health can still be achieved in countries with relatively few resources, though strategic investment is necessary to address new challenges such as complex chronic diseases and growing population expectations. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Strengthening the Referral System through Social Capital: A Qualitative Inquiry in Ghana

    Directory of Open Access Journals (Sweden)

    Padmore Adusei Amoah

    2017-10-01

    Full Text Available The referral system in health care has been noted as very influential in determining which services are accessed and when. Nonetheless, existing studies have relied on specific measurable factors relating to health personnel, transportation and communication infrastructure, and finance to explain the challenges facing the referral policy in developing countries. While this is understandable, the role of social capital remains mostly uncharted even though it is implicit in the well-known lay referral system. Using various facets of the social capital concept, this paper empirically examines how the resources embedded in both structural and cognitive aspects of social relationships influence knowledge of, and adherence to, referral policy. This study is based on semi-structured in-depth interviews conducted with 79 adults in the Ashanti Region of Ghana in 2015. Of the 79 participants, 28 lived in urban areas and 51 in rural localities. Eight health personnel and eight community leaders also contributed to the study. Additionally, six focus group discussions were held. The findings indicated that both cognitive and structural forms of social capital considerably underpinned the ability and willingness of people to adhere to the referral process. Moreover, the role of social capital was double-barrelled. It contributed in a significant way to encouraging or dissuading potential patients from rightly embracing the policy. In addition, precepts of social capital reinforced both positive and adverse effects of the other determinants of the policy such as finance and transportation. However, the magnitude of such impact was linked to how ‘resourceful’ and ‘trustworthy’ one’s available social acquaintances were. The paper suggests that a cautious engagement with social capital will make it a potentially powerful tool for understanding the gaps in and improving the effectiveness of referral policy.

  18. Moving forward on strengthening and sustaining National Immunization Technical Advisory Groups (NITAGs) globally: Recommendations from the 2nd global NITAG network meeting.

    Science.gov (United States)

    MacDonald, Noni E; Duclos, Philippe; Wichmann, Ole; Henaff, Louise; Harnden, Anthony; Alshammary, Aisha; Tijerino, Roberto Arroba; Hall, Madeline; Sacarlal, Jahit; Singh, Rupa Rajbhandari

    2017-12-15

    National Immunization Technical Advisory Groups (NITAGs) provide independent, evidence-informed advice to assist their governments in immunization policy formation. This is complex work and many NITAGs face challenges in fulfilling their roles. Inter-country NITAG collaboration opportunities have the potential to enhance NITAG function and grow the quality of recommendations. Hence the many requests for formation of a network linking NITAGs together so they can learn from each other. The first Global NITAG Network (GNN) meeting, held in 2016, led to a push to launch the GNN and grow the network. At the second GNN meeting, held June 28-29, 2017 in Berlin, the GNN was formally inaugurated. Participants discussed GNN governance, reflected on the April 2017 Strategic Advisory Group of Experts (SAGE) on Immunization conclusions concerning strengthening of NITAGs and also shared NITAG experiences in evaluation and inter-country collaborations and independence. They also discussed the role of Regional Technical Advisory Groups on Immunization (RTAGs) and regional networks. A number of issues were raised including NITAGs and communications, dissemination of recommendations and vaccine implementation as well as implications of off-label recommendations. Participants were alerted to immunization evidence assessment sites and value of sharing of resources. They also discussed potential GNN funding opportunities, developed an action plan for 2017-18 and selected a Steering Committee to help move the GNN forward. All participants agreed on the importance of the GNN and the value in attracting more countries to join the GNN. Copyright © 2017.

  19. Geographical National Condition and Complex System

    Directory of Open Access Journals (Sweden)

    WANG Jiayao

    2016-01-01

    Full Text Available The significance of studying the complex system of geographical national conditions lies in rationally expressing the complex relationships of the “resources-environment-ecology-economy-society” system. Aiming to the problems faced by the statistical analysis of geographical national conditions, including the disunity of research contents, the inconsistency of range, the uncertainty of goals, etc.the present paper conducted a range of discussions from the perspectives of concept, theory and method, and designed some solutions based on the complex system theory and coordination degree analysis methods.By analyzing the concepts of geographical national conditions, geographical national conditions survey and geographical national conditions statistical analysis, as well as investigating the relationships between theirs, the statistical contents and the analytical range of geographical national conditions are clarified and defined. This investigation also clarifies the goals of the statistical analysis by analyzing the basic characteristics of the geographical national conditions and the complex system, and the consistency between the analysis of the degree of coordination and statistical analyses. It outlines their goals, proposes a concept for the complex system of geographical national conditions, and it describes the concept. The complex system theory provides new theoretical guidance for the statistical analysis of geographical national conditions. The degree of coordination offers new approaches on how to undertake the analysis based on the measurement method and decision-making analysis scheme upon which the complex system of geographical national conditions is based. It analyzes the overall trend via the degree of coordination of the complex system on a macro level, and it determines the direction of remediation on a micro level based on the degree of coordination among various subsystems and of single systems. These results establish

  20. Balancing Management and Leadership in Complex Health Systems Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

    Science.gov (United States)

    Kwamie, Aku

    2015-08-14

    Health systems, particularly those in low- and middle-income countries (LMICs), need stronger management and leadership capacities. Management and leadership are not synonymous, yet should be considered together as there can be too much of one and not enough of the other. In complex adaptive health systems, the multiple interactions and relationships between people and elements of the system mean that management and leadership, so often treated as domains of the individual, are additionally systemic phenomena, emerging from these relational interactions. This brief commentary notes some significant implications for how we can support capacity strengthening interventions for complex management and leadership. These would necessarily move away from competency-based models focused on training for individuals, and would rather encompass longer-term initiatives explicitly focused on systemic goals of accountability, innovation, and learning. © 2015 by Kerman University of Medical Sciences.

  1. The role of the International Atomic Energy Agency in technology transfer for the peaceful use of nuclear energy and the strengthening of the Safeguards system, Santiago, 9 December 1998

    International Nuclear Information System (INIS)

    ElBaradei, M.

    1998-01-01

    The document reproduces the text of the conference given by the Director General of the IAEA at the IAEA national seminar on 'Nuclear Development and its Implications for Chilean International Policy' in Santiago, Chile, on 9 December 1998. After a short presentation of Chile's participation in all aspects of the work of the Agency, the conference focuses on the Agency's role in the following areas: technology transfer with emphasis on Agency's Technical Co-operation Programme, nuclear power and sustainable energy development, including nuclear safety aspects, and the strengthened safeguards system, including future prospects of verification

  2. Systems thinking in practice: the current status of the six WHO building blocks for health system strengthening in three BHOMA intervention districts of Zambia: a baseline qualitative study.

    Science.gov (United States)

    Mutale, Wilbroad; Bond, Virginia; Mwanamwenge, Margaret Tembo; Mlewa, Susan; Balabanova, Dina; Spicer, Neil; Ayles, Helen

    2013-08-01

    The primary bottleneck to achieving the MDGs in low-income countries is health systems that are too fragile to deliver the volume and quality of services to those in need. Strong and effective health systems are increasingly considered a prerequisite to reducing the disease burden and to achieving the health MDGs. Zambia is one of the countries that are lagging behind in achieving millennium development targets. Several barriers have been identified as hindering the progress towards health related millennium development goals. Designing an intervention that addresses these barriers was crucial and so the Better Health Outcomes through Mentorship (BHOMA) project was designed to address the challenges in the Zambia's MOH using a system wide approach. We applied systems thinking approach to describe the baseline status of the Six WHO building blocks for health system strengthening. A qualitative study was conducted looking at the status of the Six WHO building blocks for health systems strengthening in three BHOMA districts. We conducted Focus group discussions with community members and In-depth Interviews with key informants. Data was analyzed using Nvivo version 9. The study showed that building block specific weaknesses had cross cutting effect in other health system building blocks which is an essential element of systems thinking. Challenges noted in service delivery were linked to human resources, medical supplies, information flow, governance and finance building blocks either directly or indirectly. Several barriers were identified as hindering access to health services by the local communities. These included supply side barriers: Shortage of qualified health workers, bad staff attitude, poor relationships between community and health staff, long waiting time, confidentiality and the gender of health workers. Demand side barriers: Long distance to health facility, cost of transport and cultural practices. Participating communities seemed to lack the capacity

  3. Trends in antenatal care attendance and health facility delivery following community and health facility systems strengthening interventions in Northern Uganda.

    Science.gov (United States)

    Ediau, Michael; Wanyenze, Rhoda K; Machingaidze, Simba; Otim, George; Olwedo, Alex; Iriso, Robert; Tumwesigye, Nazarius M

    2013-10-18

    Maternal morbidity and mortality remains high in Uganda; largely due to inadequate antenatal care (ANC), low skilled deliveries and poor quality of other maternal health services. In order to address both the demand and quality of ANC and skilled deliveries, we introduced community mobilization and health facility capacity strengthening interventions. Interventions were introduced between January 2010 and September 2011. These included: training health workers, provision of medical supplies, community mobilization using village health teams, music dance and drama groups and male partner access clubs. These activities were implemented at Kitgum Matidi health center III and its catchment area. Routinely collected health facility data on selected outcomes in the year preceding the interventions and after 21 months of implementation of the interventions was reviewed. Trend analysis was performed using excel and statistical significance testing was performed using EPINFO StatCal option. The number of pregnant women attending the first ANC visit significantly increased from 114 to 150 in the first and fourth quarter of 2010 (OR 1.72; 95% CI 1.39-2.12) and to 202 in the third quarter of 2011(OR 11.41; 95% CI 7.97-16.34). The number of pregnant women counselled, tested and given results for HIV during the first ANC attendance significantly rose from 92 (80.7%) to 146 (97.3%) in the first and fourth quarter of 2010 and then to 201 (99.5%) in the third quarter of 2011. The number of male partners counseled, tested and given results together with their wives at first ANC visit rose from 13 (16.7%) in the fourth quarter of 2009 to 130 (89%) in the fourth quarter of 2010 and to 180 (89.6%) in the third quarter of 2011. There was a significant rise in the number of pregnant women delivering in the health facility with provision of mama-kits (delivery kits), from 74 (55.2%) to 149 (99.3%) in the second and fourth quarter of 2010. Combined community and facility systems

  4. Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening.

    Science.gov (United States)

    Raftery, Philomena; Condell, Orla; Wasunna, Christine; Kpaka, Jonathan; Zwizwai, Ruth; Nuha, Mahmood; Fallah, Mosoka; Freeman, Maxwell; Harris, Victoria; Miller, Mark; Baller, April; Massaquoi, Moses; Katawera, Victoria; Saindon, John; Bemah, Philip; Hamblion, Esther; Castle, Evelyn; Williams, Desmond; Gasasira, Alex; Nyenswah, Tolbert

    2018-01-01

    The 2014-16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the period of operation, site coordination, management and operational capacity was supported through a successful collaboration between Ministry of Health (MoH), World Health Organization (WHO) and international partners. A team of Liberian laboratory technicians were trained to conduct EVD diagnostics and the laboratory had capacity to test 64-100 blood specimens per day. Establishment of the laboratory significantly increased the daily testing capacity for EVD in Liberia, from 180 to 250 specimens at a time when the effectiveness of the surveillance system was threatened by insufficient diagnostic capacity. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Following clearance of the significant backlog of untested EVD specimens in November 2015, a new cluster of EVD cases was detected at the laboratory. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. Specimens taken from cases during both outbreaks were analysed at the laboratory with results informing clinical management of patients and discharge decisions. The GeneXpert platform is easy to use, has relatively low running costs and can be

  5. Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening

    Science.gov (United States)

    Condell, Orla; Wasunna, Christine; Kpaka, Jonathan; Zwizwai, Ruth; Nuha, Mahmood; Fallah, Mosoka; Freeman, Maxwell; Harris, Victoria; Miller, Mark; Baller, April; Massaquoi, Moses; Katawera, Victoria; Saindon, John; Bemah, Philip; Hamblion, Esther; Castle, Evelyn; Williams, Desmond; Gasasira, Alex; Nyenswah, Tolbert

    2018-01-01

    The 2014–16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the period of operation, site coordination, management and operational capacity was supported through a successful collaboration between Ministry of Health (MoH), World Health Organization (WHO) and international partners. A team of Liberian laboratory technicians were trained to conduct EVD diagnostics and the laboratory had capacity to test 64–100 blood specimens per day. Establishment of the laboratory significantly increased the daily testing capacity for EVD in Liberia, from 180 to 250 specimens at a time when the effectiveness of the surveillance system was threatened by insufficient diagnostic capacity. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Following clearance of the significant backlog of untested EVD specimens in November 2015, a new cluster of EVD cases was detected at the laboratory. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. Specimens taken from cases during both outbreaks were analysed at the laboratory with results informing clinical management of patients and discharge decisions. The GeneXpert platform is easy to use, has relatively low running costs and can

  6. Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: a cross-country qualitative study.

    Science.gov (United States)

    Lempp, H; Abayneh, S; Gurung, D; Kola, L; Abdulmalik, J; Evans-Lacko, S; Semrau, M; Alem, A; Thornicroft, G; Hanlon, C

    2018-02-01

    The aims of this paper are to: (i) explore the experiences of involvement of mental health service users, their caregivers, mental health centre heads and policy makers in mental health system strengthening in three low- and middle-income countries (LMICs) (Ethiopia, Nepal and Nigeria); (ii) analyse the potential benefits and barriers of such involvement; and (iii) identify strategies required to achieve greater service user and caregiver participation. A cross-country qualitative study was conducted, interviewing 83 stakeholders of mental health services. Our analysis showed that service user and caregiver involvement in the health system strengthening process was an alien concept for most participants. They reported very limited access to direct participation. Stigma and poverty were described as the main barriers for involvement. Several strategies were identified by participants to overcome existing hurdles to facilitate service user and caregiver involvement in the mental health system strengthening process, such as support to access treatment, mental health promotion and empowerment of service users. This study suggests that capacity building for service users, and strengthening of user groups would equip them to contribute meaningfully to policy development from informed perspectives. Involvement of service users and their caregivers in mental health decision-making is still in its infancy in LMICs. Effective strategies are required to overcome existing barriers, for example making funding more widely available for Ph.D. studies in participatory research with service users and caregivers to develop, implement and evaluate approaches to involvement that are locally and culturally acceptable in LMICs.

  7. Smart Cities and National Energy Systems

    DEFF Research Database (Denmark)

    Thellufsen, Jakob Zinck

    Energy system analysis follows two tracks, either through plans for future transitions of national energy systems, or local development of smart cities and regions. These two tracks seldom overlap. National plans neglect the local implementation of intermittent renewable technology and use of local...... resources, and smart cities and local development do not relate to national targets and fail to evaluate sub-optimization. Thus, there is a need for approaches that help researchers creating links between country analyses and local energy system transitions. This paper investigates the effects...... of such an approach, by investigating Western Denmark. By splitting Western Denmark into regions, it is possible to create individual energy systems for each region. Through interconnection, these regions can exchange electricity with each other. This enables analyses of interaction between smart cities and national...

  8. National Fire Incident Reporting System (NFIRS)

    Data.gov (United States)

    Department of Homeland Security — The National Fire Incident Reporting System (NFIRS) is a reporting standard that fire departments use to uniformly report on the full range of their activities, from...

  9. National Violent Death Reporting System (NVDRS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Violent Death Reporting System (NVDRS) provides states and communities with a clearer understanding of violent deaths to guide local decisions about...

  10. Referral Systems to Integrate Health and Economic Strengthening Services for People with HIV: A Qualitative Assessment in Malawi.

    Science.gov (United States)

    Sears, Clinton; Andersson, Zach; Cann, Meredith

    2016-12-23

    Supporting the diverse needs of people living with HIV (PLHIV) can help reduce the individual and structural barriers they face in adhering to antiretroviral treatment (ART). The Livelihoods and Food Security Technical Assistance II (LIFT) project sought to improve adherence in Malawi by establishing 2 referral systems linking community-based economic strengthening and livelihoods services to clinical health facilities. One referral system in Balaka district, started in October 2013, connected clients to more than 20 types of services while the other simplified approach in Kasungu and Lilongwe districts, started in July 2014, connected PLHIV attending HIV and nutrition support facilities directly to community savings groups. From June to July 2015, LIFT visited referral sites in Balaka, Kasungu, and Lilongwe districts to collect qualitative data on referral utility, the perceived association of referrals with client and household health and vulnerability, and the added value of the referral system as perceived by network member providers. We interviewed a random sample of 152 adult clients (60 from Balaka, 57 from Kasungu, and 35 from Lilongwe) who had completed their referral. We also conducted 2 focus group discussions per district with network providers. Clients in all 3 districts indicated their ability to save money had improved after receiving a referral, although the percentage was higher among clients in the simplified Kasungu and Lilongwe model than the more complex Balaka model (85.6% vs. 56.0%, respectively). Nearly 70% of all clients interviewed had HIV infection; 72.7% of PLHIV in Balaka and 95.7% of PLHIV in Kasungu and Lilongwe credited referrals for helping them stay on their ART. After the referral, 76.0% of clients in Balaka and 92.3% of clients in Kasungu and Lilongwe indicated they would be willing to spend their savings on health costs. The more diverse referral network and use of an mHealth app to manage data in Balaka hindered provider uptake

  11. Does National Culture Impact Capital Budgeting Systems?

    Directory of Open Access Journals (Sweden)

    Peter J. Graham

    2017-06-01

    Full Text Available We examine how national culture impacts organisational selection of capital budgeting systems to develop our understanding of what influence a holistic formulation of national culture has on capital budgeting systems. Such an understanding is important as it would not only provide a clearer link between national culture and capital budgeting systems and advance extant literature but would also help multinational firms that have business relationships with Indonesian firms in suitably designing strategies. We conducted semi-structured interviews of selected finance managers of listed firms in Indonesia and Australia. Consistent with the contingency theory, we found that economic, political, legal and social uncertainty impact on the use of capital budgeting systems. The levels of uncertainty were higher in Indonesia than Australia and need to be reckoned in the selection of capital budgeting systems used by firms. We also found that firms are influenced by project size and complexity, when selecting capital budgeting systems.

  12. Technology Transmission Across National Innovation Systems

    DEFF Research Database (Denmark)

    Haakonsson, Stine Jessen; Slepniov, Dmitrij

    This paper advances our understanding of how technology upgrading in the Chinese wind turbine industry is linked to internationalisation of Danish component suppliers. In order to grasp the interlinkages and implications hereof, the paper combines perspectives of global value chains (GVC), national.......e. linking up with global suppliers in the wind turbine global value chain, and the new role of component suppliers as technology transmitters across national innovation systems into emerging markets. Conceptually, the paper contributes to understanding how technological catching up in value chains links...... to the intersection between national innovation systems, a process driven by global value chain dynamics....

  13. Technology Transmission Across National Innovation Systems

    DEFF Research Database (Denmark)

    Haakonsson, Stine Jessen; Slepniov, Dmitrij

    2018-01-01

    This paper advances our understanding of how technology upgrading in the Chinese wind turbine industry is linked to internationalisation of Danish component suppliers. In order to grasp the interlinkages and implications hereof, the paper combines perspectives of global value chains (GVC), national.......e. linking up with global suppliers in the wind turbine global value chain, and the new role of component suppliers as technology transmitters across national innovation systems into emerging markets. Conceptually, the paper contributes to understanding how technological catching up in value chains links...... to the intersection between national innovation systems, a process driven by global value chain dynamics....

  14. National Identity in Educational System of Iran

    Directory of Open Access Journals (Sweden)

    Madi Loghmannia

    2010-06-01

    Full Text Available Identity is one the most significant discussions in contemporary world. In every society, a need, sense of dependency and tendency to national identity is inevitable. As educational system in all countries has the biggest power and humanistic capital, it is one the best tools for reinforcement and consistency of national identity and the curriculums have crucial role in national identity formation. As mentioned, the main aim of this article is to study the role of national identity in the educational system. To do so, first national identity will be discussed comparatively in Iran and other countries and later the reasons of its weakness in the educational system will be elaborated. The general goals of three educational stages (elementary, secondary and high School and the amount of attention to national identity will be subtlety discussed. The results show that national identity in Iranian educational system has no desirable situation and as this factor has effective role, it needs to take into more considerations for developmental issues.

  15. Routine Immunization Consultant Program in Nigeria: A Qualitative Review of a Country-Driven Management Approach for Health Systems Strengthening.

    Science.gov (United States)

    O'Connell, Meghan; Wonodi, Chizoba

    2016-03-01

    allowed work to be tailored to the local context; consultants were often integrated into state RI teams but could also work independently when necessary; and recruitment of experienced consultants with strong professional networks, familiarity with the local context, and ability to speak the local language facilitated advocacy efforts. Key programmatic challenges were related to inadequate and inconsistent inputs (salaries, transportation means, and dedicated office space) and gaps in communication between consultants and national leadership and in management of consultants, including lack of performance feedback, lack of formal orientation at inception, and no clear job performance targets. While weaknesses in managerial and material inputs affect current performance of RI consultants in Nigeria, the design of the RI consultant program employs a unique problem-focused, locally led model of development assistance that could prove valuable in strengthening the capacity of the government to implement such technical assistance on its own. Despite the lack of uniform deployment and implementation of RI consultants across the country, some consultants appear to have contributed to improved RI services through supportive supervision, capacity building, and advocacy. © O’Connell and Wonodi.

  16. Using the World Health Organization's 4S-Framework to Strengthen National Strategies, Policies and Services to Address Mental Health Problems in Adolescents in Resource-Constrained Settings

    Directory of Open Access Journals (Sweden)

    Cabral de Mello Meena

    2011-09-01

    Full Text Available Abstract Background Most adolescents live in resource-constrained countries and their mental health has been less well recognised than other aspects of their health. The World Health Organization's 4-S Framework provides a structure for national initiatives to improve adolescent health through: gathering and using strategic information; developing evidence-informed policies; scaling up provision and use of health services; and strengthening linkages with other government sectors. The aim of this paper is to discuss how the findings of a recent systematic review of mental health problems in adolescents in resource-constrained settings might be applied using the 4-S Framework. Method Analysis of the implications of the findings of a systematic search of the English-language literature for national strategies, policies, services and cross-sectoral linkages to improve the mental health of adolescents in resource-constrained settings. Results Data are available for only 33/112 [29%] resource-constrained countries, but in all where data are available, non-psychotic mental health problems in adolescents are identifiable, prevalent and associated with reduced quality of life, impaired participation and compromised development. In the absence of evidence about effective interventions in these settings expert opinion is that a broad public policy response which addresses direct strategies for prevention, early intervention and treatment; health service and health workforce requirements; social inclusion of marginalised groups of adolescents; and specific education is required. Specific endorsed strategies include public education, parent education, training for teachers and primary healthcare workers, psycho-educational curricula, identification through periodic screening of the most vulnerable and referral for care, and the availability of counsellors or other identified trained staff members in schools from whom adolescents can seek assistance for

  17. Capacity Development and Strengthening for Energy Policy formulation and implementation of Sustainable Energy Projects in Indonesia CASINDO. Deliverable No. 13. Integration of Renewable Energy Technologies in the national curriculum SPECTRUM

    Energy Technology Data Exchange (ETDEWEB)

    Kamphuis, E. [ETC Nederland, Leusden (Netherlands); Permana, I. [Technical Education Development Centre TEDC, Bandung (Indonesia)

    2011-11-15

    The overall objective of the CASINDO programme is to establish a self-sustaining and self-developing structure at both the national and regional level to build and strengthen human capacity to enable the provinces of North Sumatra, Yogyakarta, Central Java, West Nusa Tenggara and Papua to formulate sound policies for renewable energy and energy efficiency and to develop and implement sustainable energy projects. This report focuses on the achievements for settling a national curriculum for Renewable Energy Technologies (RET) within the framework of national programme SPECTRUM, which includes all curricula of the medium technical schools in Indonesia.

  18. Service user and care giver involvement in mental health system strengthening in Nepal: a qualitative study on barriers and facilitating factors.

    Science.gov (United States)

    Gurung, Dristy; Upadhyaya, Nawaraj; Magar, Jananee; Giri, Nir Prakash; Hanlon, Charlotte; Jordans, Mark J D

    2017-01-01

    Service user and caregiver involvement has become an increasingly common strategy to enhance mental health outcomes, and has been incorporated in the mental healthpolicies of many developed nations. However, this practice is non-existent or fragmented in low and middle income countries (LMICs). Instances of service user and caregiver involvement have been rising slowly in a few LMICs, but are rarely described in the literature. Very little is known about the context of user and caregiver participation in mental health system strengthening processes in a low-income, disaster- and conflict-affected state such as Nepal. This study explores (a) the extent and experiences of service user and caregiver involvement in policy making, service planning, monitoring, and research in Nepal; (b) perceived barriers to such involvement; and (c) possible strategies to overcome barriers. Key Informant Interviews (n = 24) were conducted with service users and caregivers who were either affiliated to a mental health organization or receiving menta health care integrated within primary care. Purposive sampling was employed. Data collection was carried out in 2014 in Chitwan and Kathmandu districts of Nepal. Data analysis was carried out in NVivo10 using a framework approach. The involvement of service users affiliated to mental health organizations in policy development was reported to be 'tokenistic'. Involvement of caregivers was non-existent. Perceived barriers to greater involvement included lack of awareness, stigma and discrimination, poor economic conditions, the centralized health system, and lack of strong leadership and unity among user organizations. Increased focus on reducing public as well as self-stigma, improved policy frameworks and initiatives, and decentralization of care are some strategies that may facilitate service user and caregiver involvement. The study highlighted need for user and caregiver networks free from competing interests and priorities. Improved

  19. Technology for national asset storage systems

    Science.gov (United States)

    Coyne, Robert A.; Hulen, Harry; Watson, Richard

    1993-01-01

    An industry-led collaborative project, called the National Storage Laboratory, was organized to investigate technology for storage systems that will be the future repositories for our national information assets. Industry participants are IBM Federal Systems Company, Ampex Recording Systems Corporation, General Atomics DISCOS Division, IBM ADSTAR, Maximum Strategy Corporation, Network Systems Corporation, and Zitel Corporation. Industry members of the collaborative project are funding their own participation. Lawrence Livermore National Laboratory through its National Energy Research Supercomputer Center (NERSC) will participate in the project as the operational site and the provider of applications. The expected result is an evaluation of a high performance storage architecture assembled from commercially available hardware and software, with some software enhancements to meet the project's goals. It is anticipated that the integrated testbed system will represent a significant advance in the technology for distributed storage systems capable of handling gigabyte class files at gigabit-per-second data rates. The National Storage Laboratory was officially launched on 27 May 1992.

  20. Development of Radiometric and Allied Analytical Methods and Strategies to Strengthen National Residue Control Programmes for Antibiotic and Anthelmintic Veterinary Drug Residues. Final Report of a Coordinated Research Project

    International Nuclear Information System (INIS)

    2016-08-01

    Awareness of food safety is rising among consumers, and many importing countries implement food control regulations to guarantee the quality and safety of imported foods for their consumers. Many developing countries have also taken steps to put in place control systems that encourage responsible use of veterinary medicines to combat possible drug resistance, control drug residues and ensure compliance with international and national standards. However, these countries still require the necessary know-how and skills to protect local consumers and to access international markets. One significant constraint is the capacity of laboratory services to generate surveillance data using reliable and cost effective analytical methods validated to national and international standards. The IAEA coordinated research project (CRP) on the Development of Radiometric and Allied Analytical Methods to Strengthen National Residue Control Programmes for Antibiotic and Anthelmintic Veterinary Drug Residues was initiated in 2009 to conduct work on robust nuclear and related technologies suitable for the screening and confirmatory analysis of residues of veterinary medicines, including antimicrobials and anthelmintics commonly used in animal production, with public health and trade significance. The CRP also explored mechanisms to enhance networking among research institutions involved in research on pharmacologically active veterinary drug residues in food (primarily) and environmental samples. The project was implemented by the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture between 2009 and 2014 and involved eleven research contracts and one technical contract, five research agreements and one institution. The CRP was a continuation of the CRP on the Development of Strategies for the Effective Monitoring of Veterinary Drug Residues in Livestock and Livestock Products in Developing Countries and the key findings are also summarized in this publication.

  1. US national material control and accounting system

    International Nuclear Information System (INIS)

    Smith, C.N.

    1984-01-01

    The State System of Accounting and Control (SSAC) for fuel cycle facilities in the licensed, commercial sector of the US nuclear community, and details of the material control and accounting measures dealing with the national safeguards program are discussed. The concept and role of the Fundamental Nuclear Material Control (FNMC) Plan is discussed. Also, the relationship between the national safeguards program and the international safeguards program of the US SSAC are described

  2. Developing capacity-building activities for mental health system strengthening in low- and middle-income countries for service users and caregivers, service planners, and researchers.

    Science.gov (United States)

    Semrau, M; Alem, A; Abdulmalik, J; Docrat, S; Evans-Lacko, S; Gureje, O; Kigozi, F; Lempp, H; Lund, C; Petersen, I; Shidhaye, R; Thornicroft, G; Hanlon, C

    2018-02-01

    There is increasing international recognition of the need to build capacity to strengthen mental health systems. This is a fundamental goal of the 'Emerging mental health systems in low- and middle-income countries' (Emerald) programme, which is being implemented in six low- and middle-income countries (LMICs) (Ethiopia, India, Nepal, Nigeria, South Africa, Uganda). This paper discusses Emerald's capacity-building approaches and outputs for three target groups in mental health system strengthening: (1) mental health service users and caregivers, (2) service planners and policy-makers, and (3) mental health researchers. When planning the capacity-building activities, the approach taken included a capabilities/skills matrix, needs assessments, a situational analysis, systematic reviews, qualitative interviews and stakeholder meetings, as well as the application of previous theory, evidence and experience. Each of the Emerald LMIC partners was found to have strengths in aspects of mental health system strengthening, which were complementary across the consortium. Furthermore, despite similarities across the countries, capacity-building interventions needed to be tailored to suit the specific needs of individual countries. The capacity-building outputs include three publicly and freely available short courses/workshops in mental health system strengthening for each of the target groups, 27 Masters-level modules (also open access), nine Emerald-linked PhD students, two MSc studentships, mentoring of post-doctoral/mid-level researchers, and ongoing collaboration and dialogue with the three groups. The approach taken by Emerald can provide a potential model for the development of capacity-building activities across the three target groups in LMICs.

  3. Investing in nursing and midwifery enterprise to empower women and strengthen health services and systems: An emerging global body of work.

    Science.gov (United States)

    Salmon, Marla E; Maeda, Akiko

    2016-01-01

    In September of 2014, the Institute of Medicine (IOM) convened a global Rockefeller Bellagio Center workshop focusing on the largely overlooked area of investment in nursing and midwifery enterprise as a means for both empowering women and strengthening health systems and services. The report of this meeting, Empowering Women and Strengthening Health Systems and Services Through Investing in Nursing and Midwifery Enterprise: Lessons from Lower-Income Countries: Workshop Summary, was released in February, 2015. This report represents a pivotal point in a growing body of work begun in 2012, providing insights and perspectives of global experts that have resulted in subsequent global discussions and are paving the way for the future. This three-part article summarizes the initial exploration leading to the IOM workshop and report, followed by highlights and insights from the report and related meetings, and authors concluding discussion of implications for the future and next steps. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. An integrated and sustainable EU health information system: national public health institutes' needs and possible benefits.

    Science.gov (United States)

    Bogaert, Petronille; Van Oyen, Herman

    2017-01-01

    Although sound data and health information are at the basis of evidence-based policy-making and research, still no single, integrated and sustainable EU-wide public health monitoring system or health information system exists. BRIDGE Health is working towards an EU health information and data generation network covering major EU health policy areas. A stakeholder consultation with national public health institutes was organised to identify the needs to strengthen the current EU health information system and to identify its possible benefits. Five key issues for improvement were identified: (1) coherence, coordination and sustainability; (2) data harmonization, collection, processing and reporting; (3) comparison and benchmarking; (4) knowledge sharing and capacity building; and (5) transferability of health information into evidence-based policy making. The vision of an improved EU health information system was formulated and the possible benefits in relation to six target groups. Through this consultation, BRIDGE Health has identified the continuous need to strengthen the EU health information system. A better system is about sustainability, better coordination, governance and collaboration among national health information systems and stakeholders to jointly improve, harmonise, standardise and analyse health information. More and better sharing of this comparable health data allows for more and better comparative health research, international benchmarking, national and EU-wide public health monitoring. This should be developed with the view to provide the tools to fight both common and individual challenges faced by the Members States and their politicians.

  5. Country ownership and capacity building: the next buzzwords in health systems strengthening or a truly new approach to development?

    Directory of Open Access Journals (Sweden)

    Goldberg Jessica

    2012-07-01

    Full Text Available Abstract Background During the last decade, donor governments and international agencies have increasingly emphasized the importance of building the capacity of indigenous health care organizations as part of strengthening health systems and ensuring sustainability. In 2009, the U.S. Global Health Initiative made country ownership and capacity building keystones of U.S. health development assistance, and yet there is still a lack of consensus on how to define either of these terms, or how to implement “country owned capacity building”. Discussion Concepts around capacity building have been well developed in the for-profit business sector, but remain less well defined in the non-profit and social sectors in low and middle-income countries. Historically, capacity building in developing countries has been externally driven, related to project implementation, and often resulted in disempowerment of local organizations rather than local ownership. Despite the expenditure of millions of dollars, there is no consensus on how to conduct capacity building, nor have there been rigorous evaluations of capacity building efforts. To shift to a new paradigm of country owned capacity building, donor assistance needs to be inclusive in the planning process and create true partnerships to conduct organizational assessments, analyze challenges to organizational success, prioritize addressing challenges, and implement appropriate activities to build new capacity in overcoming challenges. Before further investments are made, a solid evidence base should be established concerning what works and what doesn’t work to build capacity. Summary Country-owned capacity building is a relatively new concept that requires further theoretical exploration. Documents such as The Paris Declaration on Aid Effectiveness detail the principles of country ownership to which partner and donor countries should commit, but do not identify the specific mechanisms to carry out these

  6. Application of system thinking concepts in health system strengthening in low-income settings: a proposed conceptual framework for the evaluation of a complex health system intervention: the case of the BHOMA intervention in Zambia.

    Science.gov (United States)

    Mutale, Wilbroad; Balabanova, Dina; Chintu, Namwinga; Mwanamwenge, Margaret Tembo; Ayles, Helen

    2016-02-01

    The current drive to strengthen health systems provides an opportunity to develop new strategies that will enable countries to achieve targets for millennium development goals. In this paper, we present a proposed framework for evaluating a new health system strengthening intervention in Zambia known as Better Health Outcomes through Mentoring and Assessment. We briefly describe the intervention design and focus on the proposed evaluation approach through the lens of systems thinking. In this paper, we present a proposed framework to evaluate a complex health system intervention applying systems thinking concepts. We hope that lessons learnt from this process will help to adapt the intervention and limit unintended negative consequences while promoting positive effects. Emphasis will be paid to interaction and interdependence between health system building blocks, context and the community. © 2014 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  7. Relations of meeting national public health recommendations for muscular strengthening activities with strength, body composition, and obesity: the Women's Injury Study.

    Science.gov (United States)

    Trudelle-Jackson, Elaine; Jackson, Allen W; Morrow, James R

    2011-10-01

    We examined the relations of meeting or not meeting the 2008 Physical Activity Guidelines for Americans recommendations for muscular strengthening activities with percentage of body fat, body mass index (BMI; defined as weight in kilograms divided by height in meters, squared), muscular strength, and obesity classification in women. We analyzed data on 918 women aged 20 to 83 years in the Women's Injury Study from 2007 to 2009. A baseline orthopedic examination included measurement of height, body weight, skinfolds, and muscle strength. Women who met muscle strengthening activity recommendations had significantly lower BMI and percentage of body fat and higher muscle strength. Women not meeting those recommendations were more likely to be obese (BMI ≥ 30) compared with women who met the recommendations after we adjusted for age, race, and aerobic physical activity (odds ratio = 2.28; 95% confidence interval = 1.61, 3.23). There was a small but significant positive association between meeting muscle strengthening activity recommendations and muscular strength, a moderate inverse association with body fat percentage, and a strong inverse association with obesity classification, providing preliminary support for the muscle strengthening activity recommendation for women.

  8. Inserting environment into the national accounting system

    International Nuclear Information System (INIS)

    del Giudice, R.

    1992-01-01

    The article is an analysis of the problem of incorporating the environment in the national accounting system as an essential part of a country's revenue. Revenue is defined here as the value which is necessary for the prudent management of a nation's expenses and balances. After a first analysis of the importance of properly structuring national accounting systems, methods used in certain countries such as France, Japan and Germany were considered in order to single out the limitations and merits of these methods. The purpose is to find a standard method which would allow for comparison with the situation in various countries and, in this way, indicate directives for better management of the environment in all of its aspects

  9. Americal National Standard critical accident alarm system

    International Nuclear Information System (INIS)

    Smith, D.R.

    1975-01-01

    An American National Standard has been developed to provide guidance for the design, maintenance, and use of criticality accident alarm systems. Discussion includes several details of this Standard, N16.2-1969, and of a revised version which is now nearing certification

  10. Socio-economic improvements and health system strengthening of maternity care are contributing to maternal mortality reduction in Cambodia.

    Science.gov (United States)

    Liljestrand, Jerker; Sambath, Mean Reatanak

    2012-06-01

    Maternal mortality has been falling significantly in Cambodia since 2005 though it had been stagnant for at least 15 years before that. This paper analyzes the evolution of some major societal and health system factors based on recent national and international reports. The maternal mortality ratio fell from 472 per 100,000 live births in 2000-2005 to 206 in 2006-2010. Background factors have included peace and stability, economic growth and poverty reduction, improved primary education, especially for girls, improved roads, improved access to information on health and health services via TV, radio and cellphones, and increased ability to communicate with and within the health system. Specific health system improvements include a rapid increase in facility-based births and skilled birth attendance, notably investment in midwifery training and numbers of midwives providing antenatal care and deliveries within an expanding primary health care network, a monetary incentive for facility-based midwives for every live birth conducted, and an expanding system of health equity funds, making health care free of cost for poor people. Several major challenges remain, including post-partum care, family planning, prevention and treatment of breast and cervical cancer, and addressing sexual violence against women, which need the same priority attention as maternity care. Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  11. 75 FR 52587 - 2009 Fatality Analysis Reporting System (FARS)/National Automotive Sampling System General...

    Science.gov (United States)

    2010-08-26

    ... National Highway Traffic Safety Administration 2009 Fatality Analysis Reporting System (FARS)/National Automotive Sampling System General Estimates System (NASS GES) Updates AGENCY: National Highway Traffic... Traffic Safety Administration (NHTSA)--2009 Fatality Analysis Reporting System (FARS) & National...

  12. Rassyn: National radiological safety data management system

    International Nuclear Information System (INIS)

    Domenech Nieves, Haydee; Valdez Ramso, Maryzury; Jova Sed, Luis; De la Fuente, Andres

    1996-01-01

    The paper describes the menu, screens data files, programs and classifications of the systems, for keeping a record of their institutions, inspection and authorization, the personal register of incidents and accidents, and the national inventory of radiation protection sources and equipment. By making use of it, a comparison can be made of existing data of a practice with its requirements and a questionnaire of the inspection, (Checking list), the development and results of the inspection can be reported on, the program and notification of the inspection can be prepared and the information on the radiological situation- whether at a national or at a territorial level- can be evaluated

  13. National Geoscience Data Repository System. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Schiffries, C.M.; Milling, M.E.

    1994-03-01

    The American Geological Institute (AGI) has completed the first phase of a study to assess the feasibility of establishing a National Geoscience Data Repository System to capture and preserve valuable geoscientific data. The study was initiated in response to the fact that billions of dollars worth of domestic geological and geophysical data are in jeopardy of being irrevocably lost or destroyed as a consequence of the ongoing downsizing of the US energy and minerals industry. This report focuses on two major issues. First, it documents the types and quantity of data available for contribution to a National Geoscience Data Repository System. Second, it documents the data needs and priorities of potential users of the system. A National Geoscience Data Repository System would serve as an important and valuable source of information for the entire geoscience community for a variety of applications, including environmental protection, water resource management, global change studies, and basic and applied research. The repository system would also contain critical data that would enable domestic energy and minerals companies to expand their exploration and production programs in the United States for improved recovery of domestic oil, gas, and mineral resources.

  14. Strengthening regional safeguards

    International Nuclear Information System (INIS)

    Palhares, L.; Almeida, G.; Mafra, O.

    1996-01-01

    Nuclear cooperation between Argentina and Brazil has been growing since the early 1980's and as it grew, so did cooperation with the US Department of Energy (DOE). The Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC) was formed in December 1991 to operate the Common System of Accounting and Control of Nuclear Materials (SCCC). In April 1994, ABACC and the DOE signed an Agreement of Cooperation in nuclear material safeguards. This cooperation has included training safeguards inspectors, exchanging nuclear material measurement and containment and surveillance technology, characterizing reference materials, and studying enrichment plant safeguards. The goal of the collaboration is to exchange technology, evaluate new technology in Latin American nuclear facilities, and strengthen regional safeguards. This paper describes the history of the cooperation, its recent activities, and future projects. The cooperation is strongly supported by all three governments: the Republics of Argentina and Brazil and the United States

  15. The gas cylinder, the motorcycle and the village health team member: a proof-of-concept study for the use of the Microsystems Quality Improvement Approach to strengthen the routine immunization system in Uganda.

    Science.gov (United States)

    Bazos, Dorothy A; LaFave, Lea R Ayers; Suresh, Gautham; Shannon, Kevin C; Nuwaha, Fred; Splaine, Mark E

    2015-03-08

    Although global efforts to support routine immunization (RI) system strengthening have resulted in higher immunization rates, the World Health Organization (WHO) estimates that the proportion of children receiving recommended DPT3 vaccines has stagnated at 80% for the past 3 years (WHO Fact sheet-Immunization coverage 2014, WHO, 2014). Meeting the WHO goal of 90% national DPT3 coverage may require locally based strategies to support conventional approaches. The Africa Routine Immunization Systems Essentials-System Innovation (ARISE-SI) initiative is a proof-of-concept study to assess the application of the Microsystems Quality Improvement Approach for generating local solutions to strengthen RI systems and reach those unreached by current efforts in Masaka District, Uganda. The ARISE-SI intervention had three components: health unit (HU) advance preparations, an action learning collaborative, and coaching of improvement teams. The intervention was informed and assessed using qualitative and quantitative methods. Data collection focused on changes and outcomes of improvement efforts among five HUs and one district-level team during the intervention (June 2011-February 2012) and five follow-up months. Workshops and team meetings had a 95% attendance rate. All teams gained RI system knowledge and implemented changes to address locally identified problems. Specific changes included: RI register implementation and expanded use, Child Health Card provision and monitoring, staff cross-training, staffing pattern changes, predictable outreach schedules, and health system leader--community leader meetings. Several RI system barriers prevalent across Masaka District (e.g., lack of backup HU gas cylinders, inadequate outreach transportation, and village health team underutilization) were successfully addressed. Three of five HUs significantly increased the vaccines administered. All improvements were sustained 5 months post-intervention. External evaluation validated the

  16. 76 FR 57 - Special Regulation: Areas of the National Park System, National Capital Region

    Science.gov (United States)

    2011-01-03

    ...: Areas of the National Park System, National Capital Region AGENCY: National Park Service, Interior... demonstrations and special events for the National Capital Region. This proposed rule would revise the definition..., Chief, Division of Park Programs, National Park Service, National Capital Region, 1100 Ohio Drive, SW...

  17. Approaches to ensuring and improving quality in the context of health system strengthening: a cross-site analysis of the five African Health Initiative Partnership programs.

    Science.gov (United States)

    Hirschhorn, Lisa R; Baynes, Colin; Sherr, Kenneth; Chintu, Namwinga; Awoonor-Williams, John Koku; Finnegan, Karen; Philips, James F; Anatole, Manzi; Bawah, Ayaga A; Basinga, Paulin

    2013-01-01

    Integrated into the work in health systems strengthening (HSS) is a growing focus on the importance of ensuring quality of the services delivered and systems which support them. Understanding how to define and measure quality in the different key World Health Organization building blocks is critical to providing the information needed to address gaps and identify models for replication. We describe the approaches to defining and improving quality across the five country programs funded through the Doris Duke Charitable Foundation African Health Initiative. While each program has independently developed and implemented country-specific approaches to strengthening health systems, they all included quality of services and systems as a core principle. We describe the differences and similarities across the programs in defining and improving quality as an embedded process essential for HSS to achieve the goal of improved population health. The programs measured quality across most or all of the six WHO building blocks, with specific areas of overlap in improving quality falling into four main categories: 1) defining and measuring quality; 2) ensuring data quality, and building capacity for data use for decision making and response to quality measurements; 3) strengthened supportive supervision and/or mentoring; and 4) operational research to understand the factors associated with observed variation in quality. Learning the value and challenges of these approaches to measuring and improving quality across the key components of HSS as the projects continue their work will help inform similar efforts both now and in the future to ensure quality across the critical components of a health system and the impact on population health.

  18. Technology Transmission Across National Innovation Systems

    DEFF Research Database (Denmark)

    Haakonsson, Stine Jessen; Slepniov, Dmitrij

    .e. linking up with global suppliers in the wind turbine global value chain, and the new role of component suppliers as technology transmitters across national innovation systems into emerging markets. Conceptually, the paper contributes to understanding how technological catching up in value chains links......This paper advances our understanding of how technology upgrading in the Chinese wind turbine industry is linked to internationalisation of Danish component suppliers. In order to grasp the interlinkages and implications hereof, the paper combines perspectives of global value chains (GVC), national...... innovation systems (NIS) and firm level capabilities. The paper employs a qualitative methodology, drawing on explorative case studies of component suppliers and their links to lead firms in the wind turbine industry. The findings of the paper highlight the new pattern of upgrading by upstream linkages, i...

  19. Building the capacity of policy-makers and planners to strengthen mental health systems in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Keynejad, Roxanne; Semrau, Maya; Toynbee, Mark; Evans-Lacko, Sara; Lund, Crick; Gureje, Oye; Ndyanabangi, Sheila; Courtin, Emilie; Abdulmalik, Jibril O; Alem, Atalay; Fekadu, Abebaw; Thornicroft, Graham; Hanlon, Charlotte

    2016-10-21

    Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs). We conducted a systematic review with the primary aim of identifying and synthesizing the evidence base for building the capacity of policy-makers and planners to strengthen mental health systems in LMICs. We searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, ScieELO, Google Scholar and Cochrane databases for studies reporting evidence, experience or evaluation of capacity-building of policy-makers, service planners or managers in mental health system strengthening in LMICs. Reports in English, Spanish, Portuguese, French or German were included. Additional papers were identified by hand-searching references and contacting experts and key informants. Database searches yielded 2922 abstracts and 28 additional papers were identified. Following screening, 409 full papers were reviewed, of which 14 fulfilled inclusion criteria for the review. Data were extracted from all included papers and synthesized into a narrative review. Only a small number of mental health system-related capacity-building interventions for policy-makers and planners in LMICs were described. Most models of capacity-building combined brief training with longer term mentorship, dialogue and/or the establishment of networks of support. However, rigorous research and evaluation methods were largely absent, with studies being of low quality, limiting the potential to separate mental health system strengthening outcomes from the effects of associated contextual factors. This review demonstrates the need for partnership approaches to building the capacity of mental health policy-makers and planners in LMICs, assessed rigorously against pre-specified conceptual frameworks and hypotheses, utilising longitudinal evaluation and mixed quantitative and qualitative approaches.

  20. Building the capacity of policy-makers and planners to strengthen mental health systems in low- and middle-income countries: a systematic review

    Directory of Open Access Journals (Sweden)

    Roxanne Keynejad

    2016-10-01

    Full Text Available Abstract Background Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs. We conducted a systematic review with the primary aim of identifying and synthesizing the evidence base for building the capacity of policy-makers and planners to strengthen mental health systems in LMICs. Methods We searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, ScieELO, Google Scholar and Cochrane databases for studies reporting evidence, experience or evaluation of capacity-building of policy-makers, service planners or managers in mental health system strengthening in LMICs. Reports in English, Spanish, Portuguese, French or German were included. Additional papers were identified by hand-searching references and contacting experts and key informants. Database searches yielded 2922 abstracts and 28 additional papers were identified. Following screening, 409 full papers were reviewed, of which 14 fulfilled inclusion criteria for the review. Data were extracted from all included papers and synthesized into a narrative review. Results Only a small number of mental health system-related capacity-building interventions for policy-makers and planners in LMICs were described. Most models of capacity-building combined brief training with longer term mentorship, dialogue and/or the establishment of networks of support. However, rigorous research and evaluation methods were largely absent, with studies being of low quality, limiting the potential to separate mental health system strengthening outcomes from the effects of associated contextual factors. Conclusions This review demonstrates the need for partnership approaches to building the capacity of mental health policy-makers and planners in LMICs, assessed rigorously against pre-specified conceptual frameworks and hypotheses, utilising longitudinal evaluation and mixed

  1. Public health systems strengthening in Africa: the role of South Africa Field Epidemiology and Laboratory Training Programme.

    Science.gov (United States)

    Kuonza, Lazarus; Tint, Khin San; Harris, Bernice; Nabukenya, Immaculate

    2011-01-01

    The South Africa Field Epidemiology and Laboratory Training Programme (SAFELTP) was created in 2006 after recognizing the need to build and sustain the country's human resource capacity in field (applied) epidemiology and public health practice. The programme was formed as a collaboration between the South Africa Department of Health (DoH), the National Institute for Communicable Diseases (NICD), the National Health Laboratory Services (NHLS), the US Centers for Disease Control and Prevention (CDC) and the University of Pretoria. The primary goal of the programme was to produce field-trained epidemiologists equipped with knowledge and practical skills to effectively and efficiently address the public health priorities of South Africa. SAFELTP is a 2-year full-time training, consisting of a combination of classroom-based instruction (30%) and mentored field work (70%). The training places emphasis on public health surveillance, investigation of disease epidemics, public health laboratory practice and communication of epidemiologic information, among other aspects of epidemiology research. At completion, residents are awarded a Master of Public Health (MPH) degree from the University of Pretoria. Since its inception in 2006, 48 residents have enrolled onto the programme and 30 (62%) of them have completed the training. Over the past 5 years, the residents have conducted more than 92 outbreak investigations, 47 surveillance evaluations, 19 planned studies, analyzed 37 large databases and presented more than 56 papers at local and international conferences. In recognition of the high-quality work, at least five SAFELTP residents have received awards at various international scientific conferences during the 5 years. In conclusion, the South Africa FELTP is now fully established and making valuable contributions to the country's public health system, albeit with innumerable challenges.

  2. NATIONAL PAYMENT SYSTEM ORGANIZATION AND DEVELOPMENT FUNDAMENTALS

    Directory of Open Access Journals (Sweden)

    E. V. Zaytseva

    2012-01-01

    Full Text Available Rapid development of national payment systems (NPS is determined with such main factors as globalization of economic relations, application of newest information technologies, structural changes in the banking sphere and growth of the role of central banks. NPS should be considered as integral functional and institutional component of the country’s monetary system. Among main criteria that determine NPS development possibility there are its integrity, stability and flexibility. NPS may be regarded at as structure composed of the basic, organizational and regulating blocks.

  3. Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system.

    Science.gov (United States)

    Maher, Dermot

    2010-07-05

    The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis control programme activities within a strengthened health system. HIV and tuberculosis share many similarities in terms of their disease burden and the recommended stratagems for their control. HIV and tuberculosis programmes implement similar sorts of control activities, e.g. case finding and treatment, which depend for success on generic health system issues, including vital registration, drug procurement and supply, laboratory network, human resources, and financing. However, the current health system approach to HIV and tuberculosis control often involves separate specialised services. Despite some recent progress, collaboration between the programmes remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve universal access to key interventions. A fundamental re-think of the current strategic approach involves promoting integrated delivery of HIV and tuberculosis programme activities as part of strengthened general health services: epidemiological surveillance, programme monitoring and evaluation, community awareness of health-seeking behavior, risk behaviour modification, infection control, treatment scale-up (first-line treatment regimens), drug-resistance surveillance, containing and countering drug-resistance (second-line treatment regimens), research and development, global advocacy and global partnership. Health agencies should review policies and progress in HIV and tuberculosis epidemic control, learn mutual lessons for policy development and scaling up interventions, and identify ways

  4. Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system

    Directory of Open Access Journals (Sweden)

    Maher Dermot

    2010-07-01

    Full Text Available Abstract Background The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis control programme activities within a strengthened health system. Discussion HIV and tuberculosis share many similarities in terms of their disease burden and the recommended stratagems for their control. HIV and tuberculosis programmes implement similar sorts of control activities, e.g. case finding and treatment, which depend for success on generic health system issues, including vital registration, drug procurement and supply, laboratory network, human resources, and financing. However, the current health system approach to HIV and tuberculosis control often involves separate specialised services. Despite some recent progress, collaboration between the programmes remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve universal access to key interventions. A fundamental re-think of the current strategic approach involves promoting integrated delivery of HIV and tuberculosis programme activities as part of strengthened general health services: epidemiological surveillance, programme monitoring and evaluation, community awareness of health-seeking behavior, risk behaviour modification, infection control, treatment scale-up (first-line treatment regimens, drug-resistance surveillance, containing and countering drug-resistance (second-line treatment regimens, research and development, global advocacy and global partnership. Health agencies should review policies and progress in HIV and tuberculosis epidemic control, learn mutual lessons for policy

  5. National Ignition Facility environmental protection systems

    International Nuclear Information System (INIS)

    Mintz, J.M.; Reitz, T.C.; Tobin, M.T.

    1994-06-01

    The conceptual design of Environmental Protection Systems (EPS) for the National Ignition Facility (NIF) is described. These systems encompass tritium and activated debris handling, chamber, debris shield and general decontamination, neutron and gamma monitoring, and radioactive, hazardous and mixed waste handling. Key performance specifications met by EPS designs include limiting the tritium inventory to 300 Ci and total tritium release from NIF facilities to less than 10 Ci/yr. Total radiation doses attributable to NIF shall remain below 10 mrem/yr for any member of the general public and 500 mrem/yr for NIF staff. ALARA-based design features and operational procedures will, in most cases, result in much lower measured exposures. Waste minimization, improved cycle time and reduced exposures all result from the proposed CO2 robotic arm cleaning and decontamination system, while effective tritium control is achieved through a modern system design based on double containment and the proven detritiation technology

  6. Monolithic Approach to Oxide Dispersion Strengthened Aluminum, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Nassau Stern Company is investigating an approach for manufacturing oxide dispersion strengthened (ODS) aluminum in bulk rather than powder form. The approach...

  7. Quasi-experimental study designs series-paper 12: strengthening global capacity for evidence synthesis of quasi-experimental health systems research.

    Science.gov (United States)

    Rockers, Peter C; Tugwell, Peter; Grimshaw, Jeremy; Oliver, Sandy; Atun, Rifat; Røttingen, John-Arne; Fretheim, Atle; Ranson, M Kent; Daniels, Karen; Luiza, Vera Lucia; Bärnighausen, Till

    2017-09-01

    Evidence from quasi-experimental studies is often excluded from systematic reviews of health systems research despite the fact that such studies can provide strong causal evidence when well conducted. This article discusses global coordination of efforts to institutionalize the inclusion of causal evidence from quasi-experiments in systematic reviews of health systems research. In particular, we are concerned with identifying opportunities for strengthening capacity at the global and local level for implementing protocols necessary to ensure that reviews that include quasi-experiments are consistently of the highest quality. We first describe the current state of the global infrastructure that facilitates the production of systematic reviews of health systems research. We identify five important types of actors operating within this infrastructure: review authors; synthesis collaborations that facilitate the review process; synthesis interest groups that supplement the work of the larger collaborations; review funders; and end users, including policymakers. Then, we examine opportunities for intervening to build the capacity of each type of actors to support the inclusion of quasi-experiments in reviews. Finally, we suggest practical next steps for proceeding with capacity building efforts. Because of the complexity and relative nascence of the field, we recommend a carefully planned and executed approach to strengthening global capacity for the inclusion of quasi-experimental studies in systematic reviews. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Strengthening medical training programmes by focusing on professional transitions: a national bridging programme to prepare medical school graduates for their role as medical interns in Botswana.

    Science.gov (United States)

    Peluso, Michael J; Luckett, Rebecca; Mantzor, Savara; Bedada, Alemayhu G; Saleeb, Paul; Haverkamp, Miriam; Mosepele, Mosepele; Haverkamp, Cecil; Maoto, Rosa; Prozesky, Detlef; Tapela, Neo; Nkomazana, Oathokwa; Barak, Tomer

    2017-12-21

    The improvement of existing medical training programmes in resource-constrained settings is seen as key to addressing the challenge of retaining medical graduates trained at considerable cost both in-country and abroad. In Botswana, the establishment of the national Medical Internship Training Programme (MIT) in 2014 was a first step in efforts to promote retention through the expansion and standardization of internship training, but MIT faces a major challenge related to variability between incoming trainees due to factors such as their completion of undergraduate medical training in different settings. To address this challenge, in August 2016 we piloted a bridging programme for foreign and locally trained medical graduates that aimed to facilitate their transition into internship training. This study aimed to describe the programme and evaluate its impact on the participants' self-rated perceptions of their knowledge, experience, clinical skills, and familiarity with Botswana's healthcare system. We conducted a national, intensive, two-week programme designed to facilitate the transition from medical student to intern and to prepare all incoming interns for their work in Botswana's health system. Participants included all interns entering in August 2016. Formats included lectures, workshops, simulations, discussions, and reflection-oriented activities. The Kellogg Foundation Outcomes Logic Model was used to evaluate the programme, and participants self-rated their knowledge, skills, and attitudes across each of the programme objectives on paired questionnaires before and after participation. 48/54 participants (89%) provided paired data. Participants reported a high degree of satisfaction with the programme (mean 4.2/5). Self-rated preparedness improved after participation (mean 3.2 versus 3.7, p < 0.001), as did confidence across 18/19 knowledge/skill domains, suggesting that participants felt that the programme prepared them for their internship training

  9. 76 FR 77131 - Special Regulations; Areas of the National Park System, Yellowstone National Park

    Science.gov (United States)

    2011-12-12

    ... DEPARTMENT OF THE INTERIOR National Park Service 36 CFR Part 7 RIN 1024-AD92 Special Regulations; Areas of the National Park System, Yellowstone National Park AGENCY: National Park Service, Interior... National Park for the 2011-2012 winter season. The rule retains, for one additional year, the regulations...

  10. A study on the national safeguards system -Current status and suggested development-

    International Nuclear Information System (INIS)

    Park, Wan Su; Kwack, Eun Ho; An, Jong Sung; Kim, Hyun Tae; Min, Kyung Sik; Park, Chan Sik

    1995-03-01

    In Korea, 17 nuclear facilities are currently under IAEA's safeguards and it is expected that more than 25 nuclear facilities will be under IAEA's safeguards in the year 2000 according to nuclear R and D and industry expansion. In connection with unlimited extension of NPT in 1995 and IAEA's measures to strengthen the safeguards like 'Programme 93+2', the international non-proliferation regime will be strengthened more and nuclear advanced countries will require the transparency and credibility of nuclear activities in recipient countries instead of transferring advanced nuclear technologies and nuclear material. In 1995, the Korean government had revised the Atomic Energy Law to control increasing nuclear facilities and nuclear material effectively and to establish international transparency and credibility. In the revised Atomic Energy Law, it is provided that the national inspection, other than IAEA inspection, will be started from 1996. Currently, necessary arrangements for national inspection are being prepared by MOST and TCNC at KAERI. However, the safeguards system in Korea is still beginning stage, Korea's safeguards activity was passive and fragmentary that leads non-attainment of safeguards goal in many facilities. The reasons were; absence of systematic safeguards system (SSAC); lack of understanding safeguards concepts; lack of manpower, designated organization for safeguards, etc. As Korea ranked world top 10 nuclear power generation country and has a plan to be a nuclear advanced country, Korea should have appropriate safeguards system and should not spare necessary assistance to that system. 14 tabs., 15 figs., 29 refs. (Author)

  11. Establishment of national safeguards system and assistance to IAEA safeguards inspection

    International Nuclear Information System (INIS)

    Park, Wan Sou; Kwack, Eun Ho; Park, Chan Sik; Lee, Jae Sung; Jeong, Mi Young.

    1995-12-01

    In Korea, 17 nuclear facilities are currently under IAEA's safeguards and it is expected that more than 25 nuclear facilities will be under IAEA's safeguards in the year 2000 according to nuclear R and D and industry expansion. In connection with unlimited extension of NPT in 1995 and IAEA's measures to strengthen the safeguards like 'Programme 93+2', the international non-proliferation regime will be strengthened more and nuclear advanced countries will require the transparency and credibility of nuclear activities in recipient countries instead of transferring advanced nuclear technologies and nuclear material. In 1995, the Korean Government had revised the Atomic Energy Law to control increasing nuclear facilities and nuclear material effectively and to establish international transparency and credibility. In the revised Atomic Energy Law, it is provided that the national inspection, other than IAEA inspection, will be started from 1996. Currently, necessary arrangements for national inspection are being prepared by MOST and TCNC at KAERI. However, the safeguards system in Korea is still beginning stage, Korea's safeguards activity was passive and fragmentary that leads non-attainment of safeguards goal in many facilities. The reasons were; absence of systematic safeguards system(SSAC); lack of understanding safeguards concepts; lack of manpower, designated organization for safeguards, etc. As Korea ranked world top 10 nuclear power generation country and has a plan to be a nuclear advanced country, Korea should have appropriate safeguards system and should not spare necessary assistance to that system. (author). 19 tabs., 2 figs

  12. Health metrics and evaluation: strengthening the science.

    Science.gov (United States)

    Murray, Christopher J L; Frenk, Julio

    2008-04-05

    With the growing importance of health in the global agenda comes the responsibility to develop a scientific foundation of metrics and evaluation. The scope of this emerging field can be viewed in terms of key topics, including health outcomes, other social outcomes related to health systems, health services, resource inputs, evaluations of programmes and systems, and analyses to support policy choice. It can also be defined in terms of key activities that are needed to strengthen the scientific basis of the field: development of new methods, instruments, software, and hardware; setting global norms and standards for data collection; increasing the availability of high-quality primary data; systematic analysis and synthesis of existing datasets; strengthening national capacity to obtain, analyse, and use data; and reporting and disseminating results. We explore in depth topics with major scientific challenges and institutional and cultural barriers that are slowing the development of the field. Cutting across the various topical areas and disciplinary approaches to these problems are some common scientific issues, including limited comparability of measurement, uncorrected known biases in data, no standard approach to missing data, unrealistic uncertainty estimates, and the use of disease models that have not been properly validated. Only through concerted action will it be possible to assure the production, reproduction, and use of knowledge that is crucial to the advancement of global health.

  13. Measuring health system strengthening: application of the balanced scorecard approach to rank the baseline performance of three rural districts in Zambia.

    Science.gov (United States)

    Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

    2013-01-01

    There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff -0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03). The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery performing poorly in all study districts. This tool could

  14. Measuring health system strengthening: application of the balanced scorecard approach to rank the baseline performance of three rural districts in Zambia.

    Directory of Open Access Journals (Sweden)

    Wilbroad Mutale

    Full Text Available INTRODUCTION: There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. METHODOLOGY: The Better Health Outcome through Mentoring and Assessment (BHOMA project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. RESULTS: Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58% and highest in Luangwa district (77%. Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively. Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff -0.40, p = 0.02. Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04 and service readiness (coeff 0.54, p = 0.03. CONCLUSION: The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service

  15. Selecting RMF Controls for National Security Systems

    Energy Technology Data Exchange (ETDEWEB)

    Witzke, Edward L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-08-01

    In 2014, the United States Department of Defense started tra nsitioning the way it performs risk management and accreditation of informatio n systems to a process entitled Risk Management Framework for DoD Information Technology or RMF for DoD IT. There are many more security and privacy contro ls (and control enhancements) from which to select in RMF, than there w ere in the previous Information Assurance process. This report is an attempt t o clarify the way security controls and enhancements are selected. After a brief overview and comparison of RMF for DoD I T with the previously used process, this report looks at the determination of systems as National Security Systems (NSS). Once deemed to be an NSS, this report addr esses the categorization of the information system with respect to impact level s of the various security objectives and the selection of an initial baseline o f controls. Next, the report describes tailoring the controls through the use of overl ays and scoping considerations. Finally, the report discusses organizatio n-defined values for tuning the security controls to the needs of the information system.

  16. Quality system in Malaysian National Tissue Bank

    International Nuclear Information System (INIS)

    Go Boon Thong; Firdaus, M. N.; Abd Rani Shamsudin

    1999-01-01

    Quality System in Malaysian National Tissue Bank is based on the Quality Manual which has been drawn up by the chairman, who is the Dean, School of Medical Sciences. The Quality Manual include general standard for Tissue Banking in University Science of Malaysia which describe and explain a set of general standard similar to the EATB standard. The primary aim of the quality system is to produce a safe and effective tissue graft for successful clinical use and to ensure the safety of tissue bank operators. The Quality Manual also related the role of a Technical Manual, which explain the standard of technical aspect of tissue bank in a Quality Assurance. The safe working environment and Good Laboratory Practice is highlight in Quality System. Documentation of tissue bank activities is the key to the administration to tissue bank. Finally Quality System in tissue banking will never be complete without a Tissue Bank Auditing System which allow the tissue bank coordinator and staff to look into the problem and further enhance the progress of the tissue bank

  17. Perspectives on Strengthening Cancer Research and Control in Latin America Through Partnerships and Diplomacy: Experience of the National Cancer Institute’s Center for Global Health

    Directory of Open Access Journals (Sweden)

    Silvina Frech

    2018-02-01

    Full Text Available According to the Pan American Health Organization, noncommunicable diseases, including cancer, are the leading causes of preventable and premature death in the Americas. Governments and health care systems in Latin America face numerous challenges as a result of increasing morbidity and mortality from cancer. Multiple international organizations have recognized the need for collaborative action on and technical support for cancer research and control in Latin America. The Center for Global Health at the US National Cancer Institute (NCI-CGH is one entity among many that are working in the region and has sought to develop a strategy for working in Latin America that draws on and expands the collaborative potential of engaged, skilled, and diverse partners. NCI-CGH has worked toward developing and implementing initiatives in collaboration with global partners that share the common objectives of building a global cancer research community and translating research results into evidence-informed policy and practice. Both objectives are complementary and synergistic and are additionally supported by an overarching strategic framework that is focused on partnerships and science diplomacy. This work highlights the overall strategy for NCI-CGH engagement in Latin America through partnerships and diplomacy, and highlights selected collaborative efforts that are aimed at improving cancer outcomes in the region.

  18. 75 FR 52969 - National Park System Advisory Board; Meeting

    Science.gov (United States)

    2010-08-30

    ... DEPARTMENT OF THE INTERIOR National Park Service National Park System Advisory Board; Meeting AGENCY: National Park Service, Interior. ACTION: Notice of meeting. SUMMARY: Notice is hereby given in accordance with the Federal Advisory Committee Act, 5 U.S.C. Appendix, that the National Park System Advisory...

  19. Defining the Global Tendencies of Transformation of National Systems of Higher Education

    Directory of Open Access Journals (Sweden)

    Grynevych Luidmyla V.

    2017-12-01

    Full Text Available The article is aimed at generalizing and systematizing the general world tendencies of the development of higher education, as well as their adaptation to the introduction into national practice. Topicality of research and monitoring, of both the processes common to civilization and the processes of functioning of world educational systems with the purpose of coordination of their basic parameters with tendencies of development of higher education system, has been substantiated. As a result of the research it is proved that the development of higher education system is possible only in case of taking into consideration tendencies of development of education system. They are the only determinants of the main trends that will need to be implemented in the near future. Prospects for further research are to determine the evolutionary stages of the development of higher education system in order to define the factors that will influence the strengthening of the institutional autonomy of university.

  20. National innovation system as a focus of state in-novation policy

    Directory of Open Access Journals (Sweden)

    Olexandr Fedirko

    2007-02-01

    Full Text Available The article offers a systematic review of tools and mechanisms utilised by developed countries (United States, Japan, EU to pursue their innovation policies, and classifies methods which support innovation and ways that help to strengthen the innovation capacity. It describes the evolution of research and development (R&D policy in other countries. The article examines arguments in support of a trend in the innovation policy which promotes the development of national innovation systems. It reviews the substance and components of the national innovation system. It also explores the trends of R&D cooperation. The article outlines the variety of domestic tools which regulate innovation in EU countries (framework programs, the European Research Area Initiative.

  1. National Child Abuse and Neglect Data System Glossary

    Science.gov (United States)

    ... Search « Back to Search National Child Abuse and Neglect Data System Glossary Published: March 31, 2000 Types: ... the glossary for the National Child Abuse and Neglect Data System (NCANDS), including terms from both the ...

  2. National Child Abuse and Neglect Data System Glossary

    Science.gov (United States)

    ... navigation Search form Search « Back to Search National Child Abuse and Neglect Data System Glossary Published: March 31, ... This document is the glossary for the National Child Abuse and Neglect Data System (NCANDS), including terms from ...

  3. Strengthening pharmacovigilance in South Africa.

    Science.gov (United States)

    Mehta, U; Dheda, M; Steel, G; Blockman, M; Ntilivamunda, A; Maartens, G; Pillay, Y; Cohen, K

    2014-02-01

    This report outlines findings and recommendations of a national pharmacovigilance workshop held in August 2012 in South Africa (SA). A survey of current pharmacovigilance activities, conducted in preparation for the meeting, identified multiple programmes collecting drug safety data in SA, with limited co-ordination at national level. The meeting resolved that existing pharmacovigilance programmes need to be strengthened and consolidated to ensure that important local safety issues are addressed, data can be pooled and compared and outputs shared more widely. Pharmacovigilance activities should inform treatment guidelines with the goal of improving patient care. A variety of pharmaco-epidemiological approaches should be employed, including nesting drug safety studies within existing sentinel cohorts and the creation of a pregnancy exposure registry. The attendees agreed on key principles that will inform a national pharmacovigilance plan and compiled a list of priority pharmacovigilance issues facing public health programmes in SA.

  4. Strengthening post-graduate educational capacity for health policy and systems research and analysis: the strategy of the Consortium for Health Policy and Systems Analysis in Africa.

    Science.gov (United States)

    Erasmus, Ermin; Lehmann, Uta; Agyepong, Irene Akua; Alwar, John; de Savigny, Don; Kamuzora, Peter; Mirzoev, Tolib; Nxumalo, Nonhlanhla; Tomson, Göran; Uzochukwu, Benjamin; Gilson, Lucy

    2016-04-12

    The last 5-10 years have seen significant international momentum build around the field of health policy and systems research and analysis (HPSR + A). Strengthening post-graduate teaching is seen as central to the further development of this field in low- and middle-income countries. However, thus far, there has been little reflection on and documentation of what is taught in this field, how teaching is carried out, educators' challenges and what future teaching might look like. Contributing to such reflection and documentation, this paper reports on a situation analysis and inventory of HPSR + A post-graduate teaching conducted among the 11 African and European partners of the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA), a capacity development collaboration. A first questionnaire completed by the partners collected information on organisational teaching contexts, while a second collected information on 104 individual courses (more in-depth information was subsequently collected on 17 of the courses). The questionnaires yielded a mix of qualitative and quantitative data, which were analysed through counts, cross-tabulations, and the inductive grouping of material into themes. In addition, this paper draws information from internal reports on CHEPSAA's activities, as well as its external evaluation. The analysis highlighted the fluid boundaries of HPSR + A and the range and variability of the courses addressing the field, the important, though not exclusive, role of schools of public health in teaching relevant material, large variations in the time investments required to complete courses, the diversity of student target audiences, the limited availability of distance and non-classroom learning activities, and the continued importance of old-fashioned teaching styles and activities. This paper argues that in order to improve post-graduate teaching and continue to build the field of HPSR + A, key questions need to be

  5. National Unmanned Aircraft Systems Project Office

    Science.gov (United States)

    Goplen, Susan E.; Sloan, Jeff L.

    2015-01-01

    The U.S. Geological Survey (USGS) National Unmanned Aircraft Systems (UAS) Project Office leads the implementation of UAS technology in the Department of the Interior (DOI). Our mission is to support the transition of UAS into DOI as a new cost-effective tool for collecting remote-sensing data to monitor environmental conditions, respond to natural hazards, recognize the consequences and benefits of land and climate change and conduct wildlife inventories. The USGS is teaming with all DOI agencies and academia as well as local, State, and Tribal governments with guidance from the Federal Aviation Administration and the DOI Office of Aviation Services (OAS) to lead the safe, efficient, costeffective and leading-edge adoption of UAS technology into the scientific research and operational activities of the DOI.

  6. National Launch System comparative economic analysis

    Science.gov (United States)

    Prince, A.

    1992-01-01

    Results are presented from an analysis of economic benefits (or losses), in the form of the life cycle cost savings, resulting from the development of the National Launch System (NLS) family of launch vehicles. The analysis was carried out by comparing various NLS-based architectures with the current Shuttle/Titan IV fleet. The basic methodology behind this NLS analysis was to develop a set of annual payload requirements for the Space Station Freedom and LEO, to design launch vehicle architectures around these requirements, and to perform life-cycle cost analyses on all of the architectures. A SEI requirement was included. Launch failure costs were estimated and combined with the relative reliability assumptions to measure the effects of losses. Based on the analysis, a Shuttle/NLS architecture evolving into a pressurized-logistics-carrier/NLS architecture appears to offer the best long-term cost benefit.

  7. Continuum of Care Services for Maternal and Child Health using mobile technology - a health system strengthening strategy in low and middle income countries.

    Science.gov (United States)

    Balakrishnan, Ramkrishnan; Gopichandran, Vijayaprasad; Chaturvedi, Sharadprakash; Chatterjee, Rahul; Mahapatra, Tanmay; Chaudhuri, Indrajit

    2016-07-07

    Mobile phone technology is utilized for better delivery of health services worldwide. In low-and-middle income countries mobile phones are now ubiquitous. Thus leveraging mHealth applications in health sector is becoming popular rapidly in these countries. To assess the effectiveness of the Continuum of Care Services (CCS) mHealth platform in terms of strengthening the delivery of maternal and child health (MCH) services in a district in Bihar, a resource-poor state in India. The CommCare mHealth platform was customized to CCS as one of the innovations under a project funded by the Bill and Melinda Gates Foundation to improve the maternal and newborn health services in Bihar. The intervention was rolled out in one project district in Bihar, during July 2012. More than 550 frontline workers out of a total of 3000 including Accredited Social Health Activists, Anganwadi Workers, Auxilliary Nurse Midwives and Lady Health Supervisors were trained to use the mHealth platform. The service delivery components namely early registration of pregnant women, three antenatal visits, tetanus toxoid immunization of the mother, iron and folic acid tablet supply, institutional delivery, postnatal home visits and early initiation of breastfeeding were used as indicators for good quality services. The resultant coverage of these services in the implementation area was compared with rest of Bihar and previous year statistics of the same area. The time lag between delivery of a service and its record capture in the maternal and child tracking system (MCTS) database was computed in a random sample of 16,000 beneficiaries. The coverage of services among marginalized and non-marginalized castes was compared to indicate equity of service delivery. Health system strengthening was viewed from the angle of coverage, quality, equity and efficiency of services. The implementation blocks had higher coverage of all the eight indicator services compared to rest of Bihar and the previous year. There

  8. Croatian National System of Nuclear Materials Control

    International Nuclear Information System (INIS)

    Biscan, R.

    1998-01-01

    In the process of economic and technological development of Croatia by using or introducing nuclear power or in the case of international co-operation in the field of peaceful nuclear activities, including international exchange of nuclear material, Croatia should establish and implement National System of Nuclear Materials Control. Croatian National System of accounting for and control of all nuclear material will be subjected to safeguards under requirements of Agreement and Additional Protocol between the Republic of Croatia and the International Atomic Energy Agency (IAEA) for the Application of Safeguards in Connection with the Treaty on the Non-Proliferation of Nuclear Weapons (NPT). The decision by NPT parties at the 1995 NPT Review and Extension Conference to endorse the Fullscope IAEA Safeguards Standard (FSS) as a necessary precondition of nuclear supply means that states are obliged to ensure that the recipient country has a FSS agreement in place before any nuclear transfer can take place (Ref. 1). The FSS standard of nuclear supply is a central element of the Nuclear Suppliers Group (NSG) Guidelines which the NSG adopted in 1992 and should be applied to members and non-members of the NSG. The FSS standard of nuclear supply in general allows for NPT parties or countries which have undertaken the same obligations through other treaty arrangements, to receive favourable treatment in nuclear supply arrangements. However, the Iraqi experience demonstrate that trade in nuclear and dual-use items, if not properly monitored, can contribute to a nuclear weapons program in countries acting contrary to their non-proliferation obligation. Multilateral nuclear export control mechanisms, including the FSS supply standard, provide the basis for co-ordination and standardisation of export control measures. (author)

  9. Cardiovascular fitness strengthening using portable device.

    Science.gov (United States)

    Alqudah, Hamzah; Kai Cao; Tao Zhang; Haddad, Azzam; Su, Steven; Celler, Branko; Nguyen, Hung T

    2016-08-01

    The paper describes a reliable and valid Portable Exercise Monitoring system developed using TI eZ430-Chronos watch, which can control the exercise intensity through audio stimulation in order to increase the Cardiovascular fitness strengthening.

  10. Securing Chinese nuclear power development: further strengthening nuclear security

    International Nuclear Information System (INIS)

    Zhang Hui

    2014-01-01

    Chinese President Xi Jinping addresses China's new concept of nuclear security with four 'equal emphasis' at the third Nuclear Security Summit, and makes four commitments to strengthen nuclear security in the future. To convert President Xi's political commitments into practical, sustainable reality, China should take further steps to install a complete, reliable, and effective security system to ensure that all its nuclear materials and nuclear facilities are effectively protected against the full spectrum of plausible terrorist and criminal threats. This paper suggests the following measures be taken to improve China's existing nuclear security system, including updating and clarifying the requirements for a national level DBT; updating and enforcing existing regulations; further promoting nuclear security culture; balancing the costs of nuclear security, and further strengthening international cooperation on nuclear security. (author)

  11. Analysis of reporting quality for oral presentations of observational studies at 19thNational Surgical Congress: Proposal for a national evaluation system.

    Science.gov (United States)

    Hasbahçeci, Mustafa; Başak, Fatih; Acar, Aylin; Şişik, Abdullah

    2016-01-01

    To compare the quality of oral presentations presented at the 19 th National Surgical Congress with a national evaluation system with respect to the applicability of systems, and consistency between systems and reviewers. Fifty randomly selected observational studies, which were blinded for author and institute information, were evaluated by using the Strengthening the Reporting of Observational Studies (STROBE), Timmer Score, and National Evaluation System by two reviewers. Abstract scores, evaluation periods, and compatibility between reviewers were compared for each evaluation system. Abstract scores by three different evaluation systems were regarded as the main outcome. Wilcoxon matched-pairs signed rank and Friedman tests for comparison of scores and times, kappa analysis for compatibility between reviewers, and Spearman correlation for analysis of reviewers based on pairs of evaluation systems were used. There was no significant difference between abstract scores for each system (p>0.05). A significant difference for evaluation period of reviewers was detected for each system (pEvaluation System was regarded as acceptable (κ=0.394 and κ=0.354, respectively). Assessment of reviewers for pairs of evaluation systems revealed that scores increased in the same direction with each other significantly (pEvaluation System is an appropriate method for evaluation of conference abstracts due to the consistent results between the referees similarly with the current international evaluation systems and ease of applicability with regard to evaluation period.

  12. A National Drought Monitoring System in Spain

    Science.gov (United States)

    Alvarez-Rodriguez, J.; Villaverde, J.; Incio, L.

    2005-12-01

    There is a great concern in Spain about droughts. Authors refer an impact of 4.5 billion USs in lost crops because of the last one occurred during 1991-1995. Such kind of impacts motivated the inclusion of an article in the National Hydrological Law to implement a drought monitor system and plans to react against them. A system to watch water state and drought monitoring is being developed in CEDEX for the Spanish Ministry of Environment. The objective is to manage data of the whole Spanish territory. Variables managed are: rainfall, river flows, stored water in reservoirs and piezometric levels. Main remarkable points are: 1.Water state is evaluated in certain regions which are defined considering water resources, hydraulic network and water consumption 2.Monthly data is the basic time step 3.Water state is evaluated by means of percentiles estimated concerning to time series of monthly data, cumulated values from the onset of the hydrological year, cumulated values of the last 12 months and cumulated values of the last 3 months. Piezometric levels are represented using moving averaged values 4.Regional information are derived by weighting point data percentiles 5.Other drought indexes are used to identify meteorological droughts through the theory of runs and a critical parameter to join minor identified events. Also, annual minima (7day or 30day) flow quantiles are used 6.(In progress) To implement NDVI drought indexes Last hydrological year in Spain was characterised by the shortage of rainfall. A social awareness about the event raised and the system worked to identify deficits as well as the extension and evolution in time of the shortage. The system is still on development, but its state can be shown in the AGU meeting.

  13. Developing National Cancer Registration in Developing Countries- Case Study of the Nigerian National System of Cancer Registries

    Directory of Open Access Journals (Sweden)

    Elima E Jedy-Agba

    2015-07-01

    Full Text Available The epidemiologic transition in sub-Saharan Africa (SSA has given rise to a concomitant increase in the incidence of non-communicable diseases including cancers. Worldwide, cancer registries have been shown to be critical for the determination of cancer burden, conduct of research, and in the planning and implementation of cancer control measures. Cancer registration though vital is often neglected in SSA owing to competing demands for resources for healthcare.We report the implementation of a system for representative nation-wide cancer registration in Nigeria - the Nigerian National System of Cancer Registries (NSCR. The NSCR coordinates the activities of cancer registries in Nigeria, strengthens existing registries, establishes new registries, complies and analyses data, and makes these freely available to researchers and policy makers. We highlight the key challenges encountered in implementing this strategy and how they were overcome. This report serves as a guide for other low and middle income countries (LMIC wishing to expand cancer registration coverage in their countries and highlights the training, mentoring, scientific and logistic support, and advocacy that are crucial to sustaining cancer registration programs in LMIC

  14. Developing a national health research system: participatory approaches to legislative, institutional and networking dimensions in Zambia

    Directory of Open Access Journals (Sweden)

    Chanda-Kapata Pascalina

    2012-06-01

    Full Text Available Abstract For many sub-Saharan African countries, a National Health Research System (NHRS exists more in theory than in reality, with the health system itself receiving the majority of investments. However, this lack of attention to NHRS development can, in fact, frustrate health systems in achieving their desired goals. In this case study, we discuss the ongoing development of Zambia’s NHRS. We reflect on our experience in the ongoing consultative development of Zambia’s NHRS and offer this reflection and process documentation to those engaged in similar initiatives in other settings. We argue that three streams of concurrent activity are critical in developing an NHRS in a resource-constrained setting: developing a legislative framework to determine and define the system’s boundaries and the roles all actors will play within it; creating or strengthening an institution capable of providing coordination, management and guidance to the system; and focusing on networking among institutions and individuals to harmonize, unify and strengthen the overall capacities of the research community.

  15. National Environmental Change Information System Case Study

    Science.gov (United States)

    Goodman, S. J.; Ritschard, R.; Estes, M. G., Jr.; Hatch, U.

    2001-01-01

    The Global Hydrology and Climate Center and NASA's Marshall Space Flight Center conducted a fact-finding case study for the Data Management Working Group (DMWG), now referred to as the Data and Information Working Group (DIWG), of the U.S. Global Change Research Program (USGCRP) to determine the feasibility of an interagency National Environmental Change Information System (NECIS). In order to better understand the data and information needs of policy and decision makers at the national, state, and local level, the DIWG asked the case study team to choose a regional water resources issue in the southeastern United States that had an impact on a diverse group of stakeholders. The southeastern United States was also of interest because the region experiences interannual climatic variations and impacts due to El Nino and La Nina. Jointly, with input from the DIWG, a focus on future water resources planning in the Apalachicola-Chattahoochee-Flint (ACF) River basins of Alabama, Georgia, and Florida was selected. A tristate compact and water allocation formula is currently being negotiated between the states and U.S. Army Corps of Engineers (COE) that will affect the availability of water among competing uses within the ACF River basin. All major reservoirs on the ACF are federally owned and operated by the U.S. Army COE. A similar two-state negotiation is ongoing that addresses the water allocations in the adjacent Alabama-Coosa-Tallapoosa (ACT) River basin, which extends from northwest Georgia to Mobile Bay. The ACF and ACT basins are the subject of a comprehensive river basin study involving many stakeholders. The key objectives of this case study were to identify specific data and information needs of key stakeholders in the ACF region, determine what capabilities are needed to provide the most practical response to these user requests, and to identify any limitations in the use of federal data and information. The NECIS case study followed the terms of reference

  16. The political undertones of building national health research systems – reflections from The Gambia

    Directory of Open Access Journals (Sweden)

    Bloch Paul

    2009-05-01

    Full Text Available Abstract In developing countries building national health research systems is a movement similar to a political leadership contest. Increasingly, political campaigns to select leaders depend less on ideologies and political messages and more on promising change that will promptly improve the quality of life of the voters. In this process the benefits and risks of every action and statement made by the candidates are carefully assessed. Approaches currently promoted to strengthen health research within ministries of health in developing countries place emphasis on implementing logical steps towards building national health research systems including developing a national health research policy and strategic plan, conducting a situational analysis of research in the country, setting a national health research agenda, establishing research ethics and scientific committees, and building human and institutional capacity for health research management and conduct. Although these processes have successfully improved the standards of health research in some settings, many developing countries struggle to get the process going. One reason is that this approach does not deal with basic questions posed within a ministry of health, namely, "What is the political benefit of the ministry assuming control of the process?" and "What are the political implications for the ministry if another institution spearheads the process?" Seen from the perspective of non-governmental organizations, academic institutions and donors trying to support the processes of strengthening national health research systems, one of the foremost activities that needs to be undertaken is to analyze the political context of national health research and, on that basis, plan and implement appropriate political health research advocacy initiatives. This includes the development of explicit messages on the political benefits to the leadership in the ministry of health of their role in the

  17. The political undertones of building national health research systems--reflections from The Gambia.

    Science.gov (United States)

    Palmer, Ayo; Anya, Samuel E; Bloch, Paul

    2009-05-29

    In developing countries building national health research systems is a movement similar to a political leadership contest. Increasingly, political campaigns to select leaders depend less on ideologies and political messages and more on promising change that will promptly improve the quality of life of the voters. In this process the benefits and risks of every action and statement made by the candidates are carefully assessed.Approaches currently promoted to strengthen health research within ministries of health in developing countries place emphasis on implementing logical steps towards building national health research systems including developing a national health research policy and strategic plan, conducting a situational analysis of research in the country, setting a national health research agenda, establishing research ethics and scientific committees, and building human and institutional capacity for health research management and conduct. Although these processes have successfully improved the standards of health research in some settings, many developing countries struggle to get the process going. One reason is that this approach does not deal with basic questions posed within a ministry of health, namely, "What is the political benefit of the ministry assuming control of the process?" and "What are the political implications for the ministry if another institution spearheads the process?"Seen from the perspective of non-governmental organizations, academic institutions and donors trying to support the processes of strengthening national health research systems, one of the foremost activities that needs to be undertaken is to analyze the political context of national health research and, on that basis, plan and implement appropriate political health research advocacy initiatives. This includes the development of explicit messages on the political benefits to the leadership in the ministry of health of their role in the conduct, management and

  18. Immigrant Health Inequalities in the United States: Use of Eight Major National Data Systems

    Science.gov (United States)

    Kogan, Michael D.

    2013-01-01

    Eight major federal data systems, including the National Vital Statistics System (NVSS), National Health Interview Survey (NHIS), National Survey of Children's Health, National Longitudinal Mortality Study, and American Community Survey, were used to examine health differentials between immigrants and the US-born across the life course. Survival and logistic regression, prevalence, and age-adjusted death rates were used to examine differentials. Although these data systems vary considerably in their coverage of health and behavioral characteristics, ethnic-immigrant groups, and time periods, they all serve as important research databases for understanding the health of US immigrants. The NVSS and NHIS, the two most important data systems, include a wide range of health variables and many racial/ethnic and immigrant groups. Immigrants live 3.4 years longer than the US-born, with a life expectancy ranging from 83.0 years for Asian/Pacific Islander immigrants to 69.2 years for US-born blacks. Overall, immigrants have better infant, child, and adult health and lower disability and mortality rates than the US-born, with immigrant health patterns varying across racial/ethnic groups. Immigrant children and adults, however, fare substantially worse than the US-born in health insurance coverage and access to preventive health services. Suggestions and new directions are offered for improvements in health monitoring and for strengthening and developing databases for immigrant health assessment in the USA. PMID:24288488

  19. National innovation system of Russia: state of the art and prospects of development

    Directory of Open Access Journals (Sweden)

    Viktoriya K. Makhortova

    2014-01-01

    Full Text Available Objective to characterize the national innovative system of Russia to identify its main features opportunities threats strengths and weaknesses the causes for the lag in innovation to formulate development priorities as well as the key principles for improving the national innovation system of Russia. Methods in this work were applied scientific methods of cognition generalization of the logical method analysis method of economic analysis method of expert estimations. Results SWOT analysis is compiled for the national innovation system of Russia its characteristic features and peculiarities are determined. The necessity of optimization and improvement of construction principles of the national innovation system of Russia is proved. Recommendations are given. Scientific novelty new recommendations for state innovation management are given and the existing ones are improved. In addition the proposed list of principles is grouped by significance. Practical value the possibility to optimize measures of the state innovation management in Russia to accelerate its exit from unsustainable status in this field and to strengthen the growth of innovative development.

  20. The Economic Benefits of Closing Educational Achievement Gaps: Promoting Growth and Strengthening the Nation by Improving the Educational Outcomes of Children of Color

    Science.gov (United States)

    Lynch, Robert G.; Oakford, Patrick

    2014-01-01

    Our nation is currently experiencing growing levels of income and wealth inequality, which are contributing to longstanding racial and ethnic gaps in education outcomes and other areas. This report quantifies the economic benefits of closing one of the most harmful racial and ethnic gaps: the educational achievement gap that exists between black…

  1. Evaluating National Nuclear Safeguards System Implementation in the Republic of Moldova

    International Nuclear Information System (INIS)

    Mursa, E.; Sidorencu, A.; Vasilieva, N.; Sirbu, I.

    2015-01-01

    Strengthening the multilateral system of Nuclear Safeguards by the International Atomic Energy Agency (IAEA), imposed by the increasing cross-border illicit trafficking of nuclear material and redirecting for military purposes has led Republic of Moldova to ratify on 1 June 2012 the Additional Protocol (INFCIRC/690) to the Agreement of Nuclear Safeguards in relation with the NPT. This was followed by the adoption in the Parliament on 8 June 2012, of the new Law no. 132 of 08.06.2012 on the safe conduct of nuclear and radiological activities, which extends the power of the National Agency for Regulation of Nuclear and Radiological Activities (NARNRA) and details the measures to strengthen the Nuclear Safeguards in the country. The NARNRA implements safeguards measures in relation to nuclear materials by: – normative acts development; – establishing a system for inspecting of nuclear material; – implementing inventory-taking and reporting procedures for quantities of nuclear material; – implementing authorisation and monitoring procedures for the movements of nuclear material; – implementing procedures for reporting quantities of nuclear material to the IAEA; – maintaining and updating the national register of nuclear materials. A very important role to achieve results is the cooperation with the IAEA. Thus, was developed and agreed the Joint Action Plan for implementing the provisions of the Additional Protocol to the Safeguards Agreement, which is an essential aid in fulfilling the country’s international obligations. In this respect have been obtained some good practices: – Routinely performed national inspections; – On-line information provision from the Customs check points; – Developed special form for nuclear material in the National Register; – Systematic interaction with Ministry of Foreign Affairs, Ministry of Internal Affairs and authorisation holders; – Annual and quarterly presentation to the IAEA of the reports on SQP and the

  2. Cable strengthened arches

    NARCIS (Netherlands)

    Kamerling, M.W.

    2013-01-01

    The structural efficiency of arches, subjected to several variable loads, can be increased by strengthening these arches with cables. For these structures it can be necessary, especially in case the permanent load is small, to post-tension the cables to avoid any compression acting on the cables. A

  3. Strengthening of Shear Walls

    DEFF Research Database (Denmark)

    Hansen, Christian Skodborg

    -plane loaded walls and disks is however not included in any guidelines, and only a small fraction of scientists have initiated research within this topic. Furthermore, studies of the principal behavior and response of a strengthened disk has not yet been investigated satisfactorily, and this is the principal...

  4. An action research protocol to strengthen system-wide inter-professional learning and practice [LP0775514

    Directory of Open Access Journals (Sweden)

    Travaglia Joanne

    2007-09-01

    Full Text Available Abstract Background Inter-professional learning (IPL and inter-professional practice (IPP are thought to be critical determinants of effective care, improved quality and safety and enhanced provider morale, yet few empirical studies have demonstrated this. Whole-of-system research is even less prevalent. We aim to provide a four year, multi-method, multi-collaborator action research program of IPL and IPP in defined, bounded health and education systems located in the Australian Capital Territory (ACT. The project is funded by the Australian Research Council under its industry Linkage Program. Methods/Design The program of research will examine in four inter-related, prospective studies, progress with IPL and IPP across tertiary education providers, professional education, regulatory and registration bodies, the ACT health system's streams of care activities and teams, units and wards of the provider facilities of the ACT health system. One key focus will be on push-pull mechanisms, ie, how the education sector creates student-enabled IPP and the health sector demands IPL-oriented practitioners. The studies will examine four research aims and meet 20 research project objectives in a comprehensive evaluation of ongoing progress with IPL and IPP. Discussion IPP and IPL are said to be cornerstones of health system reforms. We will measure progress across an entire health system and the clinical and professional education systems that feed into it. The value of multi-methods, partnership research and a bi-directional push-pull model of IPL and IPP will be tested. Widespread dissemination of results to practitioners, policymakers, managers and researchers will be a key project goal.

  5. Innovation within a national health care system.

    Science.gov (United States)

    Young, Antony

    2017-05-01

    Tony is a practicing frontline National Health Service surgeon and director of medical innovation at Anglia Ruskin University and has founded 4 medical-technology start-ups. He has also cofounded the £500 million Anglia Ruskin MedTech Campus, which will become one of the world's largest health innovation spaces. In 2014, he was appointed as national clinical director for innovation at National Health Service England and in February 2016 became the first national clinical lead for innovation. In this role, he provides clinical leadership and support in delivering improved health outcomes in England, drives the uptake of proven innovations across the National Health Service, promotes economic growth through innovation, and helps make the National Health Service the go-to place on the planet for medical innovation. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Strengthening Health Systems for Chronic Care: Leveraging HIV Programs to Support Diabetes Services in Ethiopia and Swaziland

    Directory of Open Access Journals (Sweden)

    Miriam Rabkin

    2012-01-01

    Full Text Available The scale-up of HIV services in sub-Saharan Africa has catalyzed the development of highly effective chronic care systems. The strategies, systems, and tools developed to support life-long HIV care and treatment are locally owned contextually appropriate resources, many of which could be adapted to support continuity care for noncommunicable chronic diseases (NCD, such as diabetes mellitus (DM. We conducted two proof-of-concept studies to further the understanding of the status of NCD programs and the feasibility and effectiveness of adapting HIV program-related tools and systems for patients with DM. In Swaziland, a rapid assessment illustrated gaps in the approaches used to support DM services at 15 health facilities, despite the existence of chronic care systems at HIV clinics in the same hospitals, health centers, and clinics. In Ethiopia, a pilot study found similar gaps in DM services at baseline and illustrated the potential to rapidly improve the quality of care and treatment for DM by adapting HIV-specific policies, systems, and tools.

  7. National Weather Service (NWS) Station Information System (SIS), Version 2

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — National Weather Service (NWS) Station Information System (SIS) contains observing station metadata from November 2016 to present. These are renditions are used for...

  8. Drinking Water State Revolving Fund National Information Management System Reports

    Science.gov (United States)

    The Drinking Water State Revolving Fund (DWSRF) National Information Management System collects information that provide a record of progress and accountability for the program at both the State and National level.

  9. National inquiry system of radiological events: a viable proposal

    International Nuclear Information System (INIS)

    Xavier, Ana Maria; Cavalcante, Vera Lucia.

    1996-01-01

    The SINAER- National Inquiry System of Radiological Events is a supportive structure devised to deal with the request of help or complaints that involve sources of ionizing radiations in the national territory

  10. CPSC’s National Electronic Injury Surveillance System (NEISS)

    Data.gov (United States)

    US Consumer Product Safety Commission — CPSC’s National Electronic Injury Surveillance System (NEISS) is a national probability sample of hospitals in the U.S. and its territories. Patient information is...

  11. Developing the information management system for safeguards national inspection

    Energy Technology Data Exchange (ETDEWEB)

    Park, S. J.; Jeon, I.; Park, W. S.; Min, K. S. [KAERI, Taejon (Korea, Republic of)

    2003-10-01

    The inspection information management system for safeguards national inspection is aimed to do the national safeguards inspection with efficiency, and to decrease the inspector's load to write inspection report by systematizing the inspection jobs and sharing the inspection data. National safeguards inspection is consisted two large jobs. The first is the national safeguards supporting job of managing to support the national inspection mission. The other is the writing a national inspection report after completing the national inspection. Before the developing of inspection information management system, the official tools(spread sheet, word processor) are usually used. But there is problem to share the data, to produce the statistics data. To solve the these problem, we developed the inspection information management system that process the job from initial to final inspection work, and opened user education. This paper explain the procedure of developing the inspection information management system for safeguards national inspection.

  12. Developing the information management system for safeguards national inspection

    International Nuclear Information System (INIS)

    Park, S. J.; Jeon, I.; Park, W. S.; Min, K. S.

    2003-01-01

    The inspection information management system for safeguards national inspection is aimed to do the national safeguards inspection with efficiency, and to decrease the inspector's load to write inspection report by systematizing the inspection jobs and sharing the inspection data. National safeguards inspection is consisted two large jobs. The first is the national safeguards supporting job of managing to support the national inspection mission. The other is the writing a national inspection report after completing the national inspection. Before the developing of inspection information management system, the official tools(spread sheet, word processor) are usually used. But there is problem to share the data, to produce the statistics data. To solve the these problem, we developed the inspection information management system that process the job from initial to final inspection work, and opened user education. This paper explain the procedure of developing the inspection information management system for safeguards national inspection

  13. CNSS: Interagency Partnering to Protect Our National Security Systems

    National Research Council Canada - National Science Library

    Grimes, John G

    2008-01-01

    .... The CNSS performs the vital function of mobilizing the full, interagency National Security Community for the protection of telecommunications and information systems that support U.S. national security...

  14. Idaho National Laboratory Integrated Safety Management System FY 2012 Effectiveness Review and Declaration Report

    Energy Technology Data Exchange (ETDEWEB)

    Farren Hunt

    2012-12-01

    Idaho National Laboratory (INL) performed an Annual Effectiveness Review of the Integrated Safety Management System (ISMS), per 48 Code of Federal Regulations (CFR) 970.5223 1, “Integration of Environment, Safety and Health into Work Planning and Execution.” The annual review assessed Integrated Safety Management (ISM) effectiveness, provided feedback to maintain system integrity, and identified target areas for focused improvements and assessments for fiscal year (FY) 2013. Results of the FY 2012 annual effectiveness review demonstrated that the INL’s ISMS program was significantly strengthened. Actions implemented by the INL demonstrate that the overall Integrated Safety Management System is sound and ensures safe and successful performance of work while protecting workers, the public, and environment. This report also provides several opportunities for improvement that will help further strengthen the ISM Program and the pursuit of safety excellence. Demonstrated leadership and commitment, continued surveillance, and dedicated resources have been instrumental in maturing a sound ISMS program. Based upon interviews with personnel, reviews of assurance activities, and analysis of ISMS process implementation, this effectiveness review concludes that ISM is institutionalized and is “Effective”.

  15. How to strengthen patientcentredness in caring for people with multimorbidity in Europe? Policy Brief 22 Health systems and policy analysis.

    NARCIS (Netherlands)

    Heide, I. van der; Snoeijs, S.P.; Boerma, W.G.W.; Schellevis, F.; Rijken, P.M.

    2017-01-01

    Making care focus on patients is a way of overcoming the fragmentation that results from the “disease orientation” of Europe’s health systems, which still tend to organize around single medical specialities. Patient-centredness increases patient satisfaction and counters the problems associated with

  16. Development of the National Health Information Systems in Botswana: Pitfalls, prospects and lessons.

    Science.gov (United States)

    Seitio-Kgokgwe, Onalenna; Gauld, Robin D C; Hill, Philip C; Barnett, Pauline

    2015-01-01

    Studies evaluating development of health information systems in developing countries are limited. Most of the available studies are based on pilot projects or cross-sectional studies. We took a longitudinal approach to analysing the development of Botswana's health information systems. We aimed to: (i) trace the development of the national health information systems in Botswana (ii) identify pitfalls during development and prospects that could be maximized to strengthen the system; and (iii) draw lessons for Botswana and other countries working on establishing or improving their health information systems. This article is based on data collected through document analysis and key informant interviews with policy makers, senior managers and staff of the Ministry of Health and senior officers from various stakeholder organizations. Lack of central coordination, weak leadership, weak policy and regulatory frameworks, and inadequate resources limited development of the national health information systems in Botswana. Lack of attention to issues of organizational structure is one of the major pitfalls. The ongoing reorganization of the Ministry of Health provides opportunity to reposition the health information system function. The current efforts including development of the health information management policy and plan could enhance the health information management system.

  17. The effects of implicit gender role theories on gender system justification: Fixed beliefs strengthen masculinity to preserve the status quo.

    Science.gov (United States)

    Kray, Laura J; Howland, Laura; Russell, Alexandra G; Jackman, Lauren M

    2017-01-01

    Four studies (n = 1199) tested support for the idea that implicit theories about the fixedness versus malleability of gender roles (entity vs. incremental theories) predict differences in the degree of gender system justification, that is, support for the status quo in relations between women and men in society. Relative to an incremental theory, the holding of an entity theory correlated with more system-justifying attitudes and self-perceptions (Study 1) for men and women alike. We also found that strength of identification with one's gender in-group was a stronger predictor of system justification for men than it was for women, suggesting men's defense of the status quo may be motivated by their membership in a high status group in the social hierarchy. In 3 experiments, we then tested whether exposure to a fixed gender role theory would lead men to identify more with masculine characteristics and their male gender group, thus increasing their defense of the gender system as fair and just. We did not expect a fixed gender role theory to trigger these identity-motivated responses in women. Overall, we found that, by increasing the degree of psychological investment in their masculine identity, adopting a fixed gender role theory increased men's rationalization of the gender status quo compared with when gender roles were perceived to be changeable. This suggests that, when men are motivated to align with their masculine identity, they are more likely to endorse the persistence of gender inequality as a way of affirming their status as "real men." (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  18. Study of national registration systems for health records of radiation workers. National radiation dose registration system

    International Nuclear Information System (INIS)

    Nakagawa, Haruo; Kanda, Keiji

    1999-01-01

    A national radiation dose registration system is proposed in this paper. In Japan, only one radiation dose registration system is partly effective. It is applied for workers in nuclear power plants which are under control of regulatory laws for nuclear reactors. The total system was proposed previously by the Committee for Compensation Claims of Nuclear Accidents. The reason for the delay in establishing a registration system for all radiation workers is supposedly a lack of effort to adjust differences among items in radiation protection laws and the promotion of public acceptance to atomic power. Items about dose recordings, record keeping and dose-record reporting in all of the radiation regulatory laws are compared to each other, and items were extracted for revision. (author)

  19. Strengthening national coal transitions to raise climate ambition. Issue Brief. Part of the 'Coal Transitions: Research and Dialogue on the Future of Coal' Project

    International Nuclear Information System (INIS)

    Sartor, Oliver

    2017-11-01

    The issue of coal transitions is coming into focus in both national and international climate policy discussions. There are several drivers of this. At one level, the Paris Agreement marked a significant shift in the pace, scope and ambition of global climate change mitigation action. Consequently, it is now clear that coal will need to play a more and more diminished role in the global energy mix in the coming decades, despite carbon capture and storage (CCS) technologies. It is also increasingly clear that non-climate policy-related factors, such as rapid declines in the cost of renewable energy and battery storage, will continue to challenge the previously strong role of steam coal in the global energy mix (Randall, 2015). The business-as-usual scenario is therefore evolving quickly and the downside risks to coal demand appear to be increasing. The accumulation of these factors has in turn led to a call for an assurance of 'just transition', especially from stakeholders-notably coal sector workers and their communities-whose economic livelihoods depend on the future of an industry that will be in decline. In this context, parties to the UNFCCC will be called upon via the Facilitative Dialogue of 2018 to re-evaluate the adequacy progress and subsequently to revise their levels of ambition in their nationally determined contributions (NDCs). This moment presents an important opportunity for governments to raise the overall ambition of their policies on coal transition. But how should they do this? (author)

  20. 77 FR 62476 - Special Regulations; Areas of the National Park System, Sleeping Bear Dunes National Lakeshore...

    Science.gov (United States)

    2012-10-15

    ...-AE11 Special Regulations; Areas of the National Park System, Sleeping Bear Dunes National Lakeshore... proposes to designate the Sleeping Bear Heritage Trail currently under construction within Sleeping Bear... submitting comments. Mail or Hand Deliver to: Superintendent's Office, Sleeping Bear Dunes National Lakeshore...

  1. National Soil Information System in Turkey

    Science.gov (United States)

    Emrah Erdogan, Hakki; Sahin, Mehmet; Sahin, Yuksel

    2013-04-01

    Land consolidation (LC) represents complexity if management, legal, economic and technical procedures realized in order to adjust the land structure according to actual human preferences and needs. It includes changes in ownership rights to land and other real estate property, exchange of parcels among owners, changes in parcel borders, parcel size and shape, joining and dividing of parcels, changes in land use, construction works as roads, bridges, water changes etc.. Since the subject of LC is agricultural lands, the quality of consolidation depends on the quality of soil data. General Directorate of Agrarian Reform (GDAR) is the responsible institution on land consolidation whole of Turkey. Under GDAR, National Soil Information System (NSIS) has been build up with base soil data in relevant scale (1:5000). NSIS contain detailed information on soil chemical and physical properties, current land use, parent material, land capability class, Storie Index Values. SI were used on land consolidation, land use planning and farm development services. LCC was used for land distribution, rental land; define of village settlement, consolidation, expropriation, reconstruction, reclamation, non-agricultural usage. LCC were also specified to subclasses in four different limited factors as i) flow and erosion risk ii) requirement of drainage and soil moisture iii) Limits of soil tillage and root (shallow soils, low water retention capacity, stony, salty .etc) iv) climatic limits. In this study, digital soil survey and mapping project located in Yumurtalik, Adana is presented as an example of NSIS data structure. The project cover an area of 45709 ha that include crop lands as an area of 28528 ha and other land use (urban, roads..etc) as an area of 17181 ha. Soil profiles were described in 45 different points and totally 1279 soil samples were collected in field study and the check bore hole were made in 3170 points.

  2. Strengthening Economic Skills and Climate Change Adaptive ...

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

    Researchers will deepen their investigation of adaptation options already identified, integrate adaptation into development plans at various levels (local, regional and national), strengthen the capacity of community early warning committees to manage climate-related risks and disasters, and assure the coordination, ...

  3. British Library Systems Development: The National and International Environment.

    Science.gov (United States)

    Coward, Richard E.

    The systems approach is being applied to the re-organization of the United Kingdom Library system. The core functions to the national library organization are: (1) reference; (2) lending; (3) bibliographic services; and (4) general planning associated with the development of a national library and information system. Despite the immense potential…

  4. Cost-effectiveness of health systems strengthening interventions in improving maternal and child health in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Zeng, Wu; Li, Guohong; Ahn, Haksoon; Nguyen, Ha Thi Hong; Shepard, Donald S; Nair, Dinesh

    2018-03-01

    Health systems strengthening (HSS) interventions are increasingly being implemented to improve maternal and child health (MCH) services in low- and middle-income countries (LMICs). This study reviews global literature on cost-effectiveness of HSS interventions in improving MCH. A systematic review was conducted. Keywords, based on World Health Organization framework on health systems and prior studies, were applied to search in bibliographic databases and on the web. Articles that estimated cost-effectiveness of HSS interventions in LMICs were included in the analysis. Each of the 24 selected studies from 15 countries was assessed in terms of quality and biases using Cochrane's criteria. Review Manager and an Excel template were used to extract data and synthesize findings. HSS interventions concentrated on the components of service delivery, health financing, human resources and quality improvement. Within each component, there existed diverse strategies to strengthen health systems. Among the 24 studies, 15 were rated as high quality, 5 as medium and 4 as low quality. A majority of studies reported cost per disability-adjusted life year (DALY) averted or cost per quality-adjusted life year (QALY) gained; other studies reported cost per life saved or life year gained. However, studies used mixed perspectives of analyses. Compared with gross domestic product per capita, interventions in studies reporting cost per DALY averted or QALY gained were all cost-effective, including performance-based financing, health insurance and quality improvement. This review shows the diversity of HSS interventions in improving MCH, and their potential cost-effectiveness. However, the different perspectives employed in the studies, costing components included in the analyses, and heterogeneous measures of effectiveness and outputs, made it challenging to compare cost-effectiveness across all studies, calling for more and standardized cost-effectiveness studies. For policy making, it

  5. Foot muscles strengthener

    Directory of Open Access Journals (Sweden)

    Boris T. Glavač

    2012-04-01

    Full Text Available Previous experience in the correction of flat feet consisted of the use of insoles for shoes and exercises with toys, balls, rollers, inclined planes, etc. A device for strengthening foot muscles is designed for the correction of flat feet in children and, as its name suggests, for strengthening foot muscles in adults. The device is made of wood and metal, with a mechanism and technical solutions, enabling the implementation of specific exercises to activate muscles responsible for the formation of the foot arch. It is suitable for home use with controlled load quantities since it has calibrated springs. The device is patented with the Intellectual Property Office, Republic of Serbia, as a petty patent.

  6. Pioglitazone improves cognitive function via increasing insulin sensitivity and strengthening antioxidant defense system in fructose-drinking insulin resistance rats.

    Directory of Open Access Journals (Sweden)

    Qing-Qing Yin

    Full Text Available Insulin resistance (IR links Alzheimer's disease (AD with oxidative damage, cholinergic deficit, and cognitive impairment. Peroxisome proliferator-activated receptor γ (PPARγ agonist pioglitazone previously used to treat type 2 diabetes mellitus (T2DM has also been demonstrated to be effective in anti-inflammatory reaction and anti-oxidative stress in the animal models of AD and other neuroinflammatory diseases. Here, we investigated the effect of pioglitazone on learning and memory impairment and the molecular events that may cause it in fructose-drinking insulin resistance rats. We found that long-term fructose-drinking causes insulin resistance, oxidative stress, down-regulated activity of cholinergic system, and cognitive deficit, which could be ameliorated by pioglitazone administration. The results from the present study provide experimental evidence for using pioglitazone in the treatment of brain damage caused by insulin resistance.

  7. Mentorship and coaching to support strengthening healthcare systems: lessons learned across the five Population Health Implementation and Training partnership projects in sub-Saharan Africa.

    Science.gov (United States)

    Manzi, Anatole; Hirschhorn, Lisa R; Sherr, Kenneth; Chirwa, Cindy; Baynes, Colin; Awoonor-Williams, John Koku

    2017-12-21

    Despite global efforts to increase health workforce capacity through training and guidelines, challenges remain in bridging the gap between knowledge and quality clinical practice and addressing health system deficiencies preventing health workers from providing high quality care. In many developing countries, supervision activities focus on data collection, auditing and report completion rather than catalyzing learning and supporting system quality improvement. To address this gap, mentorship and coaching interventions were implemented in projects in five African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) as components of health systems strengthening (HSS) strategies funded through the Doris Duke Charitable Foundation's African Health Initiative. We report on lessons learned from a cross-country evaluation. The evaluation was designed based on a conceptual model derived from the project-specific interventions. Semi-structured interviews were administered to key informants to capture data in six categories: 1) mentorship and coaching goals, 2) selection and training of mentors and coaches, 3) integration with the existing systems, 4) monitoring and evaluation, 5) reported outcomes, and 6) challenges and successes. A review of project-published articles and technical reports from the individual projects supplemented interview information. Although there was heterogeneity in the approaches to mentorship and coaching and targeted areas of the country projects, all led to improvements in core health system areas, including quality of clinical care, data-driven decision making, leadership and accountability, and staff satisfaction. Adaptation of approaches to reflect local context encouraged their adoption and improved their effectiveness and sustainability. We found that incorporating mentorship and coaching activities into HSS strategies was associated with improvements in quality of care and health systems, and mentorship and coaching represents an

  8. Denali National Park: bus shuttle system analysis

    Science.gov (United States)

    2013-09-01

    This is the first in a series of briefs exploring best practices in the various ways to provide transit service in national parks. While Denali operates in a unique environment, the Visitor Transportation Service experience offers many lessons relate...

  9. A geographical information system for the management of the aquaculture data in the Adriatic Sea – the Strengthening of Centres for Aquaculture Production and Safety surveillance in the Adriatic countries experience: Present capabilities, tools and functions

    Directory of Open Access Journals (Sweden)

    Susanna Tora

    2017-11-01

    Full Text Available The European Commission (EC regulation no. 854/2004 requires a systematic monitoring of chemical and microbiological contaminants in live bivalve molluscs, live echinoderms, live tunicates and live marine gastropods for human consumption through surveillance plans to be implemented in all European Union (EU countries.A consortium of five Adriatic countries was set up in the framework of the Instrument of Pre-accession Assistance Adriatic Cross-border Cooperation Programme (IPA Adriatic CBC 2007- 2013 with the aim of collecting data and distribute information on harvesting and production in mollusc areas. A web-based geographical information system (GIS application was developed to support the partners to manage data and to make these data available to final users, policy makers and to risk assessors. The GIS for the Strengthening of Centres for Aquaculture Production and Safety surveillance in the Adriatic countries (CAPS2 is divided into two levels, the national and the supranational one, and it distributes spatial and epidemiological information coming from various data acquisition and management sites. The great innovation is the possibility for each country to use online drawing, modifying and change of the geographic areas according to national surveillance needs. Currently it hosts data coming from about 230 production and relay areas with more than 29,478 laboratory tests performed on collected samples since August 2014. Data collected are used by each national competent authority to classify production or relay areas according to the EC regulation mentioned and to conduct risk assessment studies to evaluate the level of consumers’ exposure to contaminants in the consumption of bivalve mollusc products.

  10. The Ethiopian Field Epidemiology and Laboratory Training Program: strengthening public health systems and building human resource capacity.

    Science.gov (United States)

    Jima, Daddi; Mitike, Getnet; Hailemariam, Zegeye; Bekele, Alemayehu; Addissie, Adamu; Luce, Richard; Wasswa, Peter; Namusisi, Olivia; Gitta, Sheba Nakacubo; Musenero, Monica; Mukanga, David

    2011-01-01

    The Ethiopian Field Epidemiology and Laboratory Training Program (EFELTP) is a comprehensive two-year competency-based training and service program designed to build sustainable public health expertise and capacity. Established in 2009, the program is a partnership between the Ethiopian Federal Ministry of Health, the Ethiopian Health and Nutrition Research Institute, Addis Ababa University School of Public Health, the Ethiopian Public Health Association and the US Centers of Disease Control and Prevention. Residents of the program spend about 25% of their time undergoing didactic training and the 75% in the field working at program field bases established with the MOH and Regional Health Bureaus investigating disease outbreaks, improving disease surveillance, responding to public health emergencies, using health data to make recommendations and undertaking other field Epidemiology related activities on setting health policy. Residents from the first 2 cohorts of the program have conducted more than 42 outbreaks investigations, 27analyses of surveillance data, evaluations of 11 surveillance systems, had28oral and poster presentation abstracts accepted at 10 scientific conferences and submitted 8 manuscripts of which 2are already published. The EFELTP has provided valuable opportunities to improve epidemiology and laboratory capacity building in Ethiopia. While the program is relatively young, positive and significant impacts are assisting the country better detect and respond to epidemics and address diseases of major public health significance.

  11. Strengthening Health Systems While Responding to a Health Crisis: Lessons Learned by a Nongovernmental Organization During the Ebola Virus Disease Epidemic in Sierra Leone

    Science.gov (United States)

    Cancedda, Corrado; Davis, Sheila M.; Dierberg, Kerry L.; Lascher, Jonathan; Kelly, J. Daniel; Barrie, Mohammed Bailor; Koroma, Alimamy Philip; George, Peter; Kamara, Adikali Alpha; Marsh, Ronald; Sumbuya, Manso S.; Nutt, Cameron T.; Scott, Kirstin W.; Thomas, Edgar; Bollbach, Katherine; Sesay, Andrew; Barrie, Ahmidu; Barrera, Elizabeth; Barron, Kathryn; Welch, John; Bhadelia, Nahid; Frankfurter, Raphael G.; Dahl, Ophelia M.; Das, Sarthak; Rollins, Rebecca E.; Eustis, Bryan; Schwartz, Amanda; Pertile, Piero; Pavlopoulos, Ilias; Mayfield, Allan; Marsh, Regan H.; Dibba, Yusupha; Kloepper, Danielle; Hall, Andrew; Huster, Karin; Grady, Michael; Spray, Kimberly; Walton, David A.; Daboh, Fodei; Nally, Cora; James, Sahr; Warren, Gabriel S.; Chang, Joyce; Drasher, Michael; Lamin, Gina; Bangura, Sherry; Miller, Ann C.; Michaelis, Annie P.; McBain, Ryan; Broadhurst, M. Jana; Murray, Megan; Richardson, Eugene T.; Philip, Ted; Gottlieb, Gary L.; Mukherjee, Joia S.; Farmer, Paul E.

    2016-01-01

    An epidemic of Ebola virus disease (EVD) beginning in 2013 has claimed an estimated 11 310 lives in West Africa. As the EVD epidemic subsides, it is important for all who participated in the emergency Ebola response to reflect on strengths and weaknesses of the response. Such reflections should take into account perspectives not usually included in peer-reviewed publications and after-action reports, including those from the public sector, nongovernmental organizations (NGOs), survivors of Ebola, and Ebola-affected households and communities. In this article, we first describe how the international NGO Partners In Health (PIH) partnered with the Government of Sierra Leone and Wellbody Alliance (a local NGO) to respond to the EVD epidemic in 4 of the country's most Ebola-affected districts. We then describe how, in the aftermath of the epidemic, PIH is partnering with the public sector to strengthen the health system and resume delivery of regular health services. PIH's experience in Sierra Leone is one of multiple partnerships with different stakeholders. It is also one of rapid deployment of expatriate clinicians and logistics personnel in health facilities largely deprived of health professionals, medical supplies, and physical infrastructure required to deliver health services effectively and safely. Lessons learned by PIH and its partners in Sierra Leone can contribute to the ongoing discussion within the international community on how to ensure emergency preparedness and build resilient health systems in settings without either. PMID:27688219

  12. The basis for the strengthening of safeguards

    International Nuclear Information System (INIS)

    Goldschmidt, P.

    1999-01-01

    For the past 30 years, the International Atomic Energy Agency's safeguards system has contributed to the international non-proliferation regime, by providing, inter alia, assurances regarding the peaceful uses of declared nuclear material. However, the discovery of a clandestine nuclear weapons programme in Iraq in 1991 drew world-wide attention to the need to strengthen the system to address the absence of undeclared nuclear material and activities. Efforts to strengthen the IAEA's safeguards system began in 1991 and culminated in 1997 when the IAEA's Board of Governors approved a Model Protocol Additional to IAEA Safeguards Agreements which greatly expands the legal basis and scope of IAEA safeguards. Within this strengthened system it is expected that the IAEA be able to provide assurance not only of the absence of diversion of declared nuclear material but also on the absence of undeclared nuclear material and activities. This is to be done within a safeguards system that uses an optimal combination of all safeguards measures available, thereby achieving maximum effectiveness and efficiency within the available resources. This paper will summarize the evolution of the safeguards system, describe strengthened safeguards, report on the status of implementing the strengthening measures, and outline plans for integrating all available safeguards measures. (author)

  13. Women health extension workers: Capacities, opportunities and challenges to use eHealth to strengthen equitable health systems in Southern Ethiopia.

    Science.gov (United States)

    Dusabe-Richards, John N; Tesfaye, Hayley Teshome; Mekonnen, Jarso; Kea, Aschenaki; Theobald, Sally; Datiko, Daniel G

    2016-12-27

    This study assesses the feasibility of female health extension workers (HEWs) using eHealth within their core duties, supporting both the design and capacity building for an eHealth system project focussed initially on tuberculosis, maternal child health, and gender equity. Health extension workers, Health Centre Heads, District Health Officers, Zonal Health Department and Regional Health Bureau representatives in Southern Ethiopia. The study was undertaken in Southern Ethiopia with three districts in Sidama zone (population of 3.5 million) and one district in Gedeo zone (control zone with similar health service coverage and population density). Mixed method baseline data collection was undertaken, using quantitative questionnaires (n = 57) and purposively sampled qualitative face-to-face semi-structured interviews (n = 10) and focus group discussions (n = 3). Themes were identified relating to HEW commitment and role, supervision, and performance management. The Health Management Information System (HMIS) was seen as important by all participants, but with challenges of information quality, accuracy, reliability and timeliness. Participants' perceptions varied by group regarding the purpose and benefits of HMIS as well as the potential of an eHealth system. Mobile phones were used regularly by all participants. eHealth technology presents a new opportunity for the Ethiopian health system to improve data quality and community health. Front-line female HEWs are a critical bridge between communities and health systems. Empowering HEWs, supporting them and responding to the challenges they face will be an important part of ensuring the sustainability and responsiveness of eHealth strategies. Findings have informed the subsequent eHealth technology design and implementation, capacity strengthening approach, supervision, and performance management approach.

  14. Arbuscular Mycorrhiza Augments Arsenic Tolerance in Wheat (Triticum aestivum L.) by Strengthening Antioxidant Defense System and Thiol Metabolism

    Science.gov (United States)

    Sharma, Surbhi; Anand, Garima; Singh, Neeraja; Kapoor, Rupam

    2017-01-01

    Arbuscular mycorrhiza (AM) can help plants to tolerate arsenic (As) toxicity. However, plant responses are found to vary with the host plant and the AM fungal species. The present study compares the efficacy of two AM fungi Rhizoglomus intraradices (M1) and Glomus etunicatum (M2) in amelioration of As stress in wheat (Triticum aestivum L. var. HD-2967). Mycorrhizal (M) and non-mycorrhizal (NM) wheat plants were subjected to four levels of As (0, 25, 50, and 100 mg As kg-1 soil). Although As additions had variable effects on the percentage of root colonized by the two fungal inoculants, each mycobiont conferred benefits to the host plant. Mycorrhizal plants continued to display better growth than NM plants. Formation of AM helped the host plant to overcome As-induced P deficiency and maintained favorable P:As ratio. Inoculation of AMF had variable effects on the distribution of As in plant tissues. While As translocation factor decreased in low As (25 mg kg-1 soil), it increased under high As (50 and 100 mg As kg-1 soil). Further As translocation to grain was reduced (As grain:shoot ratio) in M plants compared with NM plants. Arsenic-induced oxidative stress (generation of H2O2 and lipid peroxidation) in plants reduced significantly by AMF inoculation. The alleviation potential of AM was more evident with increase in severity of As stress. Colonization of AMF resulted in higher activities of the antioxidant enzymes (superoxide dismutase, catalase, and guaiacol peroxidase). It increased the concentrations of the antioxidant molecules (carotenoids, proline, and α-tocopherol) than their NM counterparts at high As addition level. Comparatively higher activities of enzymes of glutathione-ascorbate cycle in M plants led to higher ascorbate:dehydroascorbate (AsA:DHA) and glutathione:glutathione disulphide (GSH:GSSG) ratios. Inoculation by AMF also augmented the glyoxalase system by increasing the activities of both glyoxalase I and glyoxalase II enzymes. Mycorrhizal

  15. Strengthening and sustainability of national immunization technical advisory groups (NITAGs) globally: Lessons and recommendations from the founding meeting of the global NITAG network.

    Science.gov (United States)

    Adjagba, Alex; MacDonald, Noni E; Ortega-Pérez, Inmaculada; Duclos, Philippe

    2017-05-25

    National Immunization Technical Advisory Groups (NITAGs) provide independent, evidence-informed advice to assist their governments in immunization policy formation. However, many NITAGs face challenges in fulfilling their roles. Hence the many requests for formation of a network linking NITAGs together so they can learn from each other. To address this request, the Health Policy and Institutional Development (HPID) Center (a WHO Collaborating Center at the Agence de Médecine Préventive - AMP), in collaboration with WHO, organized a meeting in Veyrier-du-Lac, France, on 11 and 12 May 2016, to establish a Global NITAG Network (GNN). The meeting focused on two areas: the requirements for (a) the establishment of a global NITAG collaborative network; and (b) the global assessment/evaluation of the performance of NITAGs. 35 participants from 26 countries reviewed the proposed GNN framework documents and NITAG performance evaluation. Participants recommended that a GNN should be established, agreed on its governance, function, scope and a proposed work plan as well as setting a framework for NITAG evaluation. Copyright © 2017.

  16. National Finance Center Personnel/Payroll System

    Data.gov (United States)

    US Agency for International Development — The NFC system is an USDA system used for processing transactions for payroll/personnel systems. Personnel processing is done through EPIC/HCUP, which is web-based....

  17. Writing Strengthens Orthography and Alphabetic-Coding Strengthens Phonology in Learning to Read Chinese

    NARCIS (Netherlands)

    Guan, C.Q.; Liu, Y.; Chan, D.H.L.; Ye, F.F.; Perfetti, C.A.

    2011-01-01

    Learning to write words may strengthen orthographic representations and thus support word-specific recognition processes. This hypothesis applies especially to Chinese because its writing system encourages character-specific recognition that depends on accurate representation of orthographic form.

  18. Ranking national research systems by citation indicators

    DEFF Research Database (Denmark)

    Aksnes, Dag W.; Schneider, Jesper Wiborg; Gunnarsson, Magnus

    2012-01-01

    This paper presents an empirical analysis of two different methodologies for calculating national citation indicators: whole counts and fractionalised counts. The aim of our study is to investigate the effect on relative citation indicators when citations to documents are fractionalised among the...

  19. Building National Health Research Information Systems (COHRED ...

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

    Called Health Research Web (HRWeb), the resource will constitute a comprehensive, authoritative and evolving source of information that facilitates national decision-making and international cooperation on ... Studies. Health Research Web (HRWeb) Key Information for Health Research Management, Nairobi, 23/03/2009.

  20. National Strategy for Modernizing the Regulatory System for Biotechnology Products

    Science.gov (United States)

    This National Strategy for Modernizing the Regulatory System for Biotechnology Products sets forth a vision for ensuring that the federal regulatory system is prepared to efficiently assess the risks, if any, of the future products of biotechnology.

  1. Community strengthening and mental health system linking after flooding in two informal human settlements in Peru: a model for small-scale disaster response.

    Science.gov (United States)

    Contreras, C; Aguilar, M; Eappen, B; Guzmán, C; Carrasco, P; Millones, A K; Galea, J T

    2018-01-01

    Mental health is an important factor in responding to natural disasters. Observations of unmet mental health needs motivated the subsequent development of a community-based mental health intervention following one such disaster affecting Peru in 2017. Two informal human settlements on the outskirts of Lima were selected for a mental health intervention that included: (1) screening for depression and domestic violence, (2) children's activities to strengthen social and emotional skills and diminish stress, (3) participatory theater activities to support conflict resolution and community resilience, and (4) community health worker (CHW) accompaniment to government health services. A total of 129 people were screened across both conditions, of whom 12/116 (10%) presented with depression and 21/58 (36%) reported domestic violence. 27 unique individuals were identified with at least one problem. Thirteen people (48%) initially accepted CHW accompaniment to government-provided services. This intervention provides a model for a small-scale response to disasters that can effectively and acceptably identify individuals in need of mental health services and link them to a health system that may otherwise remain inaccessible.

  2. Strengthening the Radiation Protection System in Cuba (SRPS - Cuba). A co-operation project between Cuban and Swedish institutions, February 2001 - June 2003

    International Nuclear Information System (INIS)

    Avila, Rodolfo; Larsson, Carl-Magnus; Prendes, Miguel; Zerquera, Juan Tomas

    2004-02-01

    This project results from the co-operation between a number of Cuban and Swedish institutions. It started in February 2001 and ended in June 2003 and was made possible thanks to the contributions of the Swedish International Development Co-operation Agency (SIDA), the Centro de Proteccion e Higiene de las Radiaciones, Cuba (CPHR), and the Swedish Radiation Protection Authority (SSI). The overall objective was to strengthen the radiation protection system in Cuba, and in this way contribute with the control and reduction of risks to man and the environment from exposures to ionizing radiation. The project focused on four priority areas: 1) Protection of workers and patients exposed to radiation in radiation practices; 2) Preparedness for response to an emergency situation; 3) Environmental radiological protection; and, 4) Exposure to radiation in areas with high levels of natural radioactivity. The present report summarizes the findings of the whole project period, providing an overview of the overall achievements, as well as listing its deliverables. The results of an evaluation of the project, conducted during the final workshop, are also included. The report ends with a list of generic and specific conclusions and recommendations for implementation of the project's achievements and for further development of co-operation

  3. Strengthening the Radiation Protection System in Cuba (SRPS - Cuba). A co-operation project between Cuban and Swedish institutions, February 2001 - June 2003

    Energy Technology Data Exchange (ETDEWEB)

    Avila, Rodolfo; Larsson, Carl-Magnus; Prendes, Miguel; Zerquera, Juan Tomas

    2004-02-01

    This project results from the co-operation between a number of Cuban and Swedish institutions. It started in February 2001 and ended in June 2003 and was made possible thanks to the contributions of the Swedish International Development Co-operation Agency (SIDA), the Centro de Proteccion e Higiene de las Radiaciones, Cuba (CPHR), and the Swedish Radiation Protection Authority (SSI). The overall objective was to strengthen the radiation protection system in Cuba, and in this way contribute with the control and reduction of risks to man and the environment from exposures to ionizing radiation. The project focused on four priority areas: 1) Protection of workers and patients exposed to radiation in radiation practices; 2) Preparedness for response to an emergency situation; 3) Environmental radiological protection; and, 4) Exposure to radiation in areas with high levels of natural radioactivity. The present report summarizes the findings of the whole project period, providing an overview of the overall achievements, as well as listing its deliverables. The results of an evaluation of the project, conducted during the final workshop, are also included. The report ends with a list of generic and specific conclusions and recommendations for implementation of the project's achievements and for further development of co-operation.

  4. Economic evaluation of national identification and recording systems for pigs.

    NARCIS (Netherlands)

    Saatkamp, H.W.; Dijkhuizen, A.A.; Geers, R.; Huirne, R.B.M.; Noordhuizen, J.P.T.M.; Goedseels, V.

    1997-01-01

    Four national identification and recording (I&R) systems for the Belgian pig industry were evaluated economically, using a computer simulation model. These systems were: (1) the previous system; (2) a revised system (based on the previous one); (3) a system based on electronic identification;

  5. Strengthening of oral health systems

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2014-01-01

    Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care...... is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral...... diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work...

  6. The Role of Satellite Data for the National Forest Monitoring Systems in the Context of REDD+

    Science.gov (United States)

    Jonckheere, Inge

    2012-04-01

    Reducing Emissions from Deforestation and Forest Degradation (REDD) is an effort to create a financial value for the carbon stored in forests, offering incentives for developing countries to reduce emissions from forested lands and invest in low-carbon paths to sustainable development. “REDD+” goes beyond deforestation and forest degradation, and includes the role of conservation, sustainable management of forests and enhancement of forest carbon stocks. In the framework of getting countries ready for REDD+, the UN-REDD Programme assists developing countries to prepare and implement national REDD+ strategies. For the monitoring, reporting and verification (MRV), FAO supports the countries to develop national forest monitoring systems (NFMS) based on satellite data that allow for credible MRV of REDD+ activities through time. The UN-REDD Programme through a joint effort of FAO and Brazil's National Space Agency, INPE, is supporting countries to develop cost- effective, robust and compatible national monitoring and MRV systems, providing tools, methodologies, training and knowledge sharing that help countries to strengthen their technical and institutional capacity for effective MRV systems. The Brazilian forest monitoring system, TerraAmazon, which is used as a multi-user basis, allows countries to adapt it to country needs. With the technical assistance of FAO, INPE and other stakeholders, the countries will set up an autonomous operational satellite forest monitoring systems. A beta version and the methodologies of the system for DRC and PNG are launched in Durban (SA) during COP 17, while Paraguay, Zambia and Viet Nam are in development in 2012.

  7. Energy saving synergies in national energy systems

    DEFF Research Database (Denmark)

    Thellufsen, Jakob Zinck; Lund, Henrik

    2015-01-01

    In the transition towards a 100% renewable energy system, energy savings are essential. The possibility of energy savings through conservation or efficiency increases can be identified in, for instance, the heating and electricity sectors, in industry, and in transport. Several studies point...... to various optimal levels of savings in the different sectors of the energy system. However, these studies do not investigate the idea of energy savings being system dependent. This paper argues that such system dependency is critical to understand, as it does not make sense to analyse an energy saving...... without taking into account the actual benefit of the saving in relation to the energy system. The study therefore identifies a need to understand how saving methods may interact with each other and the system in which they are conducted. By using energy system analysis to do hourly simulation...

  8. How “Participatory Governance” Strengthens Authoritarian Regimes: Evidence from Electoral Authoritarian Oaxaca, Mexico

    Directory of Open Access Journals (Sweden)

    Allyson Lucinda Benton

    2016-01-01

    Full Text Available Research on the impact of participatory institutions in Latin America has not yet examined how they work in authoritarian settings. National autocrats in Mexico implemented participatory reforms during that country’s national electoral authoritarian regime. Building on research on political decentralization in authoritarian regimes, I argue that participatory institutions can be used to channel citizen demands and to incorporate citizens into authoritarian systems, thereby strengthening authoritarian rule. However, following research on democratic participatory governance, I also argue that participatory institutions will work better in this regard when designed from the bottom up rather than from the top down. Statistical analysis of patterns of municipal-level electoral authoritarian support in Mexico shows that bottom-up-designed participatory institutions implemented during electoral authoritarian rule strengthened local political control to a greater extent than top-down-designed political systems. The study supports research revealing the anti-democratic effects of participatory institutions in democratic Latin American nations.

  9. Assessing the outcome of Strengthening Laboratory Management Towards Accreditation (SLMTA) on laboratory quality management system in city government of Addis Ababa, Ethiopia.

    Science.gov (United States)

    Sisay, Abay; Mindaye, Tedla; Tesfaye, Abrham; Abera, Eyob; Desale, Adino

    2015-01-01

    Strengthening Laboratory Management Toward Accreditation (SLMTA) is a competency-based management training programme designed to bring about immediate and measurable laboratory improvement. The aim of this study is to assess the outcome of SLMTA on laboratory quality management system in Addis Ababa, Ethiopia. The study used an Institutional based cross sectional study design that employed a secondary and primary data collection approach on the participated institution of medical laboratory in SLMTA. The study was conducted in Addis Ababa city government and the data was collected from February 'April 2014 and data was entered in to EPI-data version 3.1 and was analyzed by SPSS version 20. The assessment finding indicate that there was a significant improvement in average scores (141.4; range of 65-196, 95%CI=86.275-115.5, p=0.000) at final with 3 laboratories become 3 star, 6 laboratories were at 2 star, 11 were 1 star. Laboratory facilities respondents which thought getting adequate and timely manner mentorship were found 2.5 times more likely to get good success in the final score(AOR=2.501, 95% CI=1.109-4.602) than which did not get it. At the end of SLMTA implementation,3 laboratories score 3 star, 6 laboratories were at 2 star, 11 were at 1 star. The most important contributing factor for not scoring star in the final outcome of SLMTA were not conducting their customer satisfaction survey, poor staff motivation, and lack of regular equipment service maintenance. Mentorship, onsite and offsite coaching and training activities had shown a great improvement on laboratory quality management system in most laboratories.

  10. Using adapted quality-improvement approaches to strengthen community-based health systems and improve care in high HIV-burden sub-Saharan African countries.

    Science.gov (United States)

    Horwood, Christiane M; Youngleson, Michele S; Moses, Edward; Stern, Amy F; Barker, Pierre M

    2015-07-01

    Achieving long-term retention in HIV care is an important challenge for HIV management and achieving elimination of mother-to-child transmission. Sustainable, affordable strategies are required to achieve this, including strengthening of community-based interventions. Deployment of community-based health workers (CHWs) can improve health outcomes but there is a need to identify systems to support and maintain high-quality performance. Quality-improvement strategies have been successfully implemented to improve quality and coverage of healthcare in facilities and could provide a framework to support community-based interventions. Four community-based quality-improvement projects from South Africa, Malawi and Mozambique are described. Community-based improvement teams linked to the facility-based health system participated in learning networks (modified Breakthrough Series), and used quality-improvement methods to improve process performance. Teams were guided by trained quality mentors who used local data to help nurses and CHWs identify gaps in service provision and test solutions. Learning network participants gathered at intervals to share progress and identify successful strategies for improvement. CHWs demonstrated understanding of quality-improvement concepts, tools and methods, and implemented quality-improvement projects successfully. Challenges of using quality-improvement approaches in community settings included adapting processes, particularly data reporting, to the education level and first language of community members. Quality-improvement techniques can be implemented by CHWs to improve outcomes in community settings but these approaches require adaptation and additional mentoring support to be successful. More research is required to establish the effectiveness of this approach on processes and outcomes of care.

  11. Evaluating capacity-building for mental health system strengthening in low- and middle-income countries for service users and caregivers, service planners and researchers.

    Science.gov (United States)

    Hanlon, C; Semrau, M; Alem, A; Abayneh, S; Abdulmalik, J; Docrat, S; Evans-Lacko, S; Gureje, O; Jordans, M; Lempp, H; Mugisha, J; Petersen, I; Shidhaye, R; Thornicroft, G

    2018-02-01

    Efforts to support the scale-up of integrated mental health care in low- and middle-income countries (LMICs) need to focus on building human resource capacity in health system strengthening, as well as in the direct provision of mental health care. In a companion editorial, we describe a range of capacity-building activities that are being implemented by a multi-country research consortium (Emerald: Emerging mental health systems in low- and middle-income countries) for (1) service users and caregivers, (2) service planners and policy-makers and (3) researchers in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda). In this paper, we focus on the methodology being used to evaluate the impact of capacity-building in these three target groups. We first review the evidence base for approaches to evaluation of capacity-building, highlighting the gaps in this area. We then describe the adaptation of best practice for the Emerald capacity-building evaluation. The resulting mixed method evaluation framework was tailored to each target group and to each country context. We identified a need to expand the evidence base on indicators of successful capacity-building across the different target groups. To address this, we developed an evaluation plan to measure the adequacy and usefulness of quantitative capacity-building indicators when compared with qualitative evaluation. We argue that evaluation needs to be an integral part of capacity-building activities and that expertise needs to be built in methods of evaluation. The Emerald evaluation provides a potential model for capacity-building evaluation across key stakeholder groups and promises to extend understanding of useful indicators of success.

  12. Strengthening integration of clinical and public health systems to prevent maternal-child obesity in the First 1,000Days: A Collective Impact approach.

    Science.gov (United States)

    Blake-Lamb, Tiffany; Boudreau, Alexy Arauz; Matathia, Sarah; Tiburcio, Etna; Perkins, Meghan E; Roche, Brianna; Kotelchuck, Milton; Shtasel, Derri; Price, Sarah N; Taveras, Elsie M

    2018-02-01

    Obesity interventions may be most effective if they begin in the earliest stages of life, support changes across family, clinical, and public health systems, and address socio-contextual factors. The First 1000Days is a systematic program starting in early pregnancy lasting through the first 24months of infancy to prevent obesity among low-income mother-infant pairs in three community health centers in Massachusetts. The program uses a Collective Impact approach to create the infrastructure for sustained, system-wide changes for obesity prevention across early life clinical and public health services, including Obstetrics, Pediatrics, Adult Medicine, Behavioral Health, Nutrition, Community Health, the Women, Infants and Children (WIC) program, and the Maternal, Infant and Childhood Home Visiting program. Program components include 1) staff and provider training; 2) enhanced gestational weight gain and infant overweight tracking; 3) universal screening of adverse health behaviors and socio-contextual factors; 4) universal patient navigation to support individual behavior change and social needs, while strengthening integration of clinical and public health services; 5) individualized health coaching for mother-infant pairs at high risk of obesity; and 6) educational materials to support behavior change. A quasi-experimental evaluation design will examine changes, between 2015 and 2019, in gestational weight gain and prevalence of infant overweight from 0 to 24months of age. The First 1000Days program will examine the effectiveness of an early life obesity prevention program for mother-infant pairs. If successful, the program could provide a model for chronic disease prevention and health promotion among vulnerable families starting in early life. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. 78 FR 11981 - Special Regulations; Areas of the National Park System, Sleeping Bear Dunes National Lakeshore...

    Science.gov (United States)

    2013-02-21

    ...-PPMPSPD1Z.YM0000] RIN 1024-AE11 Special Regulations; Areas of the National Park System, Sleeping Bear Dunes... rule designates the Sleeping Bear Heritage Trail currently under construction within Sleeping Bear... FURTHER INFORMATION CONTACT: Tom Ulrich, Deputy Superintendent, Sleeping Bear Dunes National Lakeshore...

  14. The Higher Education System in Malaysia: Metropolitan, Cross-National, Peripheral or National?

    Science.gov (United States)

    Selvaratnam, V.

    1985-01-01

    Burton Clark's theory of higher education institutions as academic organization governed by unique elements and disciplinary logic is outlined and applied to Malaysia. The theory's weakness in underplaying the role of national policies and environmental factors in determining a national higher education system is noted. (MSE)

  15. Unconquerable Nation: Knowing Our Enemy, Strengthening Ourselves

    Science.gov (United States)

    2006-06-01

    strength to defeat the terror they would create. Instead of issuing constant warnings and alarms, we must project stoicism and resolve. Instead of...realism in the acceptance of risk, our stoicism in the face of threats, our self-reliance, our humanity, our sense of community, too fleet- ingly

  16. Strengthening National and International Collaboration to End ...

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

    These objectives will be achieved through programs on the following five themes: civil society and aid effectiveness; ensuring trade rules support the ... Women in the developing world continue to face obstacles that limit their ability to establish careers and become leaders in the fields of science, technology, engineering, ...

  17. FINANCIAL STABILITY OF THE UKRAINE NATIONAL SYSTEM OF PENSION INSURANCE

    Directory of Open Access Journals (Sweden)

    A. Khemii

    2014-03-01

    Full Text Available The system of pension insurance is a combination of created by the state legal, economic and organizational institutions and norms, providing financial support to citizens in the form of pensions. In the article analyzing the demographic situation and the condition of pension payments in the country today. In the terms of economic and social reforms, the level of financial stability the pension system is low. Therefore important is the analysis and exploring new methods to ensure financial stability of the Ukraine national system of pension insurance. The main institution of the national pension insurance is the National Pension Fund of Ukraine.

  18. National Ignition Facility integrated computer control system

    International Nuclear Information System (INIS)

    Van Arsdall, P.J. LLNL

    1998-01-01

    The NIF design team is developing the Integrated Computer Control System (ICCS), which is based on an object-oriented software framework applicable to event-driven control systems. The framework provides an open, extensible architecture that is sufficiently abstract to construct future mission-critical control systems. The ICCS will become operational when the first 8 out of 192 beams are activated in mid 2000. The ICCS consists of 300 front-end processors attached to 60,000 control points coordinated by a supervisory system. Computers running either Solaris or VxWorks are networked over a hybrid configuration of switched fast Ethernet and asynchronous transfer mode (ATM). ATM carries digital motion video from sensors to operator consoles. Supervisory software is constructed by extending the reusable framework components for each specific application. The framework incorporates services for database persistence, system configuration, graphical user interface, status monitoring, event logging, scripting language, alert management, and access control. More than twenty collaborating software applications are derived from the common framework. The framework is interoperable among different kinds of computers and functions as a plug-in software bus by leveraging a common object request brokering architecture (CORBA). CORBA transparently distributes the software objects across the network. Because of the pivotal role played, CORBA was tested to ensure adequate performance

  19. The Brazilian national system of forest permanent plots

    Science.gov (United States)

    Yeda Maria Malheiros de Oliveira; Maria Augusta Doetzer Rosot; Patricia Povoa de Mottos; Joberto Veloso de Freitas; Guilherme Luis Augusto Gomide; < i> et al< /i>

    2009-01-01

    The Brazilian National System of Forest Permanent Plots (SisPP) is a governmental initiative designed and being implemented in partnership by the Ministry of Environment (MMA), represented by the National Forest Programme (PNF) and the Brazilian Forest Service (SFB) and the Embrapa Forestry (a research center of the Brazilian Agricultural Research Corporation - Embrapa...

  20. Developing National Systems of Innovation: University-Industry ...

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

    30 janv. 2015 ... Developing National Systems of Innovation: University-Industry Interactions in the Global South. Book cover Developing ... of Campinas, Brazil. Glenda Kruss is research director at the Human Sciences Research Council, South Africa. Keun Lee is professor at Seoul National University, South Korea.

  1. Reintroduction of American Chestnut in the National Forest System

    Science.gov (United States)

    Stacy L. Clark; Scott E. Schlarbaum; Cornelia C. Pinchot; Sandra L. Anagnostakis; Michael R. Saunders; Melissa Thomas-Van Gundy; Paul Schaberg; James McKenna; Jane F. Bard; Paul C. Berrang; David M. Casey; Chris E. Casey; Barbara Crane; Brian D. Jackson; Jeff D. Kochenderfer; Russ MacFarlane; Robert Makowske; Mark D. Miller; Jason A. Rodrigue; Jim Stelick; Christopher D. Thornton; Tyler S. Williamson

    2014-01-01

    American chestnut restoration depends on a multitude of biological, administrative, and technological factors. Germplasm traditionally bred for resistance to the chestnut blight disease caused by the exotic pathogen Cryphonectria parasitica has been deployed on national forests in the Eastern and Southern Regions of the National Forest System (NFS) since 2009. Trees...

  2. Cooling systems research at Argonne National Laboratory

    International Nuclear Information System (INIS)

    Spigarelli, S.A.

    1977-01-01

    Studies of the thermal plumes resulting from discharges from once-through cooling systems of electric generating stations are reviewed. The collection of large amounts of water temperature data for definition of the three-dimensional structure of a thermal plume, of current data, and related ambient data for model evaluation purposes required the development of an integrated data collection system. The Argonne system employs measurements of water temperature over the water column from a moving small boat. Temperatures are measured with thermistors attached to a rigid strut for surface plumes and to a flexible, faired cable for submerged plumes. Water temperatures and boat location, determined by a microwave ranging system, are recorded on magnetic tape while the boat is underway and prove a quasi-synoptic map of plume temperatures. Automated data handling and processing procedures provide for the production of isotherm maps of the plume at several elevations and in cross section. Mathematical model evaluation for surface discharges of waste heat included the consideration of over 40 different models and detailed evaluation of 11 models. Most models were run on Argonne's computers, and all models were evaluated in terms of their limitations and capabilities as well as their predictive performance against prototype data. Measurements were made of thermal plumes at the discharges of nuclear power plants located on the shores of Lake Michigan

  3. Building National Health Research Information Systems (COHRED ...

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

    Zambia already has information on its health research system that can be used to create an HRWeb page. The focus will thus be on quality control, maintenance and documenting utilization. Mali currently has very little information on health research, and will therefore need to concentrate its efforts on data collection.

  4. A 21st Century National Public Health System

    National Research Council Canada - National Science Library

    Jones, Mary J

    2008-01-01

    The attention that SARS created in 2003 has influenced public and political perceptions about the risks associated with infectious diseases and the role the public health system should play in national security...

  5. Basic components of a national control system for nuclear materials

    International Nuclear Information System (INIS)

    Rabot, G.

    1986-01-01

    The paper presents the different aspects related to the organization and the functioning of a national control and accounting system for nuclear materials. The legal aspects and the relations with the IAEA are included

  6. 75 FR 64148 - General Regulation: National Park System

    Science.gov (United States)

    2010-10-19

    ... elements of great native cultures, far older than European exploration and settlement; present battle sites... lessons they help us remember, the National Park System also includes the Japanese American World War II...

  7. DEMONSTRATION BULLETIN: IN SITU ELECTROKINETIC EXTRACTION SYSTEM - SANDIA NATIONAL LABORATORIES

    Science.gov (United States)

    Sandia National Laboratories (SNL) has developed an in situ soil remediation system that uses electrokinetic principles to remediate hexavalent chromium-contaminated unsaturated or partially saturated soils. The technology involves the in situ application of direct current to the...

  8. National Recordal System IK holder catalogue process

    CSIR Research Space (South Africa)

    Pretorius, R

    2011-11-01

    Full Text Available , development, and protection of IKS in South Africa. The IKS policy states[1]: ?In order to secure rights to knowledge, a recordal system needs to be put in place where communities, guilds and other IK holders can record their knowledge holdings in order..., and secondly to facilitate recording and documentation of IK for the preservation and protection against unauthorized access to data, for instance commercial exploitation, distortion and fraudulent acts. The fi rst version of the catalogue process...

  9. Manufacturing Experience for Oxide Dispersion Strengthened Alloys

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, Wendy D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Doherty, Ann L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Henager, Charles H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Lavender, Curt A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Montgomery, Robert O. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Omberg, Ronald P. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Smith, Mark T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Webster, Ryan A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-09-22

    This report documents the results of the development and the manufacturing experience gained at the Pacific Northwest National Laboratories (PNNL) while working with the oxide dispersion strengthened (ODS) materials MA 956, 14YWT, and 9YWT. The Fuel Cycle Research and Development program of the Office of Nuclear Energy has implemented a program to develop a Uranium-Molybdenum metal fuel for light water reactors. ODS materials have the potential to provide improved performance for the U-Mo concept.

  10. Understanding the state of health policy and systems research in West Africa and capacity strengthening needs: scoping of peer-reviewed publications trends and patterns 1990-2015.

    Science.gov (United States)

    Defor, Selina; Kwamie, Aku; Agyepong, Irene Akua

    2017-07-12

    The need for locally-driven, locally-generated evidence to guide health policy and systems decision-making and implementation in West Africa remains urgent. Thus, health policy and systems research (HPSR) is a field with great potential for addressing many of the sub-region's intransigent health challenges. This paper presents an analysis of trends and patterns of peer-reviewed HPSR publications across the Economic Community of West African States (ECOWAS), to help understand trends and patterns of HPSR publication and the degree of involvement of West African researchers in HPSR evidence generation in the sub-region. Our goal was to use the findings to inform the development of a sub-regional strategy to strengthen HPSR and its use to inform development and improvement of health outcomes. A scoping review was conducted over a 25-year period from January 1990 to September 2015. Literature searches were conducted in English and French using Google Scholar, PubMed Central and Cairn.info. A total of 258 articles were retrieved. Of these, 246 were statistically analysed, with 54% having West African lead authors. Two thirds of the papers originated from three out of the 15 countries of the ECOWAS, specifically Nigeria (28.86%), Burkina Faso (21.54%) and Ghana (17.07%). Most authors were based in academic institutions and participation of authors from ministries of health, hospitals and non-governmental organisations was limited. English was the predominant language for publication even for papers originating from Francophone West African countries. There has been a progressive increase in publications over the studied period. Despite progressive improvements over time, West Africa remains a weak sub-region in terms of peer-reviewed HPSR publications. Within the overall weakness, there is country-to-country variation. The fact that only a handful of countries accounted for nearly 70% of the total volume of publications in West Africa attests to the great disparities in

  11. Radiological protection national system. Basic security rules

    International Nuclear Information System (INIS)

    1981-01-01

    This work has been prepared as the first one of a set of standards and regulations that will be enforced to provide the protection of men and the environment against the undesirable effects of ionizing radiations. It establishes, in the first place, the system of dose limits for the country and the principles of its utilization. It takes into account the CIPR's recommendations in this area and the mentioned frame of reference, it establishes further the necessary restrictions for the application of the limits to the professionally exposed workers, as well as to the isolated members of the public and the population in general. In addition it establishes the general conditions to be met for the implementation of radiological protection, among them, the classification of working areas and working conditions as well as the compulsory periodical medical surveillance. (H.D.N.)

  12. Economic effects of national CO2 trading systems. National dilemmas for a global problem

    International Nuclear Information System (INIS)

    Broer, P.; Mulder, M.; Vromans, M.

    2002-01-01

    This document investigates the effects of the introduction of a system of tradeable tradeable permits for CO2-emissions in the Netherlands.It considers several different implementations,with as a base variant a system in which the sheltered sectors are subject to an absolute emission ceiling,while the exposed sectors are subject to a relative ceiling,based on a performance benchmark for their CO2-efficiency. The economic effects of this system are compared to the effects of a system with an absolute ceiling for all sectors, and the effects of the current national climate policy,in which the Regulatory Energy Tax system and the voluntary agreements are dominant. The results show that the system in the base variant performs best in terms of a net national income measure of welfare. A uniform emission ceiling yields a lower CO2-price,but also a lower national income, due to the relocation of energy-intensive exposed sectors across the border.Increasing energy taxes within the current tax system and continuation of the current voluntary agreements is also less efficient. The paper concludes however that from an economic point of view, a national system of CO2- trading is an expensive policy instrument, due to the high transaction costs of the performance benchmark and the distinction between sheltered and exposed sectors. The first-best option is to impose CO2-emission trading with an absolute ceiling on an international level. Since the implementation of an international system of emission trading is uncertain, it may be useful to analyse the requirements for an efficient national system. In the meantime,improving the design of the conventional regulatory energy tax system may be an attractive alternative [nl

  13. The rise of governmentality in the Italian National Health System: physiology or pathology of a decentralized and (ongoing) federalist system?

    Science.gov (United States)

    Lega, Federico; Sargiacomo, Massimo; Ianni, Luca

    2010-11-01

    In this paper, we aim to discuss the implications and lessons that can be learnt from the ongoing process of federalism affecting the Italian National Health System (INHS). Many countries are currently taking decisions concerning the decentralization or re-centralization of their health-care systems, with several key issues that are illustrated in the recent history of the INHS. The decentralization process of INHS has produced mixed results, as some regions took advantage of it to strengthen their systems, whereas others were not capable of developing an effective steering role. We argue that the mutual reinforcement of the decentralization and recentralization processes is not paradoxical, but is actually an effective way for the State to maintain control over the equity and efficiency of its health-care system while decentralizing at a regional level. In this perspective, we provide evidence backing up some of the assumptions made in previous works as well as new food-for thought - specifically on how governmentality and federalism should meet - to reshape the debate on decentralization in health care.

  14. Marketing in Greek National Health System

    Directory of Open Access Journals (Sweden)

    Maria Tseroni

    2009-01-01

    Full Text Available Introduction: The international financial situation in combination with an aging population and the appropriation of health services imposes the management of hospital services as a necessity for the survival of hospitals.Aim: To examine the perceptions of 450 upper administrative hospital executives (Nursing, Medicine and Administrative services in the wider region of Attica, on marketing, communication, and public relations in health-care.Population study: Four hundred and fifty (450 higher health executives from the three basic fields of services in health institutions (medical, nursing, administration constituted the total sample of the research. These people are employed at 9 of the 36 hospitals in the 3 Health Regions of Attica (H.Re.Materials and method:The type of design that was chosen (to gather data for the study of attitudes and perceptions of the health personnel of the health institutions of G.S.H (Greek System of Health is a cross- sectional survey.Results: The participating subjects, even though expressed some reservations at first, formed a favorable attitude towards marketing and its application in the field of health-care. Statistically important correlations emerged between the perceptions of executives and their socio-demographic background including age, sex, education, and profession, work experience in health-care and specifically in their current position in the services as well as statistically important differences between doctors, nurses and administrators as to their perceptions of some issues in marketing.Conclusions: From the comments in the survey it appears there is a need to apply marketing correctly when providing quality care, respecting the patients’ rights and using human and not financial criteria as a guide. Based on the results of the research, important proposals are being submitted in the areas of health-care research, education and clinical practice.

  15. On Chinese National Continuous Operating Reference Station System of GNSS

    Directory of Open Access Journals (Sweden)

    CHEN Junyong

    2007-11-01

    Full Text Available Objective: Global navigation satellite system (GNSS Continuous Operating Reference Station (CORS System can maintain a accurate, 3D, geocentric and dynamic reference coordinate frame in the corresponding area, can provide positioning and navigation service. It can also serve for the meteorology, geodynamics, earthquake monitoring and Location Based services (LBS etc in the same area. Until now, our country can’t provide a facing National CORS System serving for every profession and trade, and the national sharing platform of CORS System resources has not been established. So this paper discusses some valuable insight how to construct the National CORS System in China. Method: Constructing goal、Service object、CORS distribution、CORS geographic、geology and communication environment and other factors, are major considerations for the Constructing the National CORS System. Moreover, constructing GNSS CORS is more specific, mainly from four aspects, namely site-selection、civil construction、security measures and equipment-selection for consideration. Outcome: The project of the Constructing Global navigation satellite system (GNSS Continuous Operating Reference Station (CORS System in china is put forward, and is discussed from goal、principle、project and other for construction. Some meaning thought how to construct the National CORS System is submitted Conclusion: The Global navigation satellite system (GNSS Continuous Operating Reference Station (CORS System in china is the lack of a unified planning and design in the national level. So far, the national CORS system serving all walks of life has not been provided, and the national sharing platform of CORS System resources has not been established The primary mission of the Global navigation satellite system (GNSS Continuous Operating Reference Station (CORS System in china is as follows: using data set of GNSS and receiving, transport, process, integration, transmit information and

  16. Has globalization strengthened South Korea’s national research system? National and international dynamics of the Triple Helix of scientific co-authorship relationships in South Korea

    NARCIS (Netherlands)

    Kwon, K.-S.; Park, H.W.; So, M.; Leydesdorff, L.

    2012-01-01

    We trace the structural patterns of co-authorship between Korean researchers at three institutional types (university, government, and industry) and their international partners in terms of the mutual information generated in these relations. Data were collected from the Web of Science during the

  17. The national fire-danger rating system: basic equations

    Science.gov (United States)

    Jack D. Cohen; John E. Deeming

    1985-01-01

    Updating the National Fire-Danger Rating System (NFDRS) was completed in 1977, and operational use of it was begun the next year. The System provides a guide to wildfire control and suppression by its indexes that measure the relative potential of initiating fires. Such fires do not behave erratically–they spread without spotting through continuous ground fuels....

  18. Sandia National Laboratories, California Environmental Management System program manual

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2014-04-01

    The Sandia National Laboratories, California (SNL/CA) Environmental Management System (EMS) Program Manual documents the elements of the site EMS Program. The SNL/CA EMS Program conforms to the International Standard on Environmental Management Systems, ISO 14001:2004 and Department of Energy (DOE) Order 436.1.

  19. Establishing a national safeguards system at the State level

    International Nuclear Information System (INIS)

    Lopez Lizana, Fernando

    2001-01-01

    This paper is the guide to a workshop designed to enable the participants to gain a better understanding of National Safeguards Systems and their functions. The workshop provides an opportunity to address the requirements for the organization that has to carry out the system functions at the State level in a country having a research reactor and ancillary laboratories

  20. Empirical Evidence and Policy Implications from National Systems of ...

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

    Earlier efforts to understand national innovation systems in developing countries have focused on the elements of the system (firms, universities, public research organizations, etc.), with little emphasis on the relationships and knowledge flows between them. These relationships are important as they may induce positive ...

  1. The National Multi-island Smart Energy System in Philippines

    DEFF Research Database (Denmark)

    Ma, Zheng; Billanes, Joy Dalmacio; Jørgensen, Bo Nørregaard

    2016-01-01

    characteristics, technology readiness, and political support, etc. This paper uses the development of the Philippines’ energy system as case study for analyzing the challenges, opportunities and influential factors for the development and integration of a national multi-island energy system. The paper concludes...

  2. Aquaculture Thesaurus: Descriptors Used in the National Aquaculture Information System.

    Science.gov (United States)

    Lanier, James A.; And Others

    This document provides a listing of descriptors used in the National Aquaculture Information System (NAIS), a computer information storage and retrieval system on marine, brackish, and freshwater organisms. Included are an explanation of how to use the document, subject index terms, and a brief bibliography of the literature used in developing the…

  3. Developing and maintaining national food safety control systems ...

    African Journals Online (AJOL)

    The establishment of effective food safety systems is pivotal to ensuring the safety of the national food supply as well as food products for regional and international trade. The development, structure and implementation of modern food safety systems have been driven over the years by a number of developments.

  4. National Innovation Systems in Brazil, Russia, India, China and ...

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

    Brazil, Russia, India, China and South Africa (BRICS) have put innovation at the centre of their development strategies. In each case, however, there exists scant knowledge about the national innovation system and its impact on the economy. This grant will support a comparative analysis of innovation systems in the five ...

  5. Sandia National Laboratories, California Environmental Management System program manual.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2013-04-01

    The Sandia National Laboratories, California (SNL/CA) Environmental Management System (EMS) Program Manual documents the elements of the site EMS Program. The SNL/CA EMS Program conforms to the International Standard on Environmental Management Systems, ISO 14001:2004 and Department of Energy (DOE) Order 436.1.

  6. The neutron imaging system fielded at the National Ignition Facility

    Directory of Open Access Journals (Sweden)

    Fittinghoff D.N.

    2013-11-01

    Full Text Available We have fielded a neutron imaging system at the National Ignition Facility to collect images of fusion neutrons produced in the implosion of inertial confinement fusion experiments and scattered neutrons from (n, n′ reactions of the source neutrons in the surrounding dense material. A description of the neutron imaging system is presented, including the pinhole array aperture, the line-of-sight collimation, the scintillator-based detection system and the alignment systems and methods. Discussion of the alignment and resolution of the system is presented. We also discuss future improvements to the system hardware.

  7. Condition assessment and strengthening of residential units

    Directory of Open Access Journals (Sweden)

    Tatheer Zahra

    2014-01-01

    Full Text Available About 40, ground plus one (G+1 residential units were designed using a hybrid structural framing system (RC frame and load bearing walls. A few months after the completion of the ground floor of the residential units, cracks appeared at several locations in the structure. Field and Laboratory testing was conducted to ascertain the in situ strength of concrete and steel reinforcement. The results of the experimental work were used in the analytical ETABS model for the structural stability calculations. The results indicated that residential units were marginally safe in the existing condition (completed ground floor, but the anticipated construction of the floor above the ground floor (G+1 could not be carried out as the strength of the structural system was inadequate. To increase the safety of existing ground floor and to provide the option of the construction of one floor above, rehabilitation and strengthening design was performed. The proposed strengthening design made use of welded wire fabric (WWF and carbon fibre reinforced polymer (CFRP laminates/sheets for the strengthening of walls, columns and slabs. The residential units will be strengthened in the near future.

  8. Strengthening the Management of the Higher Education System in Africa: The Role of a Regional Higher Education Management Information Network System (RHEMINS)

    Science.gov (United States)

    Emetarom, Uche G.; Enyi, Dan

    2008-01-01

    Contemporary higher education managers, in Africa, seem to have found themselves in a changed environment, with increased and increasing challenges, to operate and achieve success. Although, there is the existence of diversity in the label and typology as well as in the priorities and emphasis among the higher education systems in Africa, there is…

  9. Incentive Systems That Support Sustainability: A First Nations Example

    OpenAIRE

    Ronald L. Trosper

    1998-01-01

    Prior to contact with European settlers, the incentive and governance systems used by First Nations peoples of the Northwest coast of North America provided more sustainable use of the fisheries and other resources of that region than did subsequent systems. This paper explores the major reason for that success: the requirements of the potlatch system that chiefs share their income with each other. Because chiefs controlled well-defined territories and subjected each other to review, the potl...

  10. Brookhaven National Laboratory's multiparticle spectrometer drift chamber system

    International Nuclear Information System (INIS)

    Etkin, A.; Kramer, M.A.

    1979-01-01

    A system of drift chambers is being built to replace the present spark chambers in the Brookhaven National Laboratory's Multiparticle Spectrometer. This system will handle a beam of approx. 3 million particles per second and have a resolution of 200 μm. A summary of the status of the chambers and the custom integrated circuits is presented. The data acquisition system is described. Prototype chambers have been built and tested with results that are consistent with the expected chamber properties

  11. Islam, Pancasila and Value Systems of Indonesian National Education

    OpenAIRE

    Beck, DR. Martha Catherine; Irawan, Irawan

    2014-01-01

    This paper intends to show that the Pancasila (five principles of state) and the Pillarsof Islam (the five religious value system) has synergy to build Indonesia's nationaleducation values system. To explore the relation between religion and politics inPancasila, Martha Beck used Alfred North Whitehead's process philosophy, CarlGustav Jung's archetypes psychology and Ervin Laszlo‟s systems theory. To approvethat Pancasila and Pillars of Islam has synergy to Indonesia‟s national education,Iraw...

  12. Strengthening Rural Livelihoods

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

    Kannaiyan Sasikumar is a finance and management control systems professional with experience in microfinance and technology enabling systems for credit delivery. Sasikumar has been working in the Product Development Unit of Ekgaon leading the delivery systems service area for microfinance, health insurance, ...

  13. ISLAM, PANCASILA AND VALUE SYSTEMS OF INDONESIAN NATIONAL EDUCATION

    Directory of Open Access Journals (Sweden)

    DR. Martha Catherine Beck

    2016-03-01

    Full Text Available This paper intends to show that the Pancasila (five principles of state and the Pillarsof Islam (the five religious value system has synergy to build Indonesia's nationaleducation values system. To explore the relation between religion and politics inPancasila, Martha Beck used Alfred North Whitehead's process philosophy, CarlGustav Jung's archetypes psychology and Ervin Laszlo‟s systems theory. To approvethat Pancasila and Pillars of Islam has synergy to Indonesia‟s national education,Irawan used the concept of scientia sacra by Seyyed Hossein Nasr. The results showedthat the Indonesian national education system consistently present in a triangularrelationship between religion (spiritual humanism, politics (democracy and cultural(multicultural and tolerance. The relationship manifested in Indonesian NationalEducation System, which is always grounded philosophically and aims at threethings; 1 form human who believe, cautious and has noble character; 2 master ofscience and technology; and 3 actively participate in creating order and peace in theworld, even a blessing for the entire universe. Indonesia's national education systemcould be a new alternative in building a more holistic education systems around theworld because considered crucial interconnection between science, religion, interestsof state and demands of the global. This is known as a moderate Islamic education.

  14. Evaluating the Impact of Unrestricted Operation of Unmanned Aircraft Systems in the National Airspace System

    Data.gov (United States)

    National Aeronautics and Space Administration — Unmanned aircraft systems (UAS) can be used for scientific, emergency management, and defense missions, among others. The existing federal air regulations,...

  15. 75 FR 16817 - 2010 Scientific Meeting of the National Antimicrobial Resistance Monitoring System; Public...

    Science.gov (United States)

    2010-04-02

    ... Scientific Meeting of the National Antimicrobial Resistance Monitoring System; Public Meeting; Request for... Meeting of the National Antimicrobial Resistance Monitoring System.'' The topic to be discussed is the results from the National Antimicrobial Resistance Monitoring System (NARMS) and related antimicrobial...

  16. 76 FR 37356 - 2011 Scientific Meeting of the National Antimicrobial Resistance Monitoring System; Public...

    Science.gov (United States)

    2011-06-27

    ...] 2011 Scientific Meeting of the National Antimicrobial Resistance Monitoring System; Public Meeting... Scientific Meeting of the National Antimicrobial Resistance Monitoring System.'' The topic to be discussed is animal and retail sampling methods for the National Antimicrobial Resistance Monitoring System (NARMS...

  17. Role of logistics centres in national logistics system

    Directory of Open Access Journals (Sweden)

    2010-06-01

    Full Text Available This article presents a division of logistics centres according to various criteria and specifies their role in a national logistics system. It provides a classification of the main logistics network nodes. It also describes those features of logistics centres that have an impact on zoning development of towns and regions. The current situation in the national logistics system has been presented here against theoretical analyses and also a concept for the development of a logistics centre network in Poland has been formulated.

  18. National high-level waste systems analysis report

    Energy Technology Data Exchange (ETDEWEB)

    Kristofferson, K.; Oholleran, T.P.; Powell, R.H.

    1995-09-01

    This report documents the assessment of budgetary impacts, constraints, and repository availability on the storage and treatment of high-level waste and on both existing and pending negotiated milestones. The impacts of the availabilities of various treatment systems on schedule and throughput at four Department of Energy sites are compared to repository readiness in order to determine the prudent application of resources. The information modeled for each of these sites is integrated with a single national model. The report suggests a high-level-waste model that offers a national perspective on all high-level waste treatment and storage systems managed by the Department of Energy.

  19. Systems reliability analysis for the national ignition facility

    International Nuclear Information System (INIS)

    Majumdar, K.C.; Annese, C.E.; MacIntyre, A.T.; Sicherman, A.

    1996-01-01

    A Reliability, Availability and Maintainability (RAM) analysis was initiated for the National Ignition Facility (NIF). The NIF is an inertial confinement fusion research facility designed to achieve controlled thermonuclear reaction; the preferred site for the NIF is the Lawrence Livermore National Laboratory (LLNL). The NIF RAM analysis has three purposes: (1) to allocate top level reliability and availability goals for the systems, (2) to develop an operability model for optimum maintainability, and (3) to determine the achievability of the allocated goals of the RAM parameters for the NIF systems and the facility operation as a whole. An allocation model assigns the reliability and availability goals for front line and support systems by a top-down approach; reliability analysis uses a bottom-up approach to determine the system reliability and availability from component level to system level

  20. 78 FR 9883 - National Advisory Committee for Implementation of the National Forest System Land Management...

    Science.gov (United States)

    2013-02-12

    ... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of... Jasper, Ecosystem Management Coordination, 202-260-9400, [email protected] . Individuals who use... USDA Forest Service, Ecosystem Management Coordination, 201 14th Street SW., Mail Stop 1104, Washington...

  1. The Phantom National? Assembling National Teaching Standards in Australia's Federal System

    Science.gov (United States)

    Savage, Glenn C.; Lewis, Steven

    2018-01-01

    In this paper, we use the development of the Australian Professional Standards for Teachers (APST) as an illustrative case to examine how national schooling reforms are assembled in Australia's federal system. Drawing upon an emerging body of research on "policy assemblage" within the fields of policy sociology, anthropology and critical…

  2. State and National Water Fluoridation System (Public Water Systems)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Water Fluoridation Reporting System (WFRS) has been developed to provide tools to assist states in managing fluoridation programs. WFRS is designed to track all...

  3. A national environmental monitoring system to support the Moroccan sustainable development strategy

    Science.gov (United States)

    Mourhir, A.; Rachidi, T.

    2010-12-01

    Morocco is a mountainous country, subject to both marine and Saharan influences. The increase in population has led to an increase of the gross domestic product (GDP), which accentuated by inadequate resource management, has been accompanied by the degradation of the environment. The annual cost of environmental damage has been estimated at nearly eight percent of Morocco’s GDP. Morocco is a country that has scarce natural resources, especially arable land and water. In recent years, intensive agricultural production, large-scale irrigation schemes, industrialization, and urbanization have been creating serious problems. The country has faced severe air, water and soil pollution, environmental health problems, deforestation and soil erosion. The country is very vulnerable to impacts of global climate change. Morocco’s approach to sustainable development (SD) is mainly environmental. The two main documents for Morocco’s SD strategy are the National Strategy for the Protection of the Environment and Sustainable Development (SNPEDD), 1995, and the National Plan of Action for the Environment (PANE), 1998. SNPEDD’s main objective is the integration and strengthening of environmental concerns in economic development activities. The activities for the formulation and implementation of the strategy include: a) studies on the state of the Moroccan environment; b) formulation of the PANE; c) preparation of a sensitization program on environmental issues and the implementation of a database and information system on the environment; (d) preparation of regional and local environmental monographies. The aim of the current work is to create an information system as an approach to complex sustainability analyses at the national level using GIS technologies. This information system includes the following: 1.Development of a database of SD indicators and historical data. Morocco has been involved in the working framework of the Mediterranean Commission for Sustainable

  4. Preloading Effect on Strengthening Efficiency of RC Beams Strengthened with Non- and Pretensioned NSM Strips

    Directory of Open Access Journals (Sweden)

    Renata Kotynia

    2018-02-01

    Full Text Available The near surface mounted (NSM technique has been shown to be one of the most promising methods for upgrading reinforced concrete (RC structures. Many tests carried out on RC members strengthened in flexure with NSM fiber-reinforced polymer (FRP systems have demonstrated greater strengthening efficiency than the use of externally-bonded (EB FRP laminates. Strengthening with simultaneous pretensioning of the FRP results in improvements in the serviceability limit state (SLS conditions, including the increased cracking moment and decreased deflections. The objective of the reported experimental program, which consisted of two series of RC beams strengthened in flexure with NSM CFRP strips, was to investigate the influence of a number of parameters on the strengthening efficiency. The test program focused on an analysis of the effects of preloading on the strengthening efficiency which has been investigated very rarely despite being one of the most important parameters to be taken into account in strengthening design. Two preloading levels were considered: the beam self-weight only, which corresponded to stresses on the internal longitudinal reinforcement of 25% and 14% of the yield stress (depending on a steel reinforcement ratio, and the self-weight with the additional superimposed load, corresponding to 60% of the yield strength of the unstrengthened beam and a deflection equal to the allowable deflection at the SLS. The influence of the longitudinal steel reinforcement ratio was also considered in this study. To reflect the variability seen in existing structures, test specimens were varied by using different steel bar diameters. Finally, the impact of the composite reinforcement ratio and the number of pretensioned FRP strips was considered. Specimens were divided into two series based on their strengthening configuration: series “A” were strengthened with one pretensioned and two non-pretensioned carbon FRP (CFRP strips, while series

  5. 77 FR 75254 - List of Units of the National Park System Exempt From the Provisions of the National Parks Air...

    Science.gov (United States)

    2012-12-19

    ... Park Service List of Units of the National Park System Exempt From the Provisions of the National Parks Air Tour Management Act AGENCIES: Federal Aviation Administration, Transportation; National Park Service, Interior. ACTION: List of Exempt Parks. SUMMARY: The National Parks Air Tour Management Act...

  6. Strategic environmental evaluation of National Transmission System Plan in Italy

    International Nuclear Information System (INIS)

    Lanadio, E.; Motawi, A.; Rizzuto, R.; Cappiello, A.; Micotti, M.

    2008-01-01

    The entry into force of part II of D. Lgs. 152/2006 establishing the procedures for strategic environmental assessment for plans and programs. The application of legislation to the development plan of the electric network of the National Transmission System verify testing conducted by Terna with ministries and authorities with environmental competences [it

  7. Sandia National Laboratories photovoltaic balance of systems program

    Science.gov (United States)

    Bonn, Russell H.; Ginn, Jerry; Hund, Tom; Gonzalez, Sigfredo; Ralph, Mark; Strommen, Roger

    1999-03-01

    The Sandia National Laboratories photovoltaic balance of system (BOS) program is sponsored by the Department of Energy to increase the reliability and lower the cost of BOS components. Efforts for FY1998 are discussed. Principal efforts include a quality program for inverter manufacturers, a grid-tied anti-islanding program, development of a hybrid inverter, hardware benchmarking program, and a battery evaluation program.

  8. Approach the National Quality Audit System for Radiotherapy in Latvia

    OpenAIRE

    Dehtjars, J; Popovs, S; Plaude, S

    2008-01-01

    It is very important to make National Quality Audit to ensure accurate conformal RT delivery. It is necessary to develop an Audit system to inspect all Conformal RT and IMRT delivery chain including the Quality checks of linear accelerator, Multileaf Collimator (MLC), Computer Tomography (CT) scanner or simulator, target and tissue delineation, plan evaluation, and delivery.

  9. National Innovation Systems in Brazil, Russia, India, China and ...

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

    Globalization and Innovation in China's ICT industry. 49229. Studies. Innovation and inequality: China's choice for a harmonious society. 49224. Papers. Comparative report on the role of small and medium enterprise in the national innovation system of BRICS : annex 8; BRICS project. 48315. Papers. Comparative report ...

  10. The South African national non-natural mortality surveillance system ...

    African Journals Online (AJOL)

    Background. While individual mortuaries have recorded data for non-natural deaths in time-limited studies, there have been no systematic efforts to draw forensic-medical services and state mortuaries into a nationwide fatal injury surveillance system. Beginning in June 1998, the National Non-Natural Mortality Surveillance ...

  11. General framework and key technologies of national nuclear emergency system

    International Nuclear Information System (INIS)

    Yuan Feng; Li Xudong; Zhu Guangying; Song Yafeng; Zeng Suotian; Shen Lifeng

    2014-01-01

    Nuclear emergency is the important safeguard for the sustainable development of nuclear energy, and is the significant part of national public crisis management. The paper gives the definition of nuclear emergency system explicitly based on the analysis of the characteristics of the nuclear emergency, and through the research of the structure and general framework, the general framework of the national nuclear emergency management system (NNEMS) is obtained, which is constructed in four parts, including one integrative platform, six layers, eight applications and two systems, then the paper indicate that the architecture of national emergency system that should be laid out by three-tiers, i.e. national, provincial and organizations with nuclear facilities, and also describe the functions of the NNEMS on the nuclear emergency's workflow. Finally, the paper discuss the key technology that NNIEMS needed, such as WebGIS, auxiliary decision-making, digitalized preplan and the conformity and usage of resources, and analyze the technical principle in details. (authors)

  12. National Ignition Facility system design requirements conventional facilities SDR001

    International Nuclear Information System (INIS)

    Hands, J.

    1996-01-01

    This System Design Requirements (SDR) document specifies the functions to be performed and the minimum design requirements for the National Ignition Facility (NIF) site infrastructure and conventional facilities. These consist of the physical site and buildings necessary to house the laser, target chamber, target preparation areas, optics support and ancillary functions

  13. National Plant Germplasm System: Critical Role of Customer Service

    Science.gov (United States)

    The National Plant Germplasm System (NPGS) conserves plant genetic resources, not only for use by future generations, but for immediate use by scientists and educators around the world. With a great deal of interaction between genebank curators and users of plant genetic resources, customer service...

  14. Climate change adaptation for the US national wildlife refuge system

    Science.gov (United States)

    Brad Griffith; J. Michael Scott; Robert Adamcik; Daniel Ashe; Brian Czech; Robert Fischman; Patrick Gonzalez; Joshua Lawler; A. David McGuire; Anna. Pidgorna

    2009-01-01

    Since its establishment in 1903, the National Wildlife Refuge System (NWRS) has grown to 635 units and 37 Wetland Management Districts in the United States and its territories. These units provide the seasonal habitats necessary for migratory waterfowl and other species to complete their annual life cycles. Habitat conversion and fragmentation, invasive species,...

  15. The use of management Information System in National Board for ...

    African Journals Online (AJOL)

    This study investigated the barriers to the Use of Management Information System in National Board for Technical Education Kaduna. The study adopted the survey method of research and the instruments used for data collection were the questionnaire and unstructured interview. The target population of the study ...

  16. The 1978 National Fire-Danger Rating System: technical documentation

    Science.gov (United States)

    Larry S. Bradshaw; John E. Deeming; Robert E. Burgan; Jack D. Cohen

    1984-01-01

    The National Fire-Danger Rating System (NFDRS), implemented in 1972, has been revised and reissued as the 1978 NFDRS. This report describes the full developmental history of the NFDRS, including purpose, technical foundation, and structure. Includes an extensive bibliography and appendixes.

  17. Planning for climate change on the National Wildlife Refuge System

    Science.gov (United States)

    B. Czech; S. Covington; T. M. Crimmins; J. A. Ericson; C. Flather; M. Gale; K. Gerst; M. Higgins; M. Kaib; E. Marino; T. Moran; J. Morton; N. Niemuth; H. Peckett; D. Savignano; L. Saperstein; S. Skorupa; E. Wagener; B. Wilen; B. Wolfe

    2014-01-01

    This document originated in 2008 as a collaborative project of the U.S. Fish and Wildlife Service (FWS) and the University of Maryland's Graduate Program in Sustainable Development and Conservation Biology. The original title was A Primer on Climate Change for the National Wildlife Refuge System. The Primer has evolved into Planning for Climate Change on the...

  18. The Oak Ridge National Laboratory's Robotics and Intelligent Systems Program

    International Nuclear Information System (INIS)

    Meacham, S.A.

    1987-01-01

    The goals of the newly formed Robotics and Intelligent Systems Program are discussed. The application of the remote systems technology developed by the Consolidated Fuel Reprocessing Program for the Department of Energy is presented. The activities (satellite refueling and space station truss assembly) with the National Aeronautics and Space Administration are presented in a videotape format with narration by the presenter. The goals of technology transfer to the private sector and the potential positive impact on the community conclude the oral presentation

  19. Building National Capacity To Implement National Forest Monitoring System In Africa By GLAD

    Science.gov (United States)

    Lola Amani, P. K.

    2017-12-01

    Earth Observation data provide numerous information on the earth and its phenomena from space/satellite. They also offer the ability to compile and analyze information at global or local scales in a timely manner. However, to use them, it is important to develop methods that can enable the extraction of the desired information. Such methods should be robust and consistent enough to be considered for national monitoring systems. At the University of Maryland, the Global Land Analysis and Discovery (GLAD) Laboratory, led by Dr. Hansen, has developed automatic methods using Landsat data that have been applied for the Global Forest Change (GFC) in collaboration with the World Resources Institute (WRI), Google and others to providing information on tree cover loss throughout the global on a yearly basis, and on a daily basis a tree cover loss alert system to improve transparency and accessible at GFW Initiative (Global Forest Watch) website. Following the increasing interest in utilizing the GFC data, the GLAD Laboratory is working closely with national governments of different countries to reinforce their capacities in using the data in the best way and implementing the methodological framework for supporting their national forest monitoring, notification, and reporting (MNV) system. More precisely, the Lab supports step by step the countries in developing their reference emission levels and/or forest reference levels based on the country-specific needs, goals, and requirements, including the definition of the forest. Once in place, the methodology can easily be extended to different applications, such as monitoring the droughts events, etc. Here, we present the work accomplished with the national agencies of some countries in Africa, like Cameroon, Republic of Congo and Madagascar with the support of the Silva-Carbon and USAID-CARPE Programs and WRI. These countries are mainly engaged at different levels of the REDD+ process. Keywords: Earth Observation, Landsat data

  20. Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: integrating scalable psychological interventions in eight countries.

    Science.gov (United States)

    Sijbrandij, Marit; Acarturk, Ceren; Bird, Martha; Bryant, Richard A; Burchert, Sebastian; Carswell, Kenneth; de Jong, Joop; Dinesen, Cecilie; Dawson, Katie S; El Chammay, Rabih; van Ittersum, Linde; Jordans, Mark; Knaevelsrud, Christine; McDaid, David; Miller, Kenneth; Morina, Naser; Park, A-La; Roberts, Bayard; van Son, Yvette; Sondorp, Egbert; Pfaltz, Monique C; Ruttenberg, Leontien; Schick, Matthis; Schnyder, Ulrich; van Ommeren, Mark; Ventevogel, Peter; Weissbecker, Inka; Weitz, Erica; Wiedemann, Nana; Whitney, Claire; Cuijpers, Pim

    2017-01-01

    The crisis in Syria has resulted in vast numbers of refugees seeking asylum in Syria's neighbouring countries as well as in Europe. Refugees are at considerable risk of developing common mental disorders, including depression, anxiety, and posttraumatic stress disorder (PTSD). Most refugees do not have access to mental health services for these problems because of multiple barriers in national and refugee specific health systems, including limited availability of mental health professionals. To counter some of challenges arising from limited mental health system capacity the World Health Organization (WHO) has developed a range of scalable psychological interventions aimed at reducing psychological distress and improving functioning in people living in communities affected by adversity. These interventions, including Problem Management Plus (PM+) and its variants, are intended to be delivered through individual or group face-to-face or smartphone formats by lay, non-professional people who have not received specialized mental health training, We provide an evidence-based rationale for the use of the scalable PM+ oriented programmes being adapted for Syrian refugees and provide information on the newly launched STRENGTHS programme for adapting, testing and scaling up of PM+ in various modalities in both neighbouring and European countries hosting Syrian refugees.

  1. Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: integrating scalable psychological interventions in eight countries

    Science.gov (United States)

    Sijbrandij, Marit; Acarturk, Ceren; Bird, Martha; Bryant, Richard A; Burchert, Sebastian; Carswell, Kenneth; de Jong, Joop; Dinesen, Cecilie; Dawson, Katie S.; El Chammay, Rabih; van Ittersum, Linde; Jordans, Mark; Knaevelsrud, Christine; McDaid, David; Miller, Kenneth; Morina, Naser; Park, A-La; Roberts, Bayard; van Son, Yvette; Sondorp, Egbert; Pfaltz, Monique C.; Ruttenberg, Leontien; Schick, Matthis; Schnyder, Ulrich; van Ommeren, Mark; Ventevogel, Peter; Weissbecker, Inka; Weitz, Erica; Wiedemann, Nana; Whitney, Claire; Cuijpers, Pim

    2017-01-01

    ABSTRACT The crisis in Syria has resulted in vast numbers of refugees seeking asylum in Syria’s neighbouring countries as well as in Europe. Refugees are at considerable risk of developing common mental disorders, including depression, anxiety, and posttraumatic stress disorder (PTSD). Most refugees do not have access to mental health services for these problems because of multiple barriers in national and refugee specific health systems, including limited availability of mental health professionals. To counter some of challenges arising from limited mental health system capacity the World Health Organization (WHO) has developed a range of scalable psychological interventions aimed at reducing psychological distress and improving functioning in people living in communities affected by adversity. These interventions, including Problem Management Plus (PM+) and its variants, are intended to be delivered through individual or group face-to-face or smartphone formats by lay, non-professional people who have not received specialized mental health training, We provide an evidence-based rationale for the use of the scalable PM+ oriented programmes being adapted for Syrian refugees and provide information on the newly launched STRENGTHS programme for adapting, testing and scaling up of PM+ in various modalities in both neighbouring and European countries hosting Syrian refugees. PMID:29163867

  2. Idaho National Laboratory Integrated Safety Management System FY 2013 Effectiveness Review and Declaration Report

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, Farren [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2013-12-01

    Idaho National Laboratory (INL) performed an Annual Effectiveness Review of the Integrated Safety Management System (ISMS), per 48 Code of Federal Regulations (CFR) 970.5223 1, “Integration of Environment, Safety and Health into Work Planning and Execution.” The annual review assessed Integrated Safety Management (ISM) effectiveness, provided feedback to maintain system integrity, and identified target areas for focused improvements and assessments for Fiscal Year (FY) 2014. Results of the FY 2013 annual effectiveness review demonstrate that the INL’s ISMS program is “Effective” and continually improving and shows signs of being significantly strengthened. Although there have been unacceptable serious events in the past, there has also been significant attention, dedication, and resources focused on improvement, lessons learned and future prevention. BEA’s strategy of focusing on these improvements includes extensive action and improvement plans that include PLN 4030, “INL Sustained Operational Improvement Plan, PLN 4058, “MFC Strategic Excellence Plan,” PLN 4141, “ATR Sustained Excellence Plan,” and PLN 4145, “Radiological Control Road to Excellence,” and the development of LWP 20000, “Conduct of Research.” As a result of these action plans, coupled with other assurance activities and metrics, significant improvement in operational performance, organizational competence, management oversight and a reduction in the number of operational events is being realized. In short, the realization of the fifth core function of ISMS (feedback and continuous improvement) and the associated benefits are apparent.

  3. U.S. national nuclear material control and accounting system

    International Nuclear Information System (INIS)

    Taylor, S; Terentiev, V G

    1998-01-01

    Issues related to nuclear material control and accounting and illegal dealing in these materials were discussed at the April 19--20, 1996 Moscow summit meeting (G7 + Russia). The declaration from this meeting reaffirmed that governments are responsible for the safety of all nuclear materials in their possession and for the effectiveness of the national control and accounting system for these materials. The Russian delegation at this meeting stated that ''the creation of a nuclear materials accounting, control, and physical protection system has become a government priority''. Therefore, in order to create a government nuclear material control and accounting system for the Russian Federation, it is critical to study the structure, operating principles, and regulations supporting the control and accounting of nuclear materials in the national systems of nuclear powers. In particular, Russian specialists have a definite interest in learning about the National Nuclear Material Control and Accounting System of the US, which has been operating successfully as an automated system since 1968

  4. The national response system: Where do we go from here?

    International Nuclear Information System (INIS)

    Johnson, R.C.

    1993-01-01

    The response to the Exxon Valdez incident showed that the nation needs to be better prepared to respond to a spill of that magnitude. In research conducted on the Valdez response, several inadequacies were noted in the National Response System (NRS). A key deficiency identified was the critical need for a standardized management system to direct the response effort more effectively and efficiently. The most pressing question for preparedness planners in improving the NRS is open-quotes where do we go from here?close quotes. In answering this question, planners must address another question, open-quotes how long is it going to take?close quotes. There has been wide spread failure to put existing knowledge into practice. To fill the management void identified in the NRS, it is imperative that a response management system be adopted as soon as possible. Once adopted, it can be modified and refined to provide a more effective response. The system proposed in this paper uses the sound management practices of an incident command system and modifies and/or expands these practices to fit onto the foundation built by the NRS. This response management system could be used for all spills from minor ones to large, catastrophic spills of national significance (SONS)

  5. Strengthening Bridges with Prestressed CFRP Strips

    Science.gov (United States)

    Siwowski, Tomasz; Żółtowski, Piotr

    2012-06-01

    Limitation of bridge's carrying bearing capacity due to aging and deterioration is a common problem faced by road administration and drivers. Rehabilitation of bridges including strengthening may be applied in order to maintain or upgrade existing bridge parameters. The case studies of strengthening of two small bridges with high modulus prestressed CFRP strips have been presented in the paper. The first one - reinforced concrete slab bridge - and the other - composite steel-concrete girder bridge - have been successfully upgraded with quite new technology. In both cases the additional CFRP reinforcement let increasing of bridge carrying capacity from 15 till 40 metric tons. The CFRP strip prestressing system named Neoxe Prestressing System (NPS), developed by multi-disciplinary team and tested at full scale in Rzeszow University of Technology, has been also described in the paper.

  6. Preliminary systems engineering evaluations for the National Ecological Observatory Network.

    Energy Technology Data Exchange (ETDEWEB)

    Robertson, Perry J.; Kottenstette, Richard Joseph; Crouch, Shannon M.; Brocato, Robert Wesley; Zak, Bernard Daniel; Osborn, Thor D.; Ivey, Mark D.; Gass, Karl Leslie; Heller, Edwin J.; Dishman, James Larry; Schubert, William Kent; Zirzow, Jeffrey A.

    2008-11-01

    The National Ecological Observatory Network (NEON) is an ambitious National Science Foundation sponsored project intended to accumulate and disseminate ecologically informative sensor data from sites among 20 distinct biomes found within the United States and Puerto Rico over a period of at least 30 years. These data are expected to provide valuable insights into the ecological impacts of climate change, land-use change, and invasive species in these various biomes, and thereby provide a scientific foundation for the decisions of future national, regional, and local policy makers. NEON's objectives are of substantial national and international importance, yet they must be achieved with limited resources. Sandia National Laboratories was therefore contracted to examine four areas of significant systems engineering concern; specifically, alternatives to commercial electrical utility power for remote operations, approaches to data acquisition and local data handling, protocols for secure long-distance data transmission, and processes and procedures for the introduction of new instruments and continuous improvement of the sensor network. The results of these preliminary systems engineering evaluations are presented, with a series of recommendations intended to optimize the efficiency and probability of long-term success for the NEON enterprise.

  7. A review of the National pharmacovigilance system in Malta - implementing and operating a pharmacovigilance management system.

    Science.gov (United States)

    Tanti, Amy; Micallef, Benjamin; Serracino-Inglott, Anthony; Borg, John-Joseph

    2017-01-01

    Regulatory authorities have a legal mandate to implement and maintain a Pharmacovigilance System designed to monitor the safety of authorised medicinal products and detect any change to their risk-benefit balance. Areas covered: This review maps the implementation of pharmacovigilance activities in Malta since accession in the EU in mid 2004 and discusses the challenges the Maltese Regulator encountered while setting up adequate and effective systems to fulfil its legal mandate. Areas reviewed are those around ADR reporting, promotion and safety communications including rapid alerts and recalls, direct healthcare professional communications, risk minimisation measures and safety circulars and quality systems. Expert opinion: Within a ten year period, 3 EU directives on pharmacovigilance were implemented by our agency. Despite limitations to resources, based on a prioritised implementation, the legislation provisions are now fully operational with a good level of sustainability. Lessons learnt from this process are discussed in this review. The coming years will involve strengthening and consolidation of existing processes.

  8. Pediatric Neurosurgical Outcomes Following a Neurosurgery Health System Intervention at Mulago National Referral Hospital in Uganda.

    Science.gov (United States)

    Fuller, Anthony T; Haglund, Michael M; Lim, Stephanie; Mukasa, John; Muhumuza, Michael; Kiryabwire, Joel; Ssenyonjo, Hussein; Smith, Emily R

    2016-11-01

    Pediatric neurosurgical cases have been identified as an important target for impacting health disparities in Uganda, with over 50% of the population being less than 15 years of age. The objective of the present study was to evaluate the effects of the Duke-Mulago collaboration on pediatric neurosurgical outcomes in Mulago National Referral Hospital. We performed retrospective analysis of all pediatric neurosurgical cases who presented at Mulago National Referral Hospital in Kampala, Uganda, to examine overall, preprogram (2005-2007), and postprogram (2008-2013) outcomes. We analyzed mortality, presurgical infections, postsurgical infections, length of stay, types of procedures, and significant predictors of mortality. Data on neurosurgical cases was collected from surgical logbooks, patient charts, and Mulago National Referral Hospital's yearly death registry. Of 820 pediatric neurosurgical cases, outcome data were complete for 374 children. Among children who died within 30 days of a surgical procedure, the largest group was less than a year old (45%). Postinitiation of the Duke-Mulago collaboration, we identified an overall increase in procedures, with the greatest increase in cases with complex diagnoses. Although children ages 6-18 years of age were 6.66 times more likely to die than their younger counterparts preprogram, age was no longer a predictive variable postprogram. When comparing pre- and postprogram outcomes, mortality among pediatric patients within 30 days after a neurosurgical procedure increased from 4.3% to 10.0%, mortality after 30 days increased slightly from 4.9% to 5.0%, presurgical infections decreased by 4.6%, and postsurgery infections decreased slightly by 0.7%. Our data show the provision of more complex neurological procedures does not necessitate improved outcomes. Rather, combining these higher-level procedures with essential pre- and postoperative care and continued efforts in health system strengthening for pediatric neurosurgical

  9. Strategy for Strengthening Farmer Groups by Institutional Strengthening

    Directory of Open Access Journals (Sweden)

    Purbayu Budi Santoso

    2015-08-01

    Full Text Available Agriculture sector becomes a spotlight because this sector will be full of potential but the welfare of farmers who become the leading actor is not guaranteed and has a poor tendency. The purpose of this study is to formulate strategies to strengthen farmers' groups in order to create the marketing of the agricultural sector that benefit farmers. The method used to achieve this goal is to use a qualitative approach and Analytical Network Process. In addition to the secondary data obtained from several agencies, this study also uses primary data obtained by in-depth interviews and observations. This research results a priority of aspects of the institutional strengthening of farmer groups as well as priority issues and priorities of the solution of each aspect. In addition, the priority of alternative strategies resulted based on the problems and solutions that have been analyzed in order to solve the problems in the institutional strengthening of farmer groups in Demak.

  10. Licensing telemedicine: the need for a national system.

    Science.gov (United States)

    Jacobson, P D; Selvin, E

    2000-01-01

    The expansion of information technology has shattered geographic boundaries, allowing for extraordinarily increased access to health information and expanded opportunities for telemedicine practice across state boundaries. But despite its recent growth, telemedicine technology remains embedded in a state-based licensure system that places severe limits on its expansion. The current system of medical licensure is based primarily on statutes written at the turn of the 20th century. This system is inadequate to address the emerging medical practices and future uses of medical technology in the telecommunications age. To respond to the changes offered by the telecommunications revolution, we need to design a new regulatory structure for the 21st century. The purpose of this article is to propose a policy of national telemedicine licensure. The primary goal here is not to simply develop a policy proposal, but to discuss the rationale for national licensure and place it on the policy agenda. A national licensure system will expand the market for telemedicine, promote both the use and development of new technologies, and simultaneously eliminate many of the legal and regulatory ambiguities that plague and constrain the present system.

  11. Rosatom's Crisis Response Centre within the national nuclear safety system

    International Nuclear Information System (INIS)

    Smirnov, S.N.; Komarovskij, A.V.; Moskalev, V.A.

    2011-01-01

    The Rosatom Corporation includes a number of subsidiaries associated with nuclear energy use as well as with the military, scientific, technological, nuclear and radiation safety management aspects. The Rosatom Corporation has a well-established and efficient industry-wide system of emergency prevention and response, whose purpose is to ensure safe functioning of the nuclear industry, protection of personnel, the public and nature from potential dangers; it is also a functional subsystem of the unified national system of emergency prevention and response. Overall management of the system is performed by Director General of the Rosatom Corporation, overall methodological management - by the Department of Licensing, Nuclear and Radiation Safety; everyday management of the emergency prevention and response system, round-the-clock monitoring and informational support - by the Rosatom Crisis and Response Centre (CRC). CRC acts as the national focal point for warning and communication in Russia, which provides continuous round-the-clock preparedness to cooperate with the IAEA's Incident and Emergency Centre using the formats of the ENATOM international emergency response system, similar national crisis response centres abroad [ru

  12. Physical protection as the most important part of the national system of combating illicit trafficking

    International Nuclear Information System (INIS)

    Ivanov, P.; Kokhan, V.D.

    2001-01-01

    based on the Convention on Physical Protection, IAEA Guidelines and Recommendations on Physical Protection of Nuclear Materials and Nuclear Installations as well as 'Basic Safety Standards for Ionising Radiation', practical application of which facilitates the development of a national system for combating illicit trafficking of radioactive materials and sources of radiation. These documents will assist in creating basic national legislation. An integrated approach should be provided for the improvement of the System of Physical Protection. These are main provisions of the Concept of Integration of the System of Physical Protection with the System of Accountancy and Control of Nuclear Materials. Goals: earlier detection of theft; improve accuracy of accounts, strengthen objectives and integrity of control; ensure personnel's safety; reduce dependence on human factor; speed-up detection and retrieval of stolen or lost material. The system is based on: national norms and regulations for accountancy, control and physical protection of nuclear materials and installations; existing control and management structure for nuclear materials and nuclear installations; senior officials and companies responsible for organization and quality assurance regarding work on accountancy, control and physical protection; new principles of accountancy and control; methods for supervision of working procedures, response to any abnormal event; model of life circle of nuclear materials; zone classification of nuclear materials etc. Establishment of single integrated system for accountancy, control and physical protection will undoubtedly lead to handling illicit trafficking of nuclear materials more efficiently and to eliminating unauthorized distribution of nuclear materials

  13. Safeguards implementation and strengthening in Belarus

    International Nuclear Information System (INIS)

    Sudakou, I.; Piotukh, O.

    2001-01-01

    Full text: Introduction - It is a matter of common knowledge that non proliferation regime includes such components as accounting and control of nuclear materials, physical protection of nuclear materials, export/import control and measures to combat illicit trafficking of nuclear materials. The task to establish and implement the state system of accounting and control of nuclear materials (SSAC) as well functions of the national competent body for physical protection of nuclear materials (PP) were assigned to the Committee for Supervision of Industrial and Nuclear Safety (PROMATOMNADZOR) by a resolution of the Council of Ministers in 1993. Basic regulatory documents governing functioning of the SSAC and PP both at the state and facility levels were put in force in 1995 by order of Promatomnadzor. System of accounting and control of nuclear materials - Nuclear material accounting is based on a computer program developed with due regard to the requirements of the IAEA. The program is written on FoxPro under control of the MSWINDOWS operating system. The program allows us to work with archives, to take account of material movements in real time, to prepare accounting documents and reports and to record measurement results. The system of measurement of nuclear materials provides authenticity and reliability of data. Measuring instrumentation was selected according to types of material available. With regard to the measurement system employed there are still some problems to be solved. Among them, certification of the instruments, working out and approval of quality assurance procedures, acquisition of standards. Accounting Documents and reports are processed by Promatomnadzor, including completeness and authenticity of reports. Archived data are kept with respect to material quantities in MBA's, inventory changes, etc. Information coding is based on the code 10 of the IAEA. Physical protection of nuclear materials and facilities - Nuclear materials of the Republic of

  14. Antenatal Care Strengthening in Jimma, Ethiopia: A Mixed-Method Needs Assessment

    Directory of Open Access Journals (Sweden)

    Sarah Fredsted Villadsen

    2014-01-01

    Full Text Available Objective. We assessed how health system priorities matched user expectations and what the needs for antenatal care (ANC strengthening were for improved maternal health in Jimma, Ethiopia. Methods. A questionnaire survey among all recent mothers in the study area was conducted to study the content of ANC and to identify the predictors of low ANC satisfaction. Further, a qualitative approach was applied to understand perceptions, practices, and policies of ANC. Results. There were no national guidelines for ANC in Ethiopia. Within the health system, the teaching of health professional students was given high priority, and that contributed to a lack of continuity and privacy. To the women, poor user-provider interaction was a serious concern hindering the trust in the health care providers. Further, the care provision was compromised by the inadequate laboratory facilities, unstructured health education, and lack of training of health professionals. Conclusions. Health system trials are needed to study the feasibility of ANC strengthening in the study area. Nationally and internationally, the leadership needs to be strengthened with supportive supervision geared towards building trust and mutual respect to protect maternal and infant health.

  15. Photovoltaic power systems and the National Electrical Code: Suggested practices

    Energy Technology Data Exchange (ETDEWEB)

    Wiles, J. [New Mexico State Univ., Las Cruces, NM (United States). Southwest Technology Development Inst.

    1996-12-01

    This guide provides information on how the National Electrical Code (NEC) applies to photovoltaic systems. The guide is not intended to supplant or replace the NEC; it paraphrases the NEC where it pertains to photovoltaic systems and should be used with the full text of the NEC. Users of this guide should be thoroughly familiar with the NEC and know the engineering principles and hazards associated with electrical and photovoltaic power systems. The information in this guide is the best available at the time of publication and is believed to be technically accurate; it will be updated frequently. Application of this information and results obtained are the responsibility of the user.

  16. Photovoltaic Power Systems and the National Electrical Code: Suggested Practices

    Energy Technology Data Exchange (ETDEWEB)

    None

    2002-02-01

    This guide provides information on how the National Electrical Code (NEC) applies to photovoltaic systems. The guide is not intended to supplant or replace the NEC; it paraphrases the NEC where it pertains to photovoltaic systems and should be used with the full text of the NEC. Users of this guide should be thoroughly familiar with the NEC and know the engineering principles and hazards associated with electrical and photovoltaic power systems. The information in this guide is the best available at the time of publication and is believed to be technically accurate; it will be updated frequently.

  17. Challenges in strengthening radiation safety and security programme in Malaysia

    International Nuclear Information System (INIS)

    Noriah, M.A.

    2010-01-01

    This paper illustrates the Malaysian experience in implementing steps in strengthening radiation safety and security through certification of radiation safety personnel, which is dedicated to meet the current and future needs in sustainability of radiation safety and security systems. Commitment from the workforce to treat safety as a priority and the ability to turn a requirement into a practical language is also important in implementing the radiation safety policy efficiently. Through this effort, we are able to create a basis for adequate protection of workers, the public and the environment and encourage licensees to manage radiation safety and security based on performance, and not on compliance culture, with the final objective of professing a safety culture through self regulation. This will certainly benefit an organisation with ultimate goals are to continuously strive for a healthy, accident free and environmentally sound workplace and community, while providing the technical support needed to meet the national mission. This will strengthen the radiation safety and security programme and could be used to assist in manpower development once Malaysia makes the decision to embark on a nuclear power programme. (author)

  18. The role of the International Atomic Energy Agency in technology transfer for the peaceful use of nuclear energy and the strengthening of the Safeguards system, Buenos Aires, 15 December 1998

    International Nuclear Information System (INIS)

    ElBaradei, M.

    1998-01-01

    The document reproduces the text of the conference given by the Director General of the IAEA at the meeting of the Council for International Relations in Buenos Aires, Argentina, on 15 December 1998. After a short presentation of Argentina's participation in all aspects of the work of the Agency, the conference focuses on the Agency's role in the following areas: nuclear power and sustainable energy development, including nuclear safety aspects, verification and the strengthened safeguards system (including future prospects of verification), and technology transfer with emphasis on Agency's Technical Co-operation Programme

  19. The role of the International Atomic Energy Agency in technology transfer for the peaceful use of nuclear energy and the strengthening of the Safeguards system, Brasilia, 16 December 1998

    International Nuclear Information System (INIS)

    ElBaradei, M.

    1998-01-01

    The document reproduces the text of the conference given by the Director General of the IAEA at the Diplomatic Academy of the Ministry of Foreign Affairs of Brazil in Brasilia on 16 December 1998. After a short presentation of Brazil's participation in all aspects of the work of the Agency, the conference focuses on the Agency's role in the following areas: verification and the strengthened safeguards system (including future prospects of verification), technology transfer (mainly through the Technical Co-operation Programme), and nuclear power and sustainable energy development, including nuclear safety aspects

  20. 76 FR 16795 - The National Antimicrobial Resistance Monitoring System Strategic Plan 2011-2015; Request for...

    Science.gov (United States)

    2011-03-25

    ...] The National Antimicrobial Resistance Monitoring System Strategic Plan 2011-2015; Request for Comments..., FDA requested comments on a document for the National Antimicrobial Resistance Monitoring System....fda.gov/AnimalVeterinary/SafetyHealth/AntimicrobialResistance/NationalAntimicrobialResistance...

  1. A Delivery Model for Home Fortification of Complementary Foods with Micronutrient Powders: Innovation in the Context of Vietnamese Health System Strengthening

    Directory of Open Access Journals (Sweden)

    Marie Nguyen

    2016-04-01

    Full Text Available Adding micronutrient powders (MNP to complementary foods at the point of preparation (home fortification can improve micronutrient status of young children. Ensuring sustained access to MNPs at scale, however, remains challenging in many countries. The Global Alliance for Improved Nutrition (GAIN partnered with the National Institute of Nutrition (NIN in Vietnam to pioneer the distribution of a locally-produced MNP, provided for sale through the public health system with counseling on optimal infant and young child feeding practices by trained health workers. Different packaging options were available to adapt to caregivers’ disposable income. During the six-month pilot, 1.5 million sachets were sold through 337 health centers across four provinces, targeting children 6–59 months of age. Sales were routinely monitored, and a cross-sectional survey in 32 communes for caregivers (n = 962 and health staff (n = 120 assessed MNP coverage and compliance, five months after the start of distribution. A total of 404 caregivers among the 962 caregivers surveyed (i.e., 42% had visited the health center in the past year. Among them, 290 caregivers had heard about the product and a total of 217caregivers had given the MNP to their child at least once, representing a conversion rate from product awareness to product trial of 74.8%. The effective coverage (i.e., consumption of ≥3 sachets/child/week was 11.5% among the total surveyed caregivers and reached 27.3% amongst caregivers who visited health centers in the previous month. The MNP purchase trends showed that the number of sachets bought by caregivers was positively correlated with the wealth index. The pilot showed that providing MNPs for sale in packs of various quantities, combined with infant and young child feeding (IYCF counseling at the health center, is effective for groups accessing the health system.

  2. Strengthening the security of radiation sources in Ghana

    International Nuclear Information System (INIS)

    Emi-Reynolds, G.; Banini, G.K.; Flecther, J.J.; Ennison, I.; Schandorf, C.

    1998-01-01

    Legislative instrument LI 1559 of 1993 established the Radiation Protection Board (RPB) as the National Competent Authority (NCA) on radiation matters in Ghana. The Board advises Government through the Ghana Atomic Energy Commission on matters relating to radiation safety, security of sources, sales, import and export, contamination in food and environment, among others. It has wide ranging regulatory power and works in association with country authorities. The regulations in place for controlling the movement and use of radioactive materials in Ghana are discussed. Accountability for radioactive materials especially for those which were brought in before the establishment of the RPB have been the focus of our discussion. The need to for intensify educational programs for the public on matters relating to effect of radiation on man and environment is recommended. Strengthening of regulatory control of sources and intensifying efforts against smuggling, unauthorised use and systems for notification on radioactive transport accidents are noted. (author)

  3. Health protection in Brazil: the National Sanitary Surveillance System.

    Science.gov (United States)

    Seta, Marismary Horsth De; Oliveira, Catia Veronica Dos Santos; Pepe, Vera Lúcia Edais

    2017-10-01

    This essay presents the singular arrangement named Health Surveillance in Brazil and the specificities of its components: public Health Surveillance, Worker's Surveillance, Environmental Surveillance, Sanitary Surveillance, as well as the constitutional determination to carry out the actions of sanitary and epidemiological surveillance and Worker's Surveillance. The two national systems of protection and promote health are also presented - National Public Health Surveillance System and National Sanitary Surveillance System, with an emphasis on the regulatory issues in health made by the latter and some constraints to its action by the Legislative Branch. It reaffirms the Brazilian State's constitutional duty to protect health, and to provide the means for adequate functioning of the two systems, bearing in mind that defense of the public interest in health products and services means confronting oligopolies of transnational economic interests. This paper states the opinion that the financial constraints facing the Brazilian State from time to time cannot be allowed to prevail over the rights of citizenship, independently of the public underfunding of health in Brazil.

  4. Evidence-based policy responses to strengthen health, community and legislative systems that care for women in Australia with female genital mutilation / cutting.

    Science.gov (United States)

    Varol, Nesrin; Hall, John J; Black, Kirsten; Turkmani, Sabera; Dawson, Angela

    2017-05-18

    The physical and psychological impact of female genital mutilation / cutting (FGM/C) can be substantial, long term, and irreversible. Parts of the health sector in Australia have developed guidelines in the management of FGM/C, but large gaps exist in community and professional knowledge of the consequences and treatment of FGM/C. The prevalence of FGM/C amongst Australian women is unknown. Our article reviews the literature on research on FGM/C in Australia, which focuses on health system response to women and girls with FGM/C. Recommendations are made for policy reform in health, legislation, and community programs to provide the best healthcare, protect children, and help communities abandon this harmful practice. Midwives and doctors in Australia acknowledged a lack of knowledge on FGM/C, clinical guidelines and consequences for maternity care. In a metropolitan Australian hospital with specialised FGM/C care, women with FGM/C had similar obstetric outcomes as women without FGM/C, underlining the importance of holistic FGM/C clinics. Greater focus on integration of refugee and migrant populations into their new cultures may be an important way of facilitating the abandonment of this practice, as is education of communities that practise FGM/C, and experts involved in the care and protection of children. Men could be important advocates for protecting women and girls from violence and FGM/C through a man-to-man strategy with programs focussing on men's health and other personal issues, education, and communication. The Australian Government has identified gender-based violence as an area of priority and has been implementing a National plan to reduce violence against women and their children 2010-2022. A multidisciplinary network of experts on FGM/C could be established within this taskforce to develop well-defined and rapid referral pathways to care for and protect these children, as well as coordinate education and prevention programs to help communities

  5. New integrated information system for pusan national university hospital.

    Science.gov (United States)

    Kim, Hyung Hoi; Cho, Kyung-Won; Kim, Hye Sook; Kim, Ju-Sim; Kim, Jung Hyun; Han, Sang Pil; Park, Chun Bok; Kim, Seok; Chae, Young Moon

    2011-03-01

    This study presents the information system for Pusan National University Hospital (PNUH), evaluates its performance qualitatively, and conducts economic analysis. Information system for PNUH was designed by component-based development and developed by internet technologies. Order Communication System, Electronic Medical Record, and Clinical Decision Support System were newly developed. The performance of the hospital information system was qualitatively evaluated based on the performance reference model in order to identify problem areas for the old system. The Information Economics approach was used to analyze the economic feasibility of hospital information system in order to account for the intangible benefits. Average performance scores were 3.16 for input layer, 3.35 for process layer, and 3.57 for business layer. In addition, the cumulative benefit to cost ratio was 0.50 in 2011, 1.73 in 2012, 1.76 in 2013, 1.71 in 2014, and 1.71 in 2015. The B/C ratios steadily increase as value items are added. While overall performance scores were reasonably high, doctors were less satisfied with the system, perhaps due to the weak clinical function in the systems. The information economics analysis demonstrated the economic profitability of the information systems if all intangible benefits were included. The second qualitative evaluation survey and economic analysis were proposed to evaluate the changes in performance of the new system.

  6. National high-level waste systems analysis plan

    International Nuclear Information System (INIS)

    Kristofferson, K.; Oholleran, T.P.; Powell, R.H.; Thiel, E.C.

    1995-05-01

    This document details the development of modeling capabilities that can provide a system-wide view of all US Department of Energy (DOE) high-level waste (HLW) treatment and storage systems. This model can assess the impact of budget constraints on storage and treatment system schedules and throughput. These impacts can then be assessed against existing and pending milestones to determine the impact to the overall HLW system. A nation-wide view of waste treatment availability will help project the time required to prepare HLW for disposal. The impacts of the availability of various treatment systems and throughput can be compared to repository readiness to determine the prudent application of resources or the need to renegotiate milestones

  7. Hazardous waste systems analysis at Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Urioste, J.

    1997-01-01

    Los Alamos National Laboratory produces routine and non-routine hazardous waste as a by-product of mission operations. Hazardous waste commonly generated at the Laboratory includes many types of laboratory research chemicals, solvents, acids, bases, carcinogens, compressed gases, metals, and other solid waste contaminated with hazardous waste. The Los Alamos National Laboratory Environmental Stewardship Office has established a Hazardous Waste Minimization Coordinator to specifically focus on routine and non-routine RCRA, TSCA, and other administratively controlled wastes. In this process, the Waste Minimization Coordinator has developed and implemented a systems approach to define waste streams, estimate waste management costs and develop plans to implement avoidance practices, and develop projects to reduce or eliminate the waste streams at the Laboratory. The paper describes this systems approach

  8. Strengthening Building Retrofit Markets

    Energy Technology Data Exchange (ETDEWEB)

    Templeton, Mary [Michigan Saves; Jackson, Robert [Michigan Energy Office

    2014-04-15

    The Business Energy Financing (BEF) program offered commercial businesses in Michigan affordable financing options and other incentives designed to support energy efficiency improvements. We worked through partnerships with Michigan utilities, lenders, building contractors, trade associations, and other community organizations to offer competitive interest rates and flexible financing terms to support energy efficiency projects that otherwise would not have happened. The BEF program targeted the retail food market, including restaurants, grocery stores, convenience stores, and wholesale food vendors, with the goal of achieving energy efficiency retrofits for 2 percent of the target market. We offered low interest rates, flexible payments, easy applications and approval processes, and access to other incentives and rebates. Through these efforts, we sought to help customers strive for energy savings retrofits that would save 20 percent or more on their energy use. This program helped Michigan businesses reduce costs by financing energy efficient lighting, heating and cooling systems, insulation, refrigeration, equipment upgrades, and more. Businesses completed the upgrades with the help of our authorized contractors, and, through our lending partners, we provided affordable financing options.

  9. A monitoring strategy for the national wilderness preservation system

    Science.gov (United States)

    Peter B. Landres; David N. Cole; Alan E Watson

    1994-01-01

    In 1964, the Wilderness Act (P.L. 88-577) established the National Wilderness Preservation System (NWPS), currently composed of nearly 39 million hectares in 564 separate units, ranging in size from 2.4 he&ares to 3.5 million hectares. The purpose of the NWPS is “. . . to secure for the American people of present and future generations the benefits of an enduring...

  10. National Communications System: Ensuring Essential Communications for the Homeland

    Science.gov (United States)

    2002-01-01

    GSA) MS. SANDRA N. BATES National Aeronautics and Space Administration (NASA) MR. ROBERT E. SPEARING Nuclear Regulatory Commission (NRC) MR. RICHARD...small businesses and PBXs operated by the hospitality industry (hotels and motels ). Commonly encountered problems include the need to deposit coins...at a coin telephone before dialing, improper charging by hotel and motel billing systems, and the inaccessibility of GETS IXCs because of business

  11. Assessment of Malawi’s success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluation

    Directory of Open Access Journals (Sweden)

    Tanya Doherty

    2015-12-01

    Full Text Available Malawi is estimated to have achieved its Millennium Development Goal (MDG 4 target. This paper explores factors influencing progress in child survival in Malawi including coverage of interventions and the role of key national policies. We performed a retrospective evaluation of the Catalytic Initiative (CI programme of support (2007–2013. We developed estimates of child mortality using four population household surveys undertaken between 2000 and 2010. We recalculated coverage indicators for high impact child health interventions and documented child health programmes and policies. The Lives Saved Tool (LiST was used to estimate child lives saved in 2013. The mortality rate in children under 5 years decreased rapidly in the 10 CI districts from 219 deaths per 1000 live births (95% confidence interval (CI 189 to 249 in the period 1991–1995 to 119 deaths (95% CI 105 to 132 in the period 2006–2010. Coverage for all indicators except vitamin A supplementation increased in the 10 CI districts across the time period 2000 to 2013. The LiST analysis estimates that there were 10 800 child deaths averted in the 10 CI districts in 2013, primarily attributable to the introduction of the pneumococcal vaccine (24% and increased household coverage of insecticide–treated bednets (19%. These improvements have taken place within a context of investment in child health policies and scale up of integrated community case management of childhood illnesses. Malawi provides a strong example for countries in sub–Saharan Africa of how high impact child health interventions implemented within a decentralised health system with an established community–based delivery platform, can lead to significant reductions in child mortality.

  12. Occupational dose assessment and national dose registry system in Iran

    International Nuclear Information System (INIS)

    Jafari-Zadeh, M.; Nazeri, F.; Hosseini-Pooya, S. M.; Taheri, M.; Gheshlaghi, F.; Kardan, M. R.; Babakhani, A.; Rastkhah, N.; Yousefi-Nejad, F.; Darabi, M.; Oruji, T.; Gholamali-Zadeh, Z.; Karimi-Diba, J.; Kazemi-Movahed, A. A.; Dashti-Pour, M. R.; Enferadi, A.; Jahanbakhshian, M. H.; Sadegh-Khani, M. R.

    2011-01-01

    This report presents status of external and internal dose assessment of workers and introducing the structure of National Dose Registry System of Iran (NDRSI). As well as types of individual dosemeters in use, techniques for internal dose assessment are presented. Results obtained from the International Atomic Energy Agency intercomparison programme on measurement of personal dose equivalent H p (10) and consistency of the measured doses with the delivered doses are shown. Also, implementation of dosimetry standards, establishment of quality management system, authorisation and approval procedure of dosimetry service providers are discussed. (authors)

  13. Domesday 2000 - a National Land Information System for Britain

    DEFF Research Database (Denmark)

    Sabel, C. E.; Ralphs, M. P.

    1992-01-01

    -area network, to integrate data from a wide variety of sources, using GIS technology to enable interested parties to access the on-line information via locally based terminals. This article explains the background to the project, before moving on to discuss the proposed format and data holdings......The Domesday 2000 Project aims to ensure that by the year 2000 there will be a National Land Information System for Britain, containing up to date information on land and property ownership, value and use. It is proposed that the system will make use of distributed databases connected over a wide...

  14. Strengthening health professions regulation in Cambodia: a rapid assessment.

    Science.gov (United States)

    Clarke, David; Duke, Jan; Wuliji, Tana; Smith, Alyson; Phuong, Keat; San, Un

    2016-03-10

    This paper describes a rapid assessment of Cambodia's current system for regulating its health professions. The assessment forms part of a co-design process to set strategic priorities for strengthening health profession regulation to improve the quality and safety of health services. A health system approach for strengthening health professions' regulation is underway and aims to support the Government of Cambodia's plans for scaling up its health workforce, improving health services' safety and quality, and meeting its Association of South East Asian Nations (ASEAN) obligations to facilitate trade in health care services. The assessment used a mixed methods approach including: A desktop review of key laws, plans, reports and other documents relating to the regulation of the health professions in Cambodia (medicine, dentistry, midwifery, nursing and pharmacy); Key informant interviews with stakeholders in Cambodia (The term "stakeholders" refers to government officials, people working on health professional regulation, people working for the various health worker training institutions and health workers at the national and provincial level); Surveys and questionnaires to assess Cambodian stakeholder knowledge of regulation; Self-assessments by members of the five Cambodian regulatory councils regarding key capacities and activities of high-performing regulatory bodies; and A rapid literature review to identify: The key functions of health professional regulation; The key issues affecting the Cambodian health sector (including relevant developments in the wider ASEAN region); and "Smart" health profession regulation practices of possible relevance to Cambodia. We found that the current regulatory system only partially meets Cambodia's needs. A number of key regulatory functions are being performed, but overall, the current system was not designed with Cambodia's specific needs in mind. The existing system is also overly complex, with considerable duplication and

  15. National Ignition Facility Control and Information System Operational Tools

    Energy Technology Data Exchange (ETDEWEB)

    Marshall, C D; Beeler, R G; Bowers, G A; Carey, R W; Fisher, J M; Foxworthy, C B; Frazier, T M; Mathisen, D G; Lagin, L J; Rhodes, J J; Shaw, M J

    2009-10-08

    The National Ignition Facility (NIF) in Livermore, California, is the world's highest-energy laser fusion system and one of the premier large scale scientific projects in the United States. The system is designed to setup and fire a laser shot to a fusion ignition or high energy density target at rates up to a shot every 4 hours. NIF has 192 laser beams delivering up to 1.8 MJ of energy to a {approx}2 mm target that is planned to produce >100 billion atm of pressure and temperatures of >100 million degrees centigrade. NIF is housed in a ten-story building footprint the size of three football fields as shown in Fig. 1. Commissioning was recently completed and NIF will be formally dedicated at Lawrence Livermore National Laboratory on May 29, 2009. The control system has 60,000 hardware controls points and employs 2 million lines of control system code. The control room has highly automated equipment setup prior to firing laser system shots. This automation has a data driven implementation that is conducive to dynamic modification and optimization depending on the shot goals defined by the end user experimenters. NIF has extensive facility machine history and infrastructure maintenance workflow tools both under development and deployed. An extensive operational tools suite has been developed to support facility operations including experimental shot setup, machine readiness, machine health and safety, and machine history. The following paragraphs discuss the current state and future upgrades to these four categories of operational tools.

  16. Meteorological monitoring system of TÜBİTAK National Observatory

    Science.gov (United States)

    Koçak, M.; Selam, S. O.; Keskn, V.

    2004-10-01

    A custom meteorological monitoring system was constructed to reliably monitor the meteorological parameters of the site of TÜBİTAK National Observatory (TÜBİTAK: The Scientific and Technical Research Council of Turkey). The site is located on a mountain top known as Bakırlıtepe about 50 km west of the Antalya City at a height of 2547m. The system has software (C-based data acquisition/archiving structure and PHP based WEB monitoring support) and micro-controller based control electronics, fiber based custom designed encoder sensors (for wind speed and direction) and transmission lines using fiberoptic to RS232 transcievers. The constructed system can be used in any robotic telescope project for data monitoring and alert system creation.

  17. The Lawrence Livermore National Laboratory Intelligent Actinide Analysis System

    International Nuclear Information System (INIS)

    Buckley, W.M.; Carlson, J.B.; Koenig, Z.M.

    1993-01-01

    The authors have developed an Intelligent Actinide Analysis System (IAAS) for Materials Management to use in the Plutonium Facility at the Lawrence Livermore National Laboratory. The IAAS will measure isotopic ratios for plutonium and other actinides non-destructively by high-resolution gamma-ray spectrometry. This system will measure samples in a variety of matrices and containers. It will provide automated control of many aspects of the instrument that previously required manual intervention and/or control. The IAAS is a second-generation instrument, based on experience in fielding gamma isotopic systems, that is intended to advance non-destructive actinide analysis for nuclear safeguards in performance, automation, ease of use, adaptability, systems integration and extensibility to robotics. It uses a client-server distributed monitoring and control architecture. The IAAS uses MGA as the isotopic analysis code. The design of the IAAS reduces the need for operator intervention, operator training, and operator exposure

  18. Nanostructured thin film coatings with different strengthening effects

    Directory of Open Access Journals (Sweden)

    Panfilov Yury

    2017-01-01

    Full Text Available A number of articles on strengthening thin film coatings were analyzed and a lot of unusual strengthening effects, such as super high hardness and plasticity simultaneously, ultra low friction coefficient, high wear-resistance, curve rigidity increasing of drills with small diameter, associated with process formation of nanostructured coatings by the different thin film deposition methods were detected. Vacuum coater with RF magnetron sputtering system and ion-beam source and arc evaporator for nanostructured thin film coating manufacture are represented. Diamond Like Carbon and MoS2 thin film coatings, Ti, Al, Nb, Cr, nitride, carbide, and carbo-nitride thin film materials are described as strengthening coatings.

  19. Solute strengthening at high temperatures

    Science.gov (United States)

    Leyson, G. P. M.; Curtin, W. A.

    2016-08-01

    The high temperature behavior of solute strengthening has previously been treated approximately using various scaling arguments, resulting in logarithmic and power-law scalings for the stress-dependent energy barrier Δ E(τ ) versus stress τ. Here, a parameter-free solute strengthening model is extended to high temperatures/low stresses without any a priori assumptions on the functional form of Δ E(τ ) . The new model predicts that the well-established low-temperature, with energy barrier Δ {{E}\\text{b}} and zero temperature flow stress {τy0} , transitions to a near-logarithmic form for stresses in the regime 0.2intermediate-temperature and the associated transition for the activation volume. Overall, the present analysis unifies the different qualitative models in the literature and, when coupled with the previous parameter-free solute strengthening model, provides a single predictive model for solute strengthening as a function of composition, temperature, and strain rate over the full range of practical utility.

  20. Strengthening the sports data infrastructure

    NARCIS (Netherlands)

    Annet Tiessen-Raaphorst; Jos de Haan; with contributions from Remco van den Dool

    2012-01-01

    Original title: Versterking data-infrastructuur sport Sports research in the Netherlands has developed rapidly over the last ten years; strengthening the data infrastructure will facilitate its further growth in the future. Currently, however, there is no clear overall picture of the available

  1. Economic foundation and importance of non-state security sector within the national security system

    Directory of Open Access Journals (Sweden)

    Anđelković Slobodan

    2016-01-01

    Full Text Available The main purpose of this paper was to present the causes (for, role (played by and the growing importance of the non-state actors within the national security sector, while analyzing the economic interest of individuals, organizations and the state itself that were favoring such a development. In the course of our research we established how, as the state narrowed its activities down to more vital and more dangerous fields of work, this opened up space for independent contractors to enter those fields which carried less systemic risk. Such change was made possible in the post-Cold War context, when many of the former service members were hired by private companies. The economic motive had a role to play as well, given the need for additional security going beyond what state offered to its citizens, as many doubted the ability (efficiency of state to provide it in the first place; and private sector's willingness to provide it for a price. In Serbia, position of non-state security sector is still very much limited by the traditional notion of security as well as the division of competences, both left-overs from socialist times. This goes against positive tendencies within the sector itself (improvement of types and specialization of the security as service; strengthening of legal regulation; flexibility of services being offered. By conducting its basic service and improving the security of its clients, representatives of non-state security sector are - indirectly - improving the security of society as a whole, ensuring economic stability, which presents one of key national interests.

  2. A comparative analysis of national food recall systems

    Directory of Open Access Journals (Sweden)

    Gaetano Liuzzo

    2013-12-01

    Full Text Available Food recall and withdrawal is a fundamental tool for risk management and different countries stated the mandatory application of a system for food; the present work is an analysis of different systems applied in different countries. The main objective of analysed systems is the consumer’s health protection through an audit system and the application of system to rapidly recall/withdraw food on the part of producers. The comparative analysis of different national systems [i.e. European Union (EU, Australia, Canada, US and China] shows differences both of the terminological and legal aspects; the words recall and withdrawal have different meaning in EU legislation than in other counties’ legislations; from a legal point of view, two main recall/withdrawal systems could be identified: a mandatory one (EU and China and a voluntary one (USA, Canada and Australia; all the investigated systems have a co-operative approach between authority and food business operator, but different functions on their respective roles could be identified.

  3. Interactive Forecasting with the National Weather Service River Forecast System

    Science.gov (United States)

    Smith, George F.; Page, Donna

    1993-01-01

    The National Weather Service River Forecast System (NWSRFS) consists of several major hydrometeorologic subcomponents to model the physics of the flow of water through the hydrologic cycle. The entire NWSRFS currently runs in both mainframe and minicomputer environments, using command oriented text input to control the system computations. As computationally powerful and graphically sophisticated scientific workstations became available, the National Weather Service (NWS) recognized that a graphically based, interactive environment would enhance the accuracy and timeliness of NWS river and flood forecasts. Consequently, the operational forecasting portion of the NWSRFS has been ported to run under a UNIX operating system, with X windows as the display environment on a system of networked scientific workstations. In addition, the NWSRFS Interactive Forecast Program was developed to provide a graphical user interface to allow the forecaster to control NWSRFS program flow and to make adjustments to forecasts as necessary. The potential market for water resources forecasting is immense and largely untapped. Any private company able to market the river forecasting technologies currently developed by the NWS Office of Hydrology could provide benefits to many information users and profit from providing these services.

  4. The National System for quality control and the European experience

    International Nuclear Information System (INIS)

    Dimov, A.; Vassileva, J.; Ingilizova, K.; Slavchev, A. and others

    2003-01-01

    Objective: The aim of the work is to present the structure and functions of the National System for quality control (NSQC) in the medical irradiation, created to guarantee the safety and the safe use of the radiological equipment. Material and method: The approaches are studies in the development of the NSQC, applied in Bulgaria and some European Union members - such as Germany and Great Britain - and the specifics of the way in which the Directive for medical irradiation EURATOM 97/43 is implemented in national legislations. Results: The advantages and disadvantages of Bulgarian NSQC are analysed and some ideas for tis improvement are suggested. Conclusions: The developed draft NSQC for medical irradiation is in compliance with the requirement of the European Directive. The real advantages and disadvantages of the NSQC will show after its implementation in the practical radiation protection and control in the country

  5. Chinese National Optical Education Small Private Online Course system

    Science.gov (United States)

    Zhang, XiaoJie; Lin, YuanFang; Liu, Xu; Liu, XiangDong; Cen, ZhaoFeng; Li, XiaoTong; Zheng, XiaoDong; Wang, XiaoPing

    2017-08-01

    In order to realize the sharing of high quality course resources and promote the deep integration of `Internet+' higher education and talent training, a new on-line to off-line specialized courses teaching mode was explored in Chinese colleges and universities, which emphasized different teaching places, being organized asynchronously and localized. The latest progress of the Chinese National Optical Education Small Private On-line Course (CNOESPOC) system set up by Zhejiang University and other colleges and universities having disciplines in the field of optics and photonics under the guidance of the Chinese National Steering Committee of Optics and Photonics (CNSCOP) was introduced in this paper. The On-line to Off-line (O2O) optical education teaching resource sharing practice offers a new good example for higher education in China under the background of Internet +.

  6. National Ignition Facility Cryogenic Target Systems Interim Management Plan

    International Nuclear Information System (INIS)

    Warner, B

    2002-01-01

    Restricted availability of funding has had an adverse impact, unforeseen at the time of the original decision to projectize the National Ignition Facility (NIF) Cryogenic Target Handling Systems (NCTS) Program, on the planning and initiation of these efforts. The purpose of this document is to provide an interim project management plan describing the organizational structure and management processes currently in place for NCTS. Preparation of a Program Execution Plan (PEP) for NCTS has been initiated, and a current draft is provided as Attachment 1 to this document. The National Ignition Facility is a multi-megajoule laser facility being constructed at Lawrence Livermore National Laboratory (LLNL) by the National Nuclear Security Administration (NNSA) in the Department of Energy (DOE). Its primary mission is to support the Stockpile Stewardship Program (SSP) by performing experiments studying weapons physics, including fusion ignition. NIF also supports the missions of weapons effects, inertial fusion energy, and basic science in high-energy-density physics. NIF will be operated by LLNL under contract to the University of California (UC) as a national user facility. NIF is a low-hazard, radiological facility, and its operation will meet all applicable federal, state, and local Environmental Safety and Health (ES and H) requirements. The NCTS Interim Management Plan provides a summary of primary design criteria and functional requirements, current organizational structure, tracking and reporting procedures, and current planning estimates of project scope, cost, and schedule. The NIF Director controls the NIF Cryogenic Target Systems Interim Management Plan. Overall scope content and execution schedules for the High Energy Density Physics Campaign (SSP Campaign 10) are currently undergoing rebaselining and will be brought into alignment with resources expected to be available throughout the NNSA Future Years National Security Plan (FYNSP). The revised schedule for

  7. Assessing the performance of national innovation systems in Europe

    Energy Technology Data Exchange (ETDEWEB)

    Edquist, C.; Zabala-Iturriagagoitia, J.M.

    2016-07-01

    To support the establishment of the European Innovation Union, the European Commission is using the Innovation Union Scoreboard (IUS). In this paper, the performance of EU28 national innovation systems are analyzed from an efficiency perspective by using exactly the same data as those provided by the IUS for years 2010-2015. This efficiency analysis was carried out using Data Envelopment Analysis. Our analysis demonstrates that the results based on efficiency measures reflect that in general terms innovation systems are widely underexploited in Europe and that there are important variances among territories. We have shown that many countries which devote fewer resources than the innovation leaders, achieve outstanding levels of efficiency and, contrary to what the IUS predicts, countries with consolidated innovation systems, do not show efficiency levels commensurate with their expected competitiveness. (Author)

  8. Sandia National Laboratories, California sewer system management plan.

    Energy Technology Data Exchange (ETDEWEB)

    Holland, Robert C.

    2010-02-01

    A Sewer System Management Plan (SSMP) is required by the State Water Resources Control Board (SWRCB) Order No. 2006-0003-DWQ Statewide General Waste Discharge Requirements (WDR) for Sanitary Sewer Systems (General Permit). DOE, National Nuclear Security Administration (NNSA), Sandia Site Office has filed a Notice of Intent to be covered under this General Permit. The General Permit requires a proactive approach to reduce the number and frequency of sanitary sewer overflows (SSOs) within the State. SSMPs must include provisions to provide proper and efficient management, operation, and maintenance of sanitary sewer systems and must contain a spill response plan. Elements of this Plan are under development in accordance with the SWRCB's schedule.

  9. The National Energy Modeling System: An overview 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-02-01

    The National Energy Modeling System (NEMS) is a computer-based, energy-economy modeling system of US energy markets for the midterm period through 2020. NEMS projects the production, imports, conversion, consumption, and prices of energy, subject to assumptions on macroeconomic and financial factors world energy markets, resource availability and costs, behavior and technological choice criteria, cost and performance characteristics of energy technologies, and demographics. This report presents an overview of the structure and methodology of NEMS and each of its components. The first chapter provides a description of the design and objectives of the system, followed by a chapter on the overall modeling structure and solution algorithm. The remainder of the report summarizes the methodology and scope of the component modules of NEMS. The model descriptions are intended for readers familiar with terminology from economics, operations research, and energy modeling. 21 figs.

  10. Report of a national neurosurgical emergency teleconsulting system.

    LENUS (Irish Health Repository)

    Gray, W P

    2012-02-03

    OBJECTIVE: The goal was to develop a low-cost, national, neurosurgical emergency teleconsulting system that is independent of vendor computed tomographic (CT) or magnetic resonance imaging (MRI) scanner type. METHODS: Charge-coupled device scanners are used to digitize hard copies of CT and MRI scans. An enhanced optical density range is achieved by using an algorithm to fuse data from multiple exposures at different integration periods. The system is based on personal computers using Microsoft Windows 3.11. Data are transmitted on a wide-area network at 128 kilobits\\/s, over Integrated Systems Digital Network lines. The network connects both neurosurgical departments in Ireland to all major hospitals with CT\\/MRI scanners. RESULTS: The scanner optical density is 0.05 to 3.0, with 2.24 to 2.5 line pairs\\/mm. Five-megabyte images are transmitted uncompressed in 6 minutes. To date, more than 750 CT and MRI scans have been transmitted. The system is completely automated, and operator acceptance has been very high. Images are automatically stored and displayed at the receiving workstation, where the images can be viewed and manipulated on-screen. This system has significantly enhanced acute neurosurgical patient care. CONCLUSION: The system is cost effective and simple to use, has gained widespread physician acceptance, and delivers an image quality superior to that of many commercially available systems.

  11. [Reform Act on safety of drug and health products in France: announcement effect, strengthening or upheaval?].

    Science.gov (United States)

    Maillols-Perroy, Anne-Catherine; Tillet, Yves

    2012-01-01

    In France, the Médiator(®) scandal and the trauma it has created, are the source of Law n° 2011-2012 of 29 December 2011 on strengthening safety of drug and health products, intended by the Ministry of Labour, Employment and Health, adopted by the National Assembly and promulgated in order to restore confidence and enhance safety of drug and health products. This new law affects all stakeholders and health professionals impacts key points in the life cycle of the drug: MA, reimbursement, advertising, promotion, distribution, prescription, dispensing, and pharmacovigilance. It also provides for financial, administrative or criminal penalties, which are intended deterrent. Beyond strengthening constraints on safety of health products, this new law in France foreshadowed a revolution in behaviour, attitudes and overall scenery of the health system and no one today knows exactly the outline. © 2012 Société Française de Pharmacologie et de Thérapeutique.

  12. 76 FR 61266 - Special Regulations; Areas of the National Park System, Grand Teton National Park, Bicycle Routes...

    Science.gov (United States)

    2011-10-04

    ... was on the development of a system of multi-use pathways to improve opportunities for non- motorized... other units of government. This regulatory action will improve economic efficiency. The full report is...; Areas of the National Park System, Grand Teton National Park, Bicycle Routes, Fishing and Vessels AGENCY...

  13. Design and initial implementation of the WHO FP umbrella project- to strengthen contraceptive services in the sub Saharan Africa.

    Science.gov (United States)

    Kabra, Rita; Ali, Moazzam; Kiarie, James

    2017-06-15

    Strengthening contraceptive services in sub Saharan Africa is critical to achieve the FP 2020 goal of enabling 120 million more women and girls to access and use contraceptives by 2020 and the Sustainable Development Goals (SDG) targets of universal access to sexual and reproductive health (SRH) services including family planning by 2030. The World Health Organization (WHO) and partners have designed a multifaceted project to strengthen health systems to reduce the unmet need of contraceptive and family planning services in sub Saharan Africa. The plan leverages global, regional and national partnerships to facilitate and increase the use of evidence based WHO guidelines with a specific focus on postpartum family planning. The four key approaches undertaken are i) making WHO Guidelines adaptable & appropriate for country use ii) building capacity of WHO regional/country staff iii) providing technical support to countries and iv) strengthening partnerships for introduction and implementation of WHO guidelines. This paper describes the project design and elaborates the multifaceted approaches required in initial implementation to strengthen contraceptive services. The initial results from this project reflect that simultaneous application these approaches may strengthen contraceptive services in Sub Saharan Africa and ensure sustainability of the efforts. The lessons learned may be used to scale up and expand services in other countries.

  14. Strengthening of a railway bridge with NSMR and CFRP tubes

    DEFF Research Database (Denmark)

    Täljsten, Björn; Bennitz, Anders; Danielsson, Georg

    2008-01-01

    Strengthening of structures with CFRP is today considered an accepted method to upgrade concrete structures. In this paper two different CFRP strengthening systems are combined to give extended service life to a Swedish double-trough-double-track railway bridge, constructed in concrete with a 10....... Sensors on bars and tubes display proofs of utilization of the CFRP while displacement sensors and strain gauges on the steel reinforcement due to the small loads in the service limit state show minor effect....

  15. National audit of a system for rectal contact brachytherapy

    Directory of Open Access Journals (Sweden)

    Laia Humbert-Vidan

    2017-01-01

    Full Text Available Background and purpose: Contact brachytherapy is used for the treatment of early rectal cancer. An overview of the current status of quality assurance of the rectal contact brachytherapy systems in the UK, based on a national audit, was undertaken in order to assist users in optimising their own practices. Material and methods: Four UK centres using the Papillon 50 contact brachytherapy system were audited. Measurements included beam quality, output and radiation field size and uniformity. Test frequencies and tolerances were reviewed and compared to both existing recommendations and published reviews on other kV and electronic brachytherapy systems. External validation of dosimetric measurements was provided by the National Physical Laboratory. Results: The maximum host/audit discrepancy in beam quality determination was 6.5%; this resulted in absorbed dose variations of 0.2%. The host/audit agreement in absorbed dose determination was within 2.2%. The median of the radiation field uniformity measurements was 2.7% and the host/audit agreement in field size was within 1 mm. Test tolerances and frequencies were within the national recommendations for kV units. Conclusions: The dosimetric characterisation of the Papillon 50 was validated by the audit measurements for all participating centres, thus providing reassurance that the implementation had been performed within the standards stated in previously published audit work and recommendations for kV and electronic brachytherapy units. However, optimised and standardised quality assurance testing could be achieved by reducing some methodological differences observed. Keywords: Contact brachytherapy, Electronic brachytherapy, Audit

  16. Sandia National Laboratories, California Environmental Management System program manual.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2012-03-01

    The Sandia National Laboratories, California (SNL/CA) Environmental Management System (EMS) Program Manual documents the elements of the site EMS Program. The SNL/CA EMS Program conforms to the International Standard on Environmental Management Systems, ISO 14001:2004and Department of Energy (DOE) Order 436.1. Sandia National Laboratories, California (SNL/CA) has maintained functional environmental programs to assist with regulatory compliance for more than 30 years. During 2005, these existing programs were rolled into a formal environmental management system (EMS) that expands beyond the traditional compliance focus to managing and improving environmental performance and stewardship practices for all site activities. An EMS is a set of inter-related elements that represent a continuing cycle of planning, implementing, evaluating, and improving processes and actions undertaken to achieve environmental policy and goals. The SNL/CA EMS Program conforms to the International Standard for Environmental Management Systems, ISO 14001:2004 (ISO 2004). The site first received ISO 14001 certification in September 2006 and recertification in 2009. SNL/CA's EMS Program is applicable to the Sandia, Livermore site only. Although SNL/CA operates as one organizational division of the overall Sandia National Laboratories, the EMS Program is site-specific, with site-specific objectives and targets. SNL/CA (Division 8000) benefits from the organizational structure as it provides corporate level policies, procedures, and standards, and established processes that connect to and support elements of the SNL/CA EMS Program. Additionally, SNL/CA's EMS Program benefits from two corporate functional programs (Facilities Energy and Water Resource Management and Fleet Services programs) that maintain responsibility for energy management and fleet services for all Sandia locations. Each EMS element is further enhanced with site-specific processes and standards. Division 8000 has

  17. Sandia National Laboratories, California Environmental Management System Program Manual.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2011-04-01

    The Sandia National Laboratories, California (SNL/CA) Environmental Management System (EMS) Program Manual documents the elements of the site EMS Program. The SNL/CA EMS Program conforms to the International Standard on Environmental Management Systems, ISO 14001:2004and Department of Energy (DOE) Order 450.1. Sandia National Laboratories, California (SNL/CA) has maintained functional environmental programs to assist with regulatory compliance for more than 30 years. During 2005, these existing programs were rolled into a formal environmental management system (EMS) that expands beyond the traditional compliance focus to managing and improving environmental performance and stewardship practices for all site activities. An EMS is a set of inter-related elements that represent a continuing cycle of planning, implementing, evaluating, and improving processes and actions undertaken to achieve environmental policy and goals. The SNL/CA EMS Program conforms to the International Standard for Environmental Management Systems, ISO 14001:2004 (ISO 2004). The site received ISO 14001 certification in September 2006. SNL/CA's EMS Program is applicable to the Sandia, Livermore site only. Although SNL/CA operates as one organizational division of the overall Sandia National Laboratories, the EMS Program is site-specific, with site-specific objectives and targets. SNL/CA (Division 8000) benefits from the organizational structure as it provides corporate level policies, procedures, and standards, and established processes that connect to and support elements of the SNL/CA EMS Program. Additionally, SNL/CA's EMS Program benefits from two corporate functional programs (Facilities Energy Management and Fleet Services programs) that maintain responsibility for energy management and fleet services for all Sandia locations. Each EMS element is further enhanced with site-specific processes and standards. Division 8000 has several groups operating at Sandia National Laboratories

  18. Development of a framework to measure health profession regulation strengthening.

    Science.gov (United States)

    McCarthy, Carey F; Kelley, Maureen A; Verani, Andre R; St Louis, Michael E; Riley, Patricia L

    2014-10-01

    This paper describes the development of a framework to evaluate the progress and impact of a multi-year US government initiative to strengthen nursing and midwifery professional regulation in sub-Saharan Africa. The framework was designed as a capability maturity model, which is a stepwise series of performance levels that describe the sophistication of processes necessary to achieve an organization's objectives. A model from the field of software design was adapted to comprise the key functions of a nursing and midwifery regulatory body and describe five stages of advancing each function. The framework was used to measure the progress of five countries that received direct assistance to strengthen regulations and to benchmark the status of regulations in the 17 countries participating in the initiative. The framework captured meaningful advancements in regulatory strengthening in the five supported countries and the level of regulatory capacity in participating countries. The project uses the framework to assess yearly progress of supported countries, track the overall impact of the project on national and regional nursing regulation, and to identify national and regional priorities for regulatory strengthening. It is the first of its kind to document and measure progress toward sustainably strengthening nursing and midwifery regulation in Africa. Published by Elsevier Ltd.

  19. Strengthening the Legal and Regulatory Framework of the Tobacco ...

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

    : facilitating the vote on a national law conforming to the needs of the WHO FTCT and to strengthen the ban on smoking in Touba, the "Religious City." The idea ... Special journal issue highlights IDRC-supported findings on women's paid work.

  20. Initial Semantics for Strengthened Signatures

    Directory of Open Access Journals (Sweden)

    André Hirschowitz

    2012-02-01

    Full Text Available We give a new general definition of arity, yielding the companion notions of signature and associated syntax. This setting is modular in the sense requested by Ghani and Uustalu: merging two extensions of syntax corresponds to building an amalgamated sum. These signatures are too general in the sense that we are not able to prove the existence of an associated syntax in this general context. So we have to select arities and signatures for which there exists the desired initial monad. For this, we follow a track opened by Matthes and Uustalu: we introduce a notion of strengthened arity and prove that the corresponding signatures have initial semantics (i.e. associated syntax. Our strengthened arities admit colimits, which allows the treatment of the λ-calculus with explicit substitution.

  1. Seismic strengthening of RC buildings

    OpenAIRE

    TSIONIS Georgios; APOSTOLSKA ROBERTA; TAUCER Fabio

    2014-01-01

    A literature review on the seismic strengthening of reinforced concrete buildings, using steel bracings, infills and shear walls, is presented. Extensive experimental testing and numerical analyses of elements and structures have demonstrated the feasibility and effectiveness of all three measures for the increase of global strength and stiffness. In certain cases, they provide additional energy dissipation and help reducing irregularities. The selection of the most appropriate technique i...

  2. 78 FR 6081 - Agency Information Collection Activities; Comment Request; National Student Loan Data System (NSLDS)

    Science.gov (United States)

    2013-01-29

    ...; Comment Request; National Student Loan Data System (NSLDS) AGENCY: Federal Student Aid (FSA), Department... of Collection: National Student Loan Data System (NSLDS). OMB Control Number: 1845-0035. Type of... data through the National Student Loan Data System (NSLDS) system from postsecondary schools, Perkins...

  3. A review of the Mexican national innovation system

    Directory of Open Access Journals (Sweden)

    Samantha Rullán

    2015-12-01

    Full Text Available Governments and business leaders are increasingly aware of the role that innovation plays in economic growth, development and competitiveness. There are imperative challenges for Latin American countries, among them, poverty, social inclusion, sustainable development, climate change, natural disasters, productivity, improve the quality of education and health. Innovations are essential to drive economic growth and prosperity in the region. According to the Global Innovation Index (2015, Mexico is ranked 57th. Most of the research on innovation performance is mostly focused on technological innovation. Therefore, the main variables used, such as patents and number of scientific publications, do not always reflect the other types of innovations (i.e. business model, organizational, etc. that are developing in emerging markets. The aim of this paper is to analyze the Mexican innovation system using a broad concept with a focus on other types of innovation including cultural aspects to identify the main characteristics that distinguish and determine how innovation in Mexico is formed. Although the Mexican government has improved its institutional structure for innovation and its support policies, they need to evaluate programs and adjust incentive schemes based on performance to improve their innovation policy. Purpose – The purpose of this paper is to examine the Mexican National Innovation System using a broad concept with a focus on other types of innovation and including cultural aspects to identify some of the main characteristics that determine how innovation in Mexico is formed. Design/methodology/approach – The national innovation systems framework is used to review the Mexican innovation policy.A review of relevant literature on national innovation systems and Mexican innovation policies with data from the Global Innovation Index and INEGI were used for this paper. Findings – Higher private investment in R&D is needed to enhance

  4. The Cuban National Healthcare System: Characterization of primary healthcare services.

    Directory of Open Access Journals (Sweden)

    Keli Regina DAL PRÁ

    2015-10-01

    Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

  5. Advanced Technologies for Intelligent Systems of National Border Security

    CERN Document Server

    Simek, Krzysztof; Świerniak, Andrzej

    2013-01-01

    One of the world’s leading problems in the field of national security is protection of borders and borderlands. This book addresses multiple issues on advanced innovative methods of multi-level control of both ground (UGVs) and aerial drones (UAVs). Those objects combined with innovative algorithms become autonomous objects capable of patrolling chosen borderland areas by themselves and automatically inform the operator of the system about potential place of detection of a specific incident. This is achieved by using sophisticated methods of generation of non-collision trajectory for those types of objects and enabling automatic integration of both ground and aerial unmanned vehicles. The topics included in this book also cover presentation of complete information and communication technology (ICT) systems capable of control, observation and detection of various types of incidents and threats. This book is a valuable source of information for constructors and developers of such solutions for uniformed servi...

  6. Single bunch transfer system for the National Synchrotron Light Source

    International Nuclear Information System (INIS)

    Sheehan, J.; Singh, O.; Rambo, W.

    1983-01-01

    The accelerator system at the National Synchrotron Light Source consists of an S-band 85 MeV linac and three synchrotron rings. The electron beam from the linac is accelerated by the booster ring to 600 MeV and transferred to one of the two storage rings. The smaller of the two rings operates between 300 and 800 MeV emtting photons in the vacuum ultraviolet (VUV), while the larger storage ring operates up to 2.5 GeV and emits photons in the x-ray spectrum. A system is described for loading the storage rings by filling a single-phase space bunch in the booster ring and transferring it at the end of each booster cycle into a selected bucket in one of the storage rings. By controlling the timing of the transfer on successive transfer cycles, many fill patterns may be obtained

  7. Simulation-based optimization of sustainable national energy systems

    International Nuclear Information System (INIS)

    Batas Bjelić, Ilija; Rajaković, Nikola

    2015-01-01

    The goals of the EU2030 energy policy should be achieved cost-effectively by employing the optimal mix of supply and demand side technical measures, including energy efficiency, renewable energy and structural measures. In this paper, the achievement of these goals is modeled by introducing an innovative method of soft-linking of EnergyPLAN with the generic optimization program (GenOpt). This soft-link enables simulation-based optimization, guided with the chosen optimization algorithm, rather than manual adjustments of the decision vectors. In order to obtain EnergyPLAN simulations within the optimization loop of GenOpt, the decision vectors should be chosen and explained in GenOpt for scenarios created in EnergyPLAN. The result of the optimization loop is an optimal national energy master plan (as a case study, energy policy in Serbia was taken), followed with sensitivity analysis of the exogenous assumptions and with focus on the contribution of the smart electricity grid to the achievement of EU2030 goals. It is shown that the increase in the policy-induced total costs of less than 3% is not significant. This general method could be further improved and used worldwide in the optimal planning of sustainable national energy systems. - Highlights: • Innovative method of soft-linking of EnergyPLAN with GenOpt has been introduced. • Optimal national energy master plan has been developed (the case study for Serbia). • Sensitivity analysis on the exogenous world energy and emission price development outlook. • Focus on the contribution of smart energy systems to the EU2030 goals. • Innovative soft-linking methodology could be further improved and used worldwide.

  8. Los Alamos National Laboratory's Mobile Real Time Radiography System

    International Nuclear Information System (INIS)

    Vigil, J.; Taggart, D.; Betts, S.; Mendez, J.; Rael, C.; Martinez, F.

    1997-01-01

    A 450-KeV Mobile Real Time Radiography (RTR) System was delivered to Los Alamos National Laboratory (LANL) in January 1996. It was purchased to inspect containers of radioactive waste produced at (LANL). Since its delivery it has been used to radiograph greater than 600 drums of radioactive waste at various LANL sites. It has the capability of inspecting waste containers of various sizes. It has three independent X-Ray acquisition formats. The primary system used is a 12 in. image intensifier, the second is a 36 in. linear diode array (LDA) and the last is an open system. It is fully self contained with on board generator, HVAC and a fire suppression system. It is on a 53 ft long X 8 ft. wide X 14 ft. high trailer that can be moved over any highway requiring only a easily obtainable overweight permit because it weighs approximately 38 tons. It was built to conform to industry standards for a cabinet system which does not require an exclusion zone. The fact that this unit is mobile has allowed us to operate where the waste is stored, rather than having to move the waste to a fixed facility

  9. Emergency response information within the National LLW Information Management System

    International Nuclear Information System (INIS)

    Paukert, J.G.; Fuchs, R.L.

    1986-01-01

    The U.S. Department of Energy, with operational assistance from EG and G Idaho, Inc., maintains the National Low-Level Waste Information Management System, a relational data base management system with extensive information collection and reporting capabilities. The system operates on an IBM 4341 main-frame computer in Idaho Falls, Idaho and is accessible through terminals in 46 states. One of the many programs available on the system is an emergency response data network, which was developed jointly by EG and G Idaho, Inc. and the Federal Emergency Management Agency. As a prototype, the program comprises emergency response team contacts, policies, activities and decisions; federal, state and local government contacts; facility and support center locations; and news releases for nine reactor sites in the southeast. The emergency response program provides a method for consolidating currently fragmented information into a central and user-friendly system. When the program is implemented, immediate answers to response questions will be available through a remote terminal or telephone on a 24-hour basis. In view of current hazardous and low-level waste shipment rates and future movements of high-level waste, the program can offer needed and timely information for transportation as well as site incident response

  10. Incentive Systems That Support Sustainability: A First Nations Example

    Directory of Open Access Journals (Sweden)

    Ronald L. Trosper

    1998-12-01

    Full Text Available Prior to contact with European settlers, the incentive and governance systems used by First Nations peoples of the Northwest coast of North America provided more sustainable use of the fisheries and other resources of that region than did subsequent systems. This paper explores the major reason for that success: the requirements of the potlatch system that chiefs share their income with each other. Because chiefs controlled well-defined territories and subjected each other to review, the potlatch governance system embodied the characteristics of negative feedback, coordination, resiliency, and robustness that political scientist John Dryzek identifies as means to support ecological rationality in the management of ecosystems. This ecological rationality occurs because the sharing of income made chiefs aware of the effects that their actions had on the income of other chiefs. In addition, public discussions that occurred at feasts would allow chiefs to coordinate their actions as needed. The paper concludes with proposals for application of the potlatch system to modern circumstances. Such application means changing the rules for the distribution of income from using ecosystem resources so that all entities share their surplus income with each other. The potlatch system can be applied to modern organizations by noting that chief executive officers are like chiefs, that profit is like surplus income, and that corporations can be viewed as similar to the houses of the traditional Northwest systems. One major change is that profit is no longer privately owned, and must be shared with other organizations that use an ecosystem. Although controls on behavior mandated by state power would be reduced, a modernized potlatch system would still need to operate within a context provided by governments and international agreements.

  11. Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project FY16 Annual Review

    Science.gov (United States)

    Grindle, Laurie; Hackenberg, Davis

    2016-01-01

    This presentation gives insight into the research activities and efforts being executed in order to integrate unmanned aircraft systems into the national airspace system. This briefing is to inform others of the UAS-NAS FY16 progress and future directions.

  12. Developing a systems analysis framework for the National Poverty Alleviation System

    CSIR Research Space (South Africa)

    Marais, M

    2007-09-01

    Full Text Available The purpose of the project is to use systems methodologies developed in a science and engineering environment and to apply these towards a better understanding of the National Poverty Alleviation System. The aim of such a project is to establish a...

  13. Adherence to Physical Activity Among Older Adults Using a Geographic Information System: Korean National Health and Nutrition Examinations Survey IV.

    Science.gov (United States)

    Yeom, Hye-A; Jung, Dukyoo; Choi, Mona

    2011-06-01

    The purpose of this study was to examine the adherence to physical activity (PA) among older adults in Korea using data from the Fourth Korean National Health and Nutrition Examination Survey (KNHANESIV), and to illustrate geographic variations in PA using Geographic Information Systems (GIS). A secondary analysis of the KNHANES IV data from 2007 to 2008 was used for this study. Participants of the study included 2,241 older adults over the age of 65. Estimates on adherence to PA were obtained for vigorous, moderate, walking, strengthening, and stretching activities. All estimates were weighted to represent Korean population. The association between participants' characteristics and PA was analyzed using Wald chi-square test. Maps depicting regional variations in PA were created using GIS software. Adherence to PA among Korean older adults who met national recommendations during the period of year 2007-2008 was about 9% in vigorous activity, 10% in moderate activity, and 48% in walking. The most common type of PA was walking. A higher level of PA was associated with male gender, younger age, high level of income and education, and living with family. The majority of older adults did not meet the national PA recommendations, suggesting that consistent surveillance and intervention for PA in the geriatric population are needed in the future. Maps generated using GIS visually showed regional differences in PA among the study participants. Copyright © 2011 Korean Society of Nursing Science. Published by Elsevier B.V. All rights reserved.

  14. Strengthened glass for high average power laser applications

    International Nuclear Information System (INIS)

    Cerqua, K.A.; Lindquist, A.; Jacobs, S.D.; Lambropoulos, J.

    1987-01-01

    Recent advancements in high repetition rate and high average power laser systems have put increasing demands on the development of improved solid state laser materials with high thermal loading capabilities. The authors have developed a process for strengthening a commercially available Nd doped phosphate glass utilizing an ion-exchange process. Results of thermal loading fracture tests on moderate size (160 x 15 x 8 mm) glass slabs have shown a 6-fold improvement in power loading capabilities for strengthened samples over unstrengthened slabs. Fractographic analysis of post-fracture samples has given insight into the mechanism of fracture in both unstrengthened and strengthened samples. Additional stress analysis calculations have supported these findings. In addition to processing the glass' surface during strengthening in a manner which preserves its post-treatment optical quality, the authors have developed an in-house optical fabrication technique utilizing acid polishing to minimize subsurface damage in samples prior to exchange treatment. Finally, extension of the strengthening process to alternate geometries of laser glass has produced encouraging results, which may expand the potential or strengthened glass in laser systems, making it an exciting prospect for many applications

  15. 77 FR 44673 - Meeting of the Department of Justice National Motor Vehicle Title Information System Federal...

    Science.gov (United States)

    2012-07-30

    ... Department of Justice National Motor Vehicle Title Information System Federal Advisory Committee AGENCY... a meeting of Department of Justice's (DOJ's) National Motor Vehicle Title Information System (NMVTIS...., Washington, DC 20531. FOR FURTHER INFORMATION CONTACT: Todd Brighton, Designated Federal Employee (DFE...

  16. 76 FR 38209 - Meeting of the Department of Justice's (DOJ's) National Motor Vehicle Title Information System...

    Science.gov (United States)

    2011-06-29

    ... Department of Justice's (DOJ's) National Motor Vehicle Title Information System (NMVTIS) Federal Advisory... announcement of a meeting of DOJ's National Motor Vehicle Title Information System (NMVTIS) Federal Advisory... FURTHER INFORMATION CONTACT: Alissa Huntoon, Designated Federal Employee (DFE), Bureau of Justice...

  17. National Ignition Facility Project Completion and Control System Status

    Energy Technology Data Exchange (ETDEWEB)

    Van Arsdall, P J; Azevedo, S G; Beeler, R G; Bryant, R M; Carey, R W; Demaret, R D; Fisher, J M; Frazier, T M; Lagin, L J; Ludwigsen, A P; Marshall, C D; Mathisen, D G; Reed, R K

    2009-10-02

    The National Ignition Facility (NIF) is the world's largest and most energetic laser experimental system providing a scientific center to study inertial confinement fusion (ICF) and matter at extreme energy densities and pressures. Completed in 2009, NIF is a stadium-sized facility containing a 1.8-MJ, 500-TW 192-beam ultraviolet laser and target chamber. A cryogenic tritium target system and suite of optical, X-ray and nuclear diagnostics will support experiments in a strategy to achieve fusion ignition starting in 2010. Automatic control of NIF is performed by the large-scale Integrated Computer Control System (ICCS), which is implemented by 2 MSLOC of Java and Ada running on 1300 front-end processors and servers. The ICCS framework uses CORBA distribution for interoperation between heterogeneous languages and computers. Laser setup is guided by a physics model and shots are coordinated by data-driven distributed workflow engines. The NIF information system includes operational tools and a peta-scale repository for provisioning experimental results. This paper discusses results achieved and the effort now underway to conduct full-scale operations and prepare for ignition.

  18. Control System Development Plan for the National Spherical Torus Experiment

    International Nuclear Information System (INIS)

    Neumeyer, C.; Mueller, D.; Gates, D.A.; Ferron, J.R.

    1999-01-01

    The National Spherical Torus Experiment (NSTX) has as one of its primary goals the demonstration of the attractiveness of the spherical torus concept as a fusion power plant. Central to this goal is the achievement of high plasma β ( = 2 micro 0 /B 2 a measure of the efficiency of a magnetic plasma confinement system). It has been demonstrated both theoretically and experimentally that the maximum achievable β is a strong function of both local and global plasma parameters. It is therefore important to optimize control of the plasma. To this end a phased development plan for digital plasma control on NSTX is presented. The relative level of sophistication of the control system software and hardware will be increased according to the demands of the experimental program in a three phase plan. During Day 0 (first plasma), a simple coil current control algorithm will initiate plasma operations. During the second phase (Day 1) of plasma operations the control system will continue to use the preprogrammed algorithm to initiate plasma breakdown but will then change over to a rudimentary plasma control scheme based on linear combinations of measured plasma fields and fluxes. The third phase of NSTX plasma control system development will utilize the rtEFIT code, first used on DIII-D, to determine, in real-time, the full plasma equilibrium by inverting the Grad-Shafranov equation. The details of the development plan, including a description of the proposed hardware will be presented

  19. Climate change adaptation for the US National Wildlife Refuge System

    Science.gov (United States)

    Griffith, Brad; Scott, J. Michael; Adamcik, Robert S.; Ashe, Daniel; Czech, Brian; Fischman, Robert; Gonzalez, Patrick; Lawler, Joshua J.; McGuire, A. David; Pidgorna, Anna

    2009-01-01

    Since its establishment in 1903, the National Wildlife Refuge System (NWRS) has grown to 635 units and 37 Wetland Management Districts in the United States and its territories. These units provide the seasonal habitats necessary for migratory waterfowl and other species to complete their annual life cycles. Habitat conversion and fragmentation, invasive species, pollution, and competition for water have stressed refuges for decades, but the interaction of climate change with these stressors presents the most recent, pervasive, and complex conservation challenge to the NWRS. Geographic isolation and small unit size compound the challenges of climate change, but a combined emphasis on species that refuges were established to conserve and on maintaining biological integrity, diversity, and environmental health provides the NWRS with substantial latitude to respond. Individual symptoms of climate change can be addressed at the refuge level, but the strategic response requires system-wide planning. A dynamic vision of the NWRS in a changing climate, an explicit national strategic plan to implement that vision, and an assessment of representation, redundancy, size, and total number of units in relation to conservation targets are the first steps toward adaptation. This adaptation must begin immediately and be built on more closely integrated research and management. Rigorous projections of possible futures are required to facilitate adaptation to change. Furthermore, the effective conservation footprint of the NWRS must be increased through land acquisition, creative partnerships, and educational programs in order for the NWRS to meet its legal mandate to maintain the biological integrity, diversity, and environmental health of the system and the species and ecosystems that it supports.

  20. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data.

    Science.gov (United States)

    Atun, Rifat; Gurol-Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-12-01

    Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Using routinely collected health billing records for 2005-2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co-morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply-side variables, and PHC use. Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow-up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions.