WorldWideScience

Sample records for system strengthening national

  1. 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.

  2. Strengthening biosecurity in Iraq: Development of a national biorisk management system

    Directory of Open Access Journals (Sweden)

    Gregory D Koblentz

    2016-02-01

    Full Text Available Since 2004, the Republic of Iraq has undertaken a concerted effort to comply with all of its international obligations to prevent the proliferation of chemical, biological, radiological, and nuclear (CBRN weapons. A centerpiece of this effort is Iraq’s development of a national biorisk management system to prevent, prepare for, and respond to naturally occurring and deliberate biological threats. The Iraqi National Monitoring Authority (INMA, which is responsible for CBRN security and nonproliferation in Iraq, has played a key role in establishing this system. This article provides an overview of Iraq’s international nonproliferation commitments, describes the legal and organizational steps it has taken to implement these commitments, and examines current initiatives to strengthen Iraq’s biosecurity.

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

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    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. Strengthening global health security by embedding the International Health Regulations requirements into national health systems.

    Science.gov (United States)

    Kluge, Hans; Martín-Moreno, Jose Maria; Emiroglu, Nedret; Rodier, Guenael; Kelley, Edward; Vujnovic, Melitta; Permanand, Govin

    2018-01-01

    The International Health Regulations (IHR) 2005, as the overarching instrument for global health security, are designed to prevent and cope with major international public health threats. But poor implementation in countries hampers their effectiveness. In the wake of a number of major international health crises, such as the 2014 Ebola and 2016 Zika outbreaks, and the findings of a number of high-level assessments of the global response to these crises, it has become clear that there is a need for more joined-up thinking between health system strengthening activities and health security efforts for prevention, alert and response. WHO is working directly with its Member States to promote this approach, more specifically around how to better embed the IHR (2005) core capacities into the main health system functions. This paper looks at how and where the intersections between the IHR and the health system can be best leveraged towards developing greater health system resilience. This merging of approaches is a key component in pursuit of Universal Health Coverage and strengthened global health security as two mutually reinforcing agendas.

  7. Critical role of developing national strategic plans as a guide to strengthen laboratory health systems in resource-poor settings.

    Science.gov (United States)

    Nkengasong, John N; Mesele, Tsehaynesh; Orloff, Sherry; Kebede, Yenew; Fonjungo, Peter N; Timperi, Ralph; Birx, Deborah

    2009-06-01

    Medical laboratory services are an essential, yet often neglected, component of health systems in developing countries. Their central role in public health, disease control and surveillance, and patient management is often poorly recognized by governments and donors. However, medical laboratory services in developing countries can be strengthened by leveraging funding from other sources of HIV/AIDS prevention, care, surveillance, and treatment programs. Strengthening these services will require coordinated efforts by national governments and partners and can be achieved by establishing and implementing national laboratory strategic plans and policies that integrate laboratory systems to combat major infectious diseases. These plans should take into account policy, legal, and regulatory frameworks; the administrative and technical management structure of the laboratories; human resources and retention strategies; laboratory quality management systems; monitoring and evaluation systems; procurement and maintenance of equipment; and laboratory infrastructure enhancement. Several countries have developed or are in the process of developing their laboratory plans, and others, such as Ethiopia, have implemented and evaluated their plan.

  8. 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

  9. Strengthening National Identity through National Symbols and ...

    African Journals Online (AJOL)

    South Africans vacillate in their national identity and remain largely attached to their racial and ethnic group identities. The aim of this article is to illustrate the manner in which a sense of understanding, familiarity and pride with regard to national symbols and thus to national identity can be attained. The objective is that the ...

  10. 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 buildin...

  11. 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

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

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    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

  13. Radiation and waste safety: Strengthening national capabilities

    International Nuclear Information System (INIS)

    Barretto, P.; Webb, G.; Mrabit, K.

    1997-01-01

    For many years, the IAEA has been collecting information on national infrastructures for assuring safety in applications of nuclear and radiation technologies. For more than a decade, from 1984-95, information relevant to radiation safety particularly was obtained through more than 60 expert missions undertaken by Radiation Protection Advisory Teams (RAPATs) and follow-up technical visits and expert missions. The RAPAT programme documented major weaknesses and the reports provided useful background for preparation of national requests for IAEA technical assistance. Building on this experience and subsequent policy reviews, the IAEA took steps to more systematically evaluate the needs for technical assistance in areas of nuclear and radiation safety. The outcome was the development of an integrated system designed to more closely assess national priorities and needs for upgrading their infrastructures for radiation and waste safety

  14. Strengthening Injury Surveillance System in Iran

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    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

  15. Strengthening Injury Surveillance System in Iran

    Institute of Scientific and Technical Information of China (English)

    Seyed Abbas Motevalian; Mashyaneh Haddadi; Hesam Akbari; Reza Khorramirouz; Soheil Saadat; Arash Tehrani; Vafa Rahimi-Movaghar

    2011-01-01

    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 OrganizationEastern Mediterranean Regional Organization,as well as Minister of Health and Medical Education concerning Iran were reviewed.Later a national stakeholder's 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.Contusions: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.

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

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

    Home · What we do ... As a result, Pakistan's health system has suffered and health service delivery has worsened. ... This four-year project aims to strengthen health systems governance for reproductive health and rights in Pakistan.

  17. Health-system strengthening and tuberculosis control.

    Science.gov (United States)

    Atun, Rifat; Weil, Diana E C; Eang, Mao Tan; Mwakyusa, David

    2010-06-19

    Weak health systems are hindering global efforts for tuberculosis care and control, but little evidence is available on effective interventions to address system bottlenecks. This report examines published evidence, programme reviews, and case studies to identify innovations in system design and tuberculosis control to resolve these bottlenecks. We outline system bottlenecks in relation to governance, financing, supply chain management, human resources, health-information systems, and service delivery; and adverse effects from rapid introduction of suboptimum system designs. This report also documents innovative solutions for disease control and system design. Solutions pursued in individual countries are specific to the nature of the tuberculosis epidemic, the underlying national health system, and the contributors engaged: no one size fits all. Findings from countries, including Bangladesh, Cambodia, India, Tanzania, Thailand, and Vietnam, suggest that advances in disease control and system strengthening are complementary. Tuberculosis care and control are essential elements of health systems, and simultaneous efforts to innovate systems and disease response are mutually reinforcing. Highly varied and context-specific responses to tuberculosis show that solutions need to be documented and compared to develop evidence-based policies and practice. Copyright 2010 Elsevier Ltd. All rights reserved.

  18. Strengthening Dairy Cooperative through National Development of Livestock Region

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    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.

  19. 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)

  20. Strengthening health system to improve immunization for migrants in China.

    Science.gov (United States)

    Fang, Hai; Yang, Li; Zhang, Huyang; Li, Chenyang; Wen, Liankui; Sun, Li; Hanson, Kara; Meng, Qingyue

    2017-07-01

    Immunization is the most cost-effective method to prevent and control vaccine-preventable diseases. Migrant population in China has been rising rapidly, and their immunization status is poor. China has tried various strategies to strengthen its health system, which has significantly improved immunization for migrants. This study applied a qualitative retrospective review method aiming to collect, analyze and synthesize health system strengthening experiences and practices about improving immunizations for migrants in China. A conceptual framework of Theory of Change was used to extract the searched literatures. 11 searched literatures and 4 national laws and policies related to immunizations for migrant children were carefully studied. China mainly employed 3 health system strengthening strategies to significantly improve immunization for migrant population: stop charging immunization fees or immunization insurance, manage immunization certificates well, and pay extra attentions on immunization for special children including migrant children. These health system strengthening strategies were very effective, and searched literatures show that up-to-date and age-appropriate immunization rates were significantly improved for migrant children. Economic development led to higher migrant population in China, but immunization for migrants, particularly migrant children, were poor. Fortunately various health system strengthening strategies were employed to improve immunization for migrants in China and they were rather successful. The experiences and lessons of immunization for migrant population in China might be helpful for other developing countries with a large number of migrant population.

  1. 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 Ministry's work on national health accounts, resource allocation, and national health ... a combined INS-FIOCRUS program, and the master's in public health and field ...

  2. Strengthening health-related rehabilitation services at national levels.

    Science.gov (United States)

    Gutenbrunner, Christoph; Bickenbach, Jerome; Melvin, John; Lains, Jorge; Nugraha, Boya

    2018-04-18

    One of the aims of the World Health Organization's Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up) rehabilitation services. This paper describes the measures required and how (advisory) missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

  3. Strengthening health-related rehabilitation services at national levels

    Directory of Open Access Journals (Sweden)

    Christoph Gutenbrunner

    2017-04-01

    Full Text Available Objective: One of the aims of the World Health Organization’s Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up rehabilitation services. This paper describes the measures required and how (advisory missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. Recommendations: It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. Conclusion: This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

  4. 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.

  5. 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.

  6. 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.

  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. 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 ...

  9. GOLD NETTING TO STRENGTHEN FINANCIAL SYSTEM STABILITY

    Directory of Open Access Journals (Sweden)

    Ahamed Kameel Mydin Meera

    2017-08-01

    Full Text Available Economic and financial crises seem to occur with increased frequency. Indeed now most countries, including several advanced economies like the US, Europe and Japan, are in serious economic recession. Employment and business opportunities have been much dampened. Inflation seems to be soaring globally and nations are witnessing widening gaps in income and wealth distribution. Many of these advanced economies are also facing shrinking population sizes that translate into aging problems and labor shortages. On top of those, there are environmental issues, including global warming. All these, in turn, have caused regional and global political conflicts and turmoil. The Arab Spring and the sovereign debt problems faced by some European countries like Greece are examples of this. Sustainability of economics and environment is thus of paramount concern of today. This paper considers those problems and suggests Interest-free Gold-based Electronic Netting System (IGENS as an effective way of injecting liquidity into the economy, practically free, that can spur business and employment while bringing about structural stability, inflation checked with both economic and environmental sustainability. Netting or muqassah is a transaction allowed in shari’ah and is practiced worldwide in different forms. Examples include the highly successful WIR Bank of Switzerland, various Local Exchange Trading Schemes (LETS and Bilateral and Multilateral Payment Arrangements between central banks.   Keywords:  Global crisis, Payment system, Gold, Netting, Muqassah, Liquidity, Sustainability, Financial system stability JEL Classification: E40, E42, E51

  10. 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.

  11. 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)

  12. 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

  13. Strengthening Health Systems Governance in Latin American ...

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

    This project seeks to improve the governance of health systems by designing and ... of the data (locally elected officials, health authorities, civil society groups), the ... In partnership with UNESCO's Organization for Women in Science for the ...

  14. 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.

  15. 78 FR 38053 - Regulatory Systems Strengthening

    Science.gov (United States)

    2013-06-25

    ... current state of medical product regulation globally, including challenges, risks, and emerging trends... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0010... product regulation; generation and analysis of evidence of regulatory systems performance; and provision...

  16. 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

  17. 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 ...

  18. 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).

  19. An approach to health system strengthening in the Democratic Peoples Republic of Korea (North Korea).

    Science.gov (United States)

    Grundy, John; Moodie, Rob

    2009-01-01

    The Democratic Peoples Republic of Korea (DPRK), under the leadership of the Ministry of Public Health (MOPH), undertook the development of a Health System Strengthening (HSS) proposal through the support of the Global Alliance for Vaccines and Immunization (GAVI). The aim of this paper is to outline the approach to the development of the HSS strategy in DPRK, and describe opportunities and challenges associated with its development and future implementation. Sources of information for this review have included national programme plans, in country social sector reviews, information generated through HSS proposal developments and the international literature. Updated assessments in DPRK indicate some recent improvements in the health situation for women and children, but there remain ongoing concerns regarding health management, human resource and physical infrastructure barriers to health services access. In response to this situation, the DPRK developed a health system strengthening strategy, the main elements of which are the strengthening of health management and service delivery systems at the implementing agency levels of county (district) and Ri (sub district). Three success factors were associated with the reaching of consensus on HSS strategy in DPRK. These were partnerships formed between system planners and programme planners, the identification of an overall health sector strategic framework, and high-level leadership of the MOPH. Although DPRK is in the very early stages of health system reconstruction, there are significant and new opportunities to alleviate the health conditions of women and children in DPRK, through implementation of health system strengthening strategies that are nationally coordinated and internationally supported.

  20. 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

  1. Improving the use of health data for health system strengthening

    Directory of Open Access Journals (Sweden)

    Tara Nutley

    2013-02-01

    Full Text Available Background: Good quality and timely data from health information systems are the foundation of all health systems. However, too often data sit in reports, on shelves or in databases and are not sufficiently utilised in policy and program development, improvement, strategic planning and advocacy. Without specific interventions aimed at improving the use of data produced by information systems, health systems will never fully be able to meet the needs of the populations they serve. Objective: To employ a logic model to describe a pathway of how specific activities and interventions can strengthen the use of health data in decision making to ultimately strengthen the health system. Design: A logic model was developed to provide a practical strategy for developing, monitoring and evaluating interventions to strengthen the use of data in decision making. The model draws on the collective strengths and similarities of previous work and adds to those previous works by making specific recommendations about interventions and activities that are most proximate to affect the use of data in decision making. The model provides an organizing framework for how interventions and activities work to strengthen the systematic demand, synthesis, review, and use of data. Results: The logic model and guidance are presented to facilitate its widespread use and to enable improved data-informed decision making in program review and planning, advocacy, policy development. Real world examples from the literature support the feasible application of the activities outlined in the model. Conclusions: The logic model provides specific and comprehensive guidance to improve data demand and use. It can be used to design, monitor and evaluate interventions, and to improve demand for, and use of, data in decision making. As more interventions are implemented to improve use of health data, those efforts need to be evaluated.

  2. 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

  3. Nanoscale strengthening mechanisms in metallic thin film systems

    Science.gov (United States)

    Schoeppner, Rachel Lynn

    Nano-scale strengthening mechanisms for thin films were investigated for systems governed by two different strengthening techniques: nano-laminate strengthening and oxide dispersion strengthening. Films were tested under elevated temperature conditions to investigate changes in deformation mechanisms at different operating temperatures, and the structural stability. Both systems exhibit remarkable stability after annealing and thus long-term reliability. Nano-scale metallic multilayers with smaller layer thicknesses show a greater relative resistance to decreasing strength at higher temperature testing conditions than those with larger layer thicknesses. This is seen in both Cu/Ni/Nb multilayers as well as a similar tri-component bi-layer system (Cu-Ni/Nb), which removed the coherent interface from the film. Both nanoindentation and micro-pillar compression tests investigated the strain-hardening ability of these two systems to determine what role the coherent interface plays in this mechanism. Tri-layer films showed a higher strain-hardening ability as the layer thickness decreased and a higher strain-hardening exponent than the bi-layer system: verifying the presence of a coherent interface increases the strain-hardening ability of these multilayer systems. Both systems exhibited hardening of the room temperature strength after annealing, suggesting a change in microstructure has occurred, unlike that seen in other multilayer systems. Oxide dispersion strengthened Au films showed a marked increase in hardness and wear resistance with the addition of ZnO particles. The threshold for stress-induced grain-refinement as opposed to grain growth is seen at concentrations of at least 0.5 vol%. These systems exhibited stable microstructures during thermal cycling in films containing at least 1.0%ZnO. Nanoindentation experiments show the drop in hardness following annealing is almost completely attributed to the resulting grain growth. Four-point probe resistivity

  4. 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.

  5. [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.

  6. 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

  7. Rethinking health systems strengthening: key systems thinking tools and strategies for transformational change.

    Science.gov (United States)

    Swanson, R Chad; Cattaneo, Adriano; Bradley, Elizabeth; Chunharas, Somsak; Atun, Rifat; Abbas, Kaja M; Katsaliaki, Korina; Mustafee, Navonil; Mason Meier, Benjamin; Best, Allan

    2012-10-01

    While reaching consensus on future plans to address current global health challenges is far from easy, there is broad agreement that reductionist approaches that suggest a limited set of targeted interventions to improve health around the world are inadequate. We argue that a comprehensive systems perspective should guide health practice, education, research and policy. We propose key 'systems thinking' tools and strategies that have the potential for transformational change in health systems. Three overarching themes span these tools and strategies: collaboration across disciplines, sectors and organizations; ongoing, iterative learning; and transformational leadership. The proposed tools and strategies in this paper can be applied, in varying degrees, to every organization within health systems, from families and communities to national ministries of health. While our categorization is necessarily incomplete, this initial effort will provide a valuable contribution to the health systems strengthening debate, as the need for a more systemic, rigorous perspective in health has never been greater.

  8. 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.

  9. 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

  10. 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.

  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. Strengthening Child Protection Systems for Unaccompanied Migrant Children in Mozambique

    DEFF Research Database (Denmark)

    Verdasco Martinez, Andrea

    children. By identifying children’s reasons for migrating, it identifies the main risks they encounter once they start living and working in Ressano Garcia. These include: lack of access to educational opportunities, exposure to child labour exploitation, trafficking and smuggling. This paper argues......This research sets out to understand the why, how and with whom of rural-urban internal migration of children to Ressano Garcia, a border town between Mozambique and South Africa. It addresses the overarching research question of how to strengthen child protection systems for unaccompanied migrant...... that child protection systems must respond to the unique situation of migrant children’s needs. Child protection and migration policies need to strike a balance between discouraging unsafe migration, which has the potential to expose children to violence, and ensuring that systems are in place for safe...

  13. 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

  14. 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

  15. 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.

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

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

    ... and the development of MSMEs and electronic commerce. Information and Communication Technologies (ICTs) are key to modernizing public administration systems in general and public procurement in particular. In 2002, national government procurement bodies established the Inter-American Network for Government ...

  17. Strengthening laboratory systems in resource-limited settings.

    Science.gov (United States)

    Olmsted, Stuart S; Moore, Melinda; Meili, Robin C; Duber, Herbert C; Wasserman, Jeffrey; Sama, Preethi; Mundell, Ben; Hilborne, Lee H

    2010-09-01

    Considerable resources have been invested in recent years to improve laboratory systems in resource-limited settings. We reviewed published reports, interviewed major donor organizations, and conducted case studies of laboratory systems in 3 countries to assess how countries and donors have worked together to improve laboratory services. While infrastructure and the provision of services have seen improvement, important opportunities remain for further advancement. Implementation of national laboratory plans is inconsistent, human resources are limited, and quality laboratory services rarely extend to lower tier laboratories (eg, health clinics, district hospitals). Coordination within, between, and among governments and donor organizations is also frequently problematic. Laboratory standardization and quality control are improving but remain challenging, making accreditation a difficult goal. Host country governments and their external funding partners should coordinate their efforts effectively around a host country's own national laboratory plan to advance sustainable capacity development throughout a country's laboratory system.

  18. 40 CFR 141.551 - What strengthened combined filter effluent turbidity limits must my system meet?

    Science.gov (United States)

    2010-07-01

    ... effluent turbidity limits must my system meet? 141.551 Section 141.551 Protection of Environment... Effluent Requirements § 141.551 What strengthened combined filter effluent turbidity limits must my system meet? Your system must meet two strengthened combined filter effluent turbidity limits. (a) The first...

  19. 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)

  20. 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

  1. A Strategic Approach to Establishing and Strengthening National Infrastructure for Radiation, Transport and Waste Safety

    International Nuclear Information System (INIS)

    Mastauskas, A.

    2016-01-01

    In Lithuania, as in the other countries of the world, in various areas, such as medicine, industry, education and training, agriculture the different technologies with the radioactive substances or devices, which generate ionizing radiation, are used. The responsibilities of each party and concern is to ensure the safe use ensure the radiation protection of the population and the environment. For every IAEA Member State in order to ensure the radiation safety, it is necessary to create the States radiation safety infrastructure: legislation, Regulatory Authority, technical support organizations. The International Atomic Energy Agency (IAEA) develops safety standards and assists Member States to create radiation safety infrastructure according the IAEA safety standards requirements. Noting that many Member States would benefit from bringing their radiation safety infrastructure more in line with IAEA Safety Standards, the Secretariat organized a meeting in May of 2014 of senior radiation safety experts from Africa, Asia & the Pacific, Europe, Latin America and North America, with the aim of developing a model strategic approach to establishing and strengthening national radiation safety infrastructure, with a special focus on Member States receiving assistance from the Agency. This model approach was presented to a wider audience on the margins of the IAEA General Conference in September 2014, where it was well received. This paper describes how the key elements of the model strategic approach were applied in Lithuania. The outcome of which showed that there is an adequate radiation safety infrastructure in place covering more than 50 legal acts, the establishment and empowerment of a Regulatory Authority – Radiation Protection Centre, technical support organizations – metrology and dosimetry services, and training centres. In Lithuania there exists a State registry of sources of ionizing radiation and occupational doses of exposure, a strong system of the

  2. 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.

  3. Health information system strengthening and malaria elimination in Papua New Guinea.

    Science.gov (United States)

    Rosewell, Alexander; Makita, Leo; Muscatello, David; John, Lucy Ninmongo; Bieb, Sibauk; Hutton, Ross; Ramamurthy, Sundar; Shearman, Phil

    2017-07-05

    The objective of the study was to describe an m-health initiative to strengthen malaria surveillance in a 184-health facility, multi-province, project aimed at strengthening the National Health Information System (NHIS) in a country with fragmented malaria surveillance, striving towards enhanced control, pre-elimination. A remote-loading mobile application and secure online platform for health professionals was created to interface with the new system (eNHIS). A case-based malaria testing register was developed and integrated geo-coded households, villages and health facilities. A malaria programme management dashboard was created, with village-level malaria mapping tools, and statistical algorithms to identify malaria outbreaks. Since its inception in 2015, 160,750 malaria testing records, including village of residence, have been reported to the eNHIS. These case-based, geo-coded malaria data are 100% complete, with a median data entry delay of 9 days from the date of testing. The system maps malaria to the village level in near real-time as well as the availability of treatment and diagnostics to health facility level. Data aggregation, analysis, outbreak detection, and reporting are automated. The study demonstrates that using mobile technologies and GIS in the capture and reporting of NHIS data in Papua New Guinea provides timely, high quality, geo-coded, case-based malaria data required for malaria elimination. The health systems strengthening approach of integrating malaria information management into the eNHIS optimizes sustainability and provides enormous flexibility to cater for future malaria programme needs.

  4. Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

    DEFF Research Database (Denmark)

    Obel, J; McKenzie, J; Buenconsejo-Lum, L E

    2015-01-01

    OBJECTIVE: To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccinatio...... of prevention programs, operational research and advocacy could strengthen political momentum for cervical cancer prevention and avoid risking the lives of many women in the Pacific....

  5. 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.

  6. 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.

  7. 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.

  8. Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership.

    Science.gov (United States)

    Drobac, Peter C; Basinga, Paulin; Condo, Jeanine; Farmer, Paul E; Finnegan, Karen E; Hamon, Jessie K; Amoroso, Cheryl; Hirschhorn, Lisa R; Kakoma, Jean Baptise; Lu, Chunling; Murangwa, Yusuf; Murray, Megan; Ngabo, Fidele; Rich, Michael; Thomson, Dana; Binagwaho, Agnes

    2013-01-01

    Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women's Hospital. The PHIT Partnership's health systems support aligns with the World Health Organization's six health systems building blocks. HSS activities focus across all levels of the health system - community, health center, hospital, and district leadership - to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health survey (DHS) in the intervention districts. The overall impact evaluation is complemented by an analysis of trends in facility health care utilization. A comprehensive costing project captures the total expenditures and financial inputs of the health care system to determine the cost of systems improvement. Targeted evaluations and operational research pieces focus on specific

  9. A policy study in strengthening the national infrastructure for radiation protection

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan Il [Korean Association for Radiation Protection, Seoul (Korea, Republic of); Lee, Jai Ki; Chang, Jaik Won; Lee, Choon Sik [Hanyang Univ., Seoul (Korea, Republic of); Whang, Joo Ho; Kim, Ki Ho [Kyunghee Univ., Seoul (Korea, Republic of)

    1999-03-15

    Public attitude declined further toward against the nuclear technology and eventually caused undue societal costs. Since the general public are aware of, or even afraid of, effects of radiation, it is hard to expect successful nuclear program without making them ease about radiation. In order to make the public feel easy and think that they get adequate protection, the infrastructure for radiation protection should be strengthened to the level corresponding to the utilization of nuclear/radiation technologies in the country. Public confidence in the role of the regulatory body is utmost important. The objectives of this study are to figure out a good model of regulatory body for radiation protection in Korea and to promulgate a draft legislations including provisions on the competent authority, the national policy and programs for upgraded infrastructure for radiation protection. As an appropriate form for the regulatory body in Korea, 'board of nuclear and radiation regulation', an independent and specialized organization under the direction of the prime minister, was proposed. It is expected that disadvantages dominate if the organization for radiation protection is separated from one for nuclear regulation. The proposed draft radiation protection acts consist of 8 chapters and 55 articles and some supplementary provisions. Copious footnotes provide explanations of the articles including the basis, considerations. justification.

  10. 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

  11. 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.

  12. 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.

  13. National Emission Information System

    International Nuclear Information System (INIS)

    Sajtakova, E.; Spisakova, K.

    2005-01-01

    In this presentation the Slovak National Emission Information System (NEIS) is presented. The NEIS represents hierarchical oriented modular system of acquisition, verification, saving and reporting of data about annual emissions and payments for pollution of atmosphere

  14. 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.

  15. [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.

  16. A national control system

    International Nuclear Information System (INIS)

    Larsson, A.

    1975-01-01

    An effective control of nuclear fissionable material is dependent on three different kinds of control, the industry - laboratory management, a national control system and an international safeguards system. The national systems of control differ greatly between various industrialized countries. Two principal reasons for fact can be mentioned. The type and the amounts for nuclear material may be different depending upon the stage of development of the nuclear industry in the country in question. Another reason may be that the country may wish to establish a very elaborate national system of control in order to minimize the IAEA control as much as possible. The two safeguards agreements between the Agency and Sweden on one hand and the Agency and Japan on the other hand can serve as examples for the understanding of the latitude of the IAEA safeguards system under NPT due to the influence of the national control system. If it thus is apparent that the national control system is strongly interrelated to the international safeguards system it is equally influenced by the control and accountancy systems which exist at the nuclear plants and development laboratories. A detailed study of national control systems and their relations to plant management control would fall outside the scope of this article. Some important features will however be examined. (author)

  17. 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 ...

  18. 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

  19. 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.

  20. 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...

  1. 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.

  2. Health system strengthening and hypertension management in China.

    Science.gov (United States)

    Huang, Kehui; Song, Yu Ting; He, Yong Huan; Feng, Xing Lin

    2016-01-01

    Non-communicable diseases are the leading causes of global burden of diseases, and hypertension is one of the most important risk factors. Hypertension prevalence doubled in China in the past decade and affects more than 300 million Chinese people. In the review we systematically searched peer-reviewed publications that link health system level factors with hypertension management in China and provide the current knowledge on how to improve a country's health system to manage the hypertension epidemic. A framework was developed to guide the review. The database of PubMed, CNKI were systematically searched from inception to April 13, 2016. Two authors independently screened the searched results for inclusion, conducted data extraction and appraised the quality of studies. Key findings were described according to the framework. Five hundred seventy-two publications were identified, where 11 articles were left according to the inclusion and exclusion criteria. The study periods range from 2010 to 2015. All about 11 researches linked health system factors to the outcome of hypertension management. And the outcomes were just focused on the awareness, treatment and control of hypertension but not hypertension incidence. One study is about the role of health system governance, investigating the performance of different organized community health care centers; three studies were about health financing comparing differences in insurance coverage; three studies were about health information practicing the hypertension guidelines of China or the WHO, and the rest three about mechanisms of health service delivery. No researches were identified about physical resources for health and human resources for health. Hypertension prevalence has been rising rapidly in China and the management of hypertension in China is a detection problem rather than treatment problem. Limited evidence shows the positive effect of health system factors on hypertension management and joint efforts

  3. 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

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

    Directory of Open Access Journals (Sweden)

    Alessandro De Vita

    2017-07-01

    Full Text Available 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 reinforced concrete (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.

  6. 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.

  7. 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.

  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. Implementation of a Strengthened International Safeguards System ABBAC 15 years

    International Nuclear Information System (INIS)

    Vicens, Hugo; Maceiras, Elena; Dominguez, Cristina A.

    2008-01-01

    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 for Accounting and Control of Nuclear Materials (ABACC), and how the international recommendation of radiological protection must be taken into account in the safeguards implementation and its impact in the international context. The ABACC has been a dynamic system, which contributes worldwide in the application of the regional and international safeguard. In 2006, the ABACC celebrated its 15th anniversary. The ABBAC was created in 1991 in the framework of a Bilateral Agreement for the Exclusively Peaceful use of Nuclear Energy, the ABBAC was created in order to apply the aforementioned system called 'Common System for Accounting and Control of Nuclear Materials' (SCCC). During this time, the ABBAC has grown in its implementation and has become a model in the application of regional safeguards that is recognized internationally. The ABBAC was the pillar to signed an Agreement between Argentina, Brazil, the ABBAC and the International Atomic Energy Agency, called 'Quadripartite Agreement', committed themselves to accept the application of safeguards to all nuclear materials in all the nuclear activities performed in both countries. The ABACC and the relevant implementing and supplementary agreements, set forth the conditions for the peaceful use of nuclear energy, the exchange of technical staff, the transfer of knowledge and international cooperation in a strong commitment to non-proliferation of nuclear weapons. This introduction provides an overview of political, legal and technical aspects implemented in the ABACC, which will be developed later in the paper. (author)

  10. Importance of Public-Private Partnerships: Strengthening Laboratory Medicine Systems and Clinical Practice in Africa.

    Science.gov (United States)

    Shrivastava, Ritu; Gadde, Renuka; Nkengasong, John N

    2016-04-15

    After the launch of the US President's Emergency Plan for AIDS Relief in 2003, it became evident that inadequate laboratory systems and services would severely limit the scale-up of human immunodeficiency virus infection prevention, care, and treatment programs. Thus, the Office of the US Global AIDS Coordinator, Centers for Disease Control and Prevention, and Becton, Dickinson and Company developed a public-private partnership (PPP). Between October 2007 and July 2012, the PPP combined the competencies of the public and private sectors to boost sustainable laboratory systems and develop workforce skills in 4 African countries. Key accomplishments of the initiative include measurable and scalable outcomes to strengthen national capacities to build technical skills, develop sample referral networks, map disease prevalence, support evidence-based health programming, and drive continuous quality improvement in laboratories. This report details lessons learned from our experience and a series of recommendations on how to achieve successful PPPs. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  11. Strengthening flood warning systems: the benefits of encouraging social preparedness

    Science.gov (United States)

    Girons Lopez, Marc; Di Baldassarre, Giuliano; Seibert, Jan

    2017-04-01

    Flood warning and response have normally been focused on the technical aspects and disregarded the connections and feedbacks between the hydrological and social dimensions. An increasing body of research, however, points at the importance of considering socio-hydrological aspects to improve flood damage mitigation. One of the key factors is the preparedness of the public and first responders during flood situations, which is influenced by many behavioural traits such as perceived benefits, risk awareness, or denial. In this study, we investigate the impact of social preparedness on the efficiency of flood early warning systems by using the recency of flood experience as a proxy for social preparedness. To this end, we developed a stylised model and a synthetic data-set to perform a hypothetical analysis. The main findings point to the importance of social preparedness for flood loss mitigation, especially when the technical forecasting and warning capabilities are limited. More specifically, efforts to promote and preserve social preparedness may help to reduce disaster-induced losses by almost one half. The findings from this study provide insights into the importance of considering social preparedness in decision-making for disaster risk reduction.

  12. 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.

  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. 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.

  15. Evaluation of a health system strengthening initiative in the Zambian prison system

    Science.gov (United States)

    Sharma, Anjali; Moonga, Clement N; Chileshe, Chisele; Magwende, George; Henostroza, German

    2018-01-01

    Introduction In 2013, the Zambian Correctional Service (ZCS) partnered with the Centre for Infectious Disease Research in Zambia on the Zambian Prisons Health System Strengthening project, seeking to tackle structural, organisational and cultural weaknesses within the prison health system. We present findings from a nested evaluation of the project impact on high, mid-level and facility-level health governance and health service arrangements in the Zambian Correctional Service. Methods Mixed methods were used, including document review, indepth interviews with ministry (11) and prison facility (6) officials, focus group discussions (12) with male and female inmates in six of the eleven intervention prisons, and participant observation during project workshops and meetings. Ethical clearance and verbal informed consent were obtained for all activities. Analysis incorporated deductive and iterative inductive coding. Results Outcomes: Improved knowledge of the prison health system strengthened political and bureaucratic will to materially address prison health needs. This found expression in a tripartite Memorandum of Understanding between the Ministry of Home Affairs, Ministry of Health (MOH) and Ministry of Community Development, and in the appointment of a permanent liaison between MOH and ZCS. Capacity-building workshops for ZCS Command resulted in strengthened health planning and management outcomes, including doubling ZCS health professional workforce (from 37 to78 between 2014 and 2016), new preservice basic health training for incoming ZCS officers and formation of facility-based prison health committees with a mandate for health promotion and protection. Mechanisms: continuous and facilitated communication among major stakeholders and the emergence of interorganisational trust were critical. Enabling contextual factors included a permissive political environment, a shift within ZCS from a ‘punitive’ to ‘correctional’ organisational culture, and

  16. 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.

  17. mHealth Interventions for Health System Strengthening in China: A Systematic Review

    Science.gov (United States)

    Zhang, Jing; Luo, Rong; Chen, Shi; Petrovic, Djordje; Redfern, Julie; Xu, Dong Roman; Patel, Anushka

    2017-01-01

    Background With rapidly expanding infrastructure in China, mobile technology has been deemed to have the potential to revolutionize health care delivery. There is particular promise for mobile health (mHealth) to positively influence health system reform and confront the new challenges of chronic diseases. Objective The aim of this study was to systematically review existing mHealth initiatives in China, characterize them, and examine the extent to which mHealth contributes toward the health system strengthening in China. Furthermore, we also aimed to identify gaps in mHealth development and evaluation. Methods We systematically reviewed the literature from English and Chinese electronic database and trial registries, including PubMed, EMBASE, Cochrane, China National Knowledge of Infrastructure (CNKI), and World Health Organization (WHO) International Clinical Trials Registry Platform. We used the English keywords of mHealth, eHealth, telemedicine, telehealth, mobile phone, cell phone, text messaging, and China, as well as their corresponding Chinese keywords. All articles using mobile technology for health care management were included in the study. Results A total of 1704 articles were found using the search terms, and eventually 72 were included. Overall, few high quality interventions were identified. Most interventions were found to be insufficient in scope, and their evaluation was of inadequate rigor to generate scalable solutions and provide reliable evidence of effectiveness. Most interventions focused on text messaging for consumer education and behavior change. There were a limited number of interventions that addressed health information management, health workforce issues, use of medicines and technologies, or leadership and governance from a health system perspective. Conclusions We provide four recommendations for future mHealth interventions in China that include the need for the development, evaluation and trials examining integrated m

  18. The Chinese version of monitoring and evaluation system strengthening tool for human immunodeficiency virus (HIV) capacity building: Development and evaluation.

    Science.gov (United States)

    Zhao, Ran; Chen, Ren; Zhang, Bing; Ma, Ying; Qin, Xia; Hu, Zhi

    2015-08-01

    Monitoring and evaluation (M&E) for human immunodeficiency virus (HIV) capacity building has become a significant step for HIV prevention and control. The M&E system strengthening tool published by the United Nations Joint Programme on HIV/AIDS (UNAIDS) was intended to be the most authoritative assessment tool internationally. Facing the fact that the M&E system in China did not function at an optimum level, we considered taking the international standards for reference. By linguistic validating and different stages' discussions and revisions, we came up with the Chinese version of the capacity diagnosis tool with at least 12 components and tested its validity and reliability. The tool turned out to have a sufficiently linguistic validation and proved to be a scientific and feasible instrument which was suitable for China's national conditions.

  19. 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.

  20. 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/.

  1. Rapid Syphilis Tests as Catalysts for Health Systems Strengthening: A Case Study from Peru

    Science.gov (United States)

    García, Patricia J.; Cárcamo, César P.; Chiappe, Marina; Valderrama, Maria; La Rosa, Sayda; Holmes, King K.; Mabey, David C. W.; Peeling, Rosanna W.

    2013-01-01

    Objectives Untreated maternal syphilis leads to adverse pregnancy outcomes. The use of point of care tests (POCT) offers an opportunity to improve screening coverage for syphilis and other aspects of health systems. Our objective is to present the experience of the introduction of POCT for syphilis in Peru and describe how new technology can catalyze health system strengthening. Methods The study was implemented from September 2009–November 2010 to assess the feasibility of the use of a POCT for syphilis for screening pregnant women in Lima, Peru. Outcomes measured included access to syphilis screening, treatment coverage, partner treatment, effect on patient flow and service efficiency, acceptability among providers and patients, and sustainability. Results Before the introduction of POCT, a pregnant woman needed 6 visits to the health center in 27 days before she received her syphilis result. We trained 604 health providers and implemented the POCT for syphilis as the “two for one strategy”, offering with one finger stick both syphilis and HIV testing. Implementation of the POCT resulted in testing and treatment on the first visit. Screening and treatment coverages for syphilis improved significantly compared with the previous year. Implementation of POCT has been scaled up nationally since the study ended, and coverages for screening, treatment and partner treatment have remained over 92%. Conclusions Implementation of POCT for syphilis proved feasible and acceptable, and led to improvement in several aspects of health services. For the process to be effective we highlight the importance of: (1) engaging the authorities; (2) dissipating tensions between providers and identifying champions; (3) training according to the needs; (4) providing monitoring, supervision, support and recognition; (5) sharing results and discussing actions together; (6) consulting and obtaining feedback from users; and (7) integrating with other services such as with rapid HIV

  2. Rapid Syphilis Tests as Catalysts for Health Systems Strengthening: A Case Study from Peru.

    Directory of Open Access Journals (Sweden)

    Patricia J García

    Full Text Available Untreated maternal syphilis leads to adverse pregnancy outcomes. The use of point of care tests (POCT offers an opportunity to improve screening coverage for syphilis and other aspects of health systems. Our objective is to present the experience of the introduction of POCT for syphilis in Peru and describe how new technology can catalyze health system strengthening.The study was implemented from September 2009-November 2010 to assess the feasibility of the use of a POCT for syphilis for screening pregnant women in Lima, Peru. Outcomes measured included access to syphilis screening, treatment coverage, partner treatment, effect on patient flow and service efficiency, acceptability among providers and patients, and sustainability.Before the introduction of POCT, a pregnant woman needed 6 visits to the health center in 27 days before she received her syphilis result. We trained 604 health providers and implemented the POCT for syphilis as the "two for one strategy", offering with one finger stick both syphilis and HIV testing. Implementation of the POCT resulted in testing and treatment on the first visit. Screening and treatment coverages for syphilis improved significantly compared with the previous year. Implementation of POCT has been scaled up nationally since the study ended, and coverages for screening, treatment and partner treatment have remained over 92%.Implementation of POCT for syphilis proved feasible and acceptable, and led to improvement in several aspects of health services. For the process to be effective we highlight the importance of: (1 engaging the authorities; (2 dissipating tensions between providers and identifying champions; (3 training according to the needs; (4 providing monitoring, supervision, support and recognition; (5 sharing results and discussing actions together; (6 consulting and obtaining feedback from users; and (7 integrating with other services such as with rapid HIV testing.

  3. National Innovation Systems

    DEFF Research Database (Denmark)

    Lundvall, Bengt-Åke

    2007-01-01

    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...... and why the concept came about. The paper argues that a key to progress is to get a better understanding of knowledge and learning as the basis for innovation and to understand how difference modes of innovation complement each other and find support in the specific national context. A core...... 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...

  4. 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.

  5. Pumping Iron in Australia: Prevalence, Trends and Sociodemographic Correlates of Muscle Strengthening Activity Participation from a National Sample of 195,926 Adults.

    Directory of Open Access Journals (Sweden)

    Jason A Bennie

    Full Text Available The current Australian Physical Activity Guidelines recommend that adults engage in regular muscle-strengthening activity (e.g. strength or resistance training. However, public health surveillance studies describing the patterns and trends of population-level muscle-strengthening activity participation are sparse. The aim of this study is to examine the prevalence, trends and sociodemographic correlates of muscle-strengthening activity participation in a national-representative sample of Australians aged 15 years and over.Between 2001 and 2010, quarterly cross-sectional national telephone surveys were conducted as part of the Australian Sports Commission's 'Exercise, Recreation and Sport Survey'. Pooled population-weighted proportions were calculated for reporting: [i] no muscle-strengthening activity; [ii] insufficient muscle-strengthening activity, and [iii] sufficient muscle-strengthening activity. Associations with sociodemographic variables were assessed using multiple logistic regression analyses.Out of 195,926 participants, aged 15-98 years, only 10.4% (95% CI: 10.1-10.7 and 9.3% (95% CI: 9.1-9.5 met the muscle-strengthening activity recommendations in the past two weeks and in the past year, respectively. Older adults (50+ years, and those living in socioeconomically disadvantaged, outer regional/remote areas and with lower education were less likely to report sufficient muscle-strengthening activity (p<0.001. Over the 10-year monitoring period, there was a significant increase in the prevalence of sufficient muscle-strengthening activity (6.4% to 12.0%, p-value for linear trend <0.001.A vast majority of Australian adults did not engage in sufficient muscle-strengthening activity. There is a need for public health strategies to support participation in muscle-strengthening activity in this population. Such strategies should target older and lower educated adults, and those living in socioeconomically disadvantaged, outer regional

  6. Public Health Perspectives of Preeclampsia in Developing Countries: Implication for Health System Strengthening

    OpenAIRE

    Kayode O. Osungbade; Olusimbo K. Ige

    2011-01-01

    Objectives. Review of public health perspectives of preeclampsia in developing countries and implications for health system strengthening. Methods. Literature from Pubmed (MEDLINE), AJOL, Google Scholar, and Cochrane database were reviewed. Results. The prevalence of preeclampsia in developing countries ranges from 1.8% to 16.7%. Many challenges exist in the prediction, prevention, and management of preeclampsia. Promising prophylactic measures like low-dose aspirin and calcium supplem...

  7. 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 ...

  8. 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.

  9. Global Fund investments in human resources for health: innovation and missed opportunities for health systems strengthening.

    Science.gov (United States)

    Bowser, Diana; Sparkes, Susan Powers; Mitchell, Andrew; Bossert, Thomas J; Bärnighausen, Till; Gedik, Gulin; Atun, Rifat

    2014-12-01

    a variety of mechanisms including salary top-ups, performance incentives, extra compensation and contracting of workers for part-time work, to pay health workers using Global Fund financing. Global Fund support for training and salary support was not co-ordinated with national strategic plans and there were major deficiencies in the data collected by the Global Fund to track HRH financing and to provide meaningful assessments of health system performance. The narrow disease focus and lack of co-ordination with national governments call into question the efficiency of funding and sustainability of Global Fund investments in HRH and their effectiveness in strengthening recipient countries' health systems. The lessons that emerge from this analysis can be used by both the Global Fund and other donors to improve co-ordination of investments and the effectiveness of programmes in recipient countries. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  10. Laboratory equipment maintenance: a critical bottleneck for strengthening health systems in sub-Saharan Africa?

    Science.gov (United States)

    Fonjungo, Peter N; Kebede, Yenew; Messele, Tsehaynesh; Ayana, Gonfa; Tibesso, Gudeta; Abebe, Almaz; Nkengasong, John N; Kenyon, Thomas

    2012-02-01

    Properly functioning laboratory equipment is a critical component for strengthening health systems in developing countries. The laboratory can be an entry point to improve population health and care of individuals for targeted diseases - prevention, care, and treatment of TB, HIV/AIDS, and malaria, plus maternal and neonatal health - as well as those lacking specific attention and funding. We review the benefits and persistent challenges associated with sustaining laboratory equipment maintenance. We propose equipment management policies as well as a comprehensive equipment maintenance strategy that would involve equipment manufacturers and strengthen local capacity through pre-service training of biomedical engineers. Strong country leadership and commitment are needed to assure development and sustained implementation of policies and strategies for standardization of equipment, and regulation of its procurement, donation, disposal, and replacement.

  11. 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

  12. 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

  13. mHealth Interventions for Health System Strengthening in China: A Systematic Review.

    Science.gov (United States)

    Tian, Maoyi; Zhang, Jing; Luo, Rong; Chen, Shi; Petrovic, Djordje; Redfern, Julie; Xu, Dong Roman; Patel, Anushka

    2017-03-16

    With rapidly expanding infrastructure in China, mobile technology has been deemed to have the potential to revolutionize health care delivery. There is particular promise for mobile health (mHealth) to positively influence health system reform and confront the new challenges of chronic diseases. The aim of this study was to systematically review existing mHealth initiatives in China, characterize them, and examine the extent to which mHealth contributes toward the health system strengthening in China. Furthermore, we also aimed to identify gaps in mHealth development and evaluation. We systematically reviewed the literature from English and Chinese electronic database and trial registries, including PubMed, EMBASE, Cochrane, China National Knowledge of Infrastructure (CNKI), and World Health Organization (WHO) International Clinical Trials Registry Platform. We used the English keywords of mHealth, eHealth, telemedicine, telehealth, mobile phone, cell phone, text messaging, and China, as well as their corresponding Chinese keywords. All articles using mobile technology for health care management were included in the study. A total of 1704 articles were found using the search terms, and eventually 72 were included. Overall, few high quality interventions were identified. Most interventions were found to be insufficient in scope, and their evaluation was of inadequate rigor to generate scalable solutions and provide reliable evidence of effectiveness. Most interventions focused on text messaging for consumer education and behavior change. There were a limited number of interventions that addressed health information management, health workforce issues, use of medicines and technologies, or leadership and governance from a health system perspective. We provide four recommendations for future mHealth interventions in China that include the need for the development, evaluation and trials examining integrated mHealth interventions to guide the development of future m

  14. 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.

  15. 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

  16. Comparison between TRM and FRP strengthening systems at preventing buckling failure of brick masonry walls

    Directory of Open Access Journals (Sweden)

    Bernat-Maso, E.

    2016-09-01

    Full Text Available Fibre Reinforced Polymer (FRP and Textile Reinforced Mortar (TRM have been studied, compared and applied to strengthen brick masonry walls. The comparison of their performance against second order bending effects is addressed in this paper for the first time. Experimental and analytical data from previous researches and new analytical data for TRM cases are summarised, ordered and systematically compared to analyse the structural response of strengthened brick masonry walls. The results show a similar performance for both systems in terms of load bearing capacity and in-plane response. However, TRM strengthened cases showed greater lateral deformation than FRP ones.Materiales tipo Fibre Reinforced Polymer (FRP y Textile Reinforced Mortar (TRM han sido estudiados, comparados y aplicados para reforzar muros de fábrica de ladrillo. La comparación de su comportamiento frente a efectos de flexión de segundo orden se abordada en este artículo por primera vez. Datos experimentales y analíticos de investigaciones previas y nuevos datos analíticos para los casos de TRM son resumidos, ordenados y sistemáticamente comparados para analizar la respuesta estructural de los muros de fábrica de ladrillo reforzados. Los resultados muestran un comportamiento similar de los dos sistemas respecto su capacidad de carga y su respuesta en el plano. Los casos reforzados con TRM mostraron desplazamientos laterales superiores a los reforzados con FRP.

  17. 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

  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. 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.

  20. 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...

  1. 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.

  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. 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.

  4. What It's Worth: Strengthening the Financial Future of Families, Communities and the Nation

    Directory of Open Access Journals (Sweden)

    Cherie Stueve

    2016-09-01

    Full Text Available This book overviews the financial challenges of vulnerable Americans and creative programs that look beyond income as a metric of financial health is divided into four sections. The first section, “Where We Are,” describes the current financial statistics of households by demographic and economic era. The second (and largest section, “Why Financial Well-Being Matters for All,” is broken into four topics: the economy, financial services system, and community; employment and business; health and social services; and education. Each illustrates the strong role financial well-being plays in other systems at the individual and community level.

  5. 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

  6. 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.

  7. What It's Worth: Strengthening the Financial Future of Families, Communities and the Nation

    OpenAIRE

    Cherie Stueve

    2016-01-01

    This book overviews the financial challenges of vulnerable Americans and creative programs that look beyond income as a metric of financial health is divided into four sections. The first section, “Where We Are,” describes the current financial statistics of households by demographic and economic era. The second (and largest) section, “Why Financial Well-Being Matters for All,” is broken into four topics: the economy, financial services system, and community; employment and business; health a...

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. The importance of gender analysis in research for health systems strengthening.

    Science.gov (United States)

    Theobald, Sally; Morgan, Rosemary; Hawkins, Kate; Ssali, Sarah; George, Asha; Molyneux, Sassy

    2017-12-01

    This editorial discusses a collection of papers examining gender across a range of health policy and systems contexts, from access to services, governance, health financing, and human resources for health. The papers interrogate differing health issues and core health systems functions using a gender lens. Together they produce new knowledge on the multiple impacts of gender on health experiences and demonstrate the importance of gender analyses and gender sensitive interventions for promoting well-being and health systems strengthening. The findings from these papers collectively show how gender intersects with other axes of inequity within specific contexts to shape experiences of health and health seeking within households, communities and health systems; illustrate how gender power relations affect access to important resources; and demonstrate that gender norms, poverty and patriarchy interplay to limit women's choices and chances both within household interactions and within the health sector. Health systems researchers have a responsibility to promote the incorporation of gender analyses into their studies in order to inform more strategic, effective and equitable health systems interventions, programmes, and policies. Responding to gender inequitable systems, institutions, and services in this sector requires an 'all hands-on deck' approach. We cannot claim to take a 'people-centred approach' to health systems if the status quo continues. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  13. Polio Eradication Initiative (PEI) contribution in strengthening public health laboratories systems in the African region.

    Science.gov (United States)

    Gumede, Nicksy; Coulibaly, Sheick Oumar; Yahaya, Ali Ahmed; Ndihokubwayo, Jean-Bosco; Nsubuga, Peter; Okeibunor, Joseph; Dosseh, Annick; Salla, Mbaye; Mihigo, Richard; Mkanda, Pascal; Byabamazima, Charles

    2016-10-10

    The laboratory has always played a very critical role in diagnosis of the diseases. The success of any disease programme is based on a functional laboratory network. Health laboratory services are an integral component of the health system. Efficiency and effectiveness of both clinical and public health functions including surveillance, diagnosis, prevention, treatment, research and health promotion are influenced by reliable laboratory services. The establishment of the African Regional polio laboratory for the Polio Eradication Initiative (PEI) has contributed in supporting countries in their efforts to strengthen laboratory capacity. On the eve of the closing of the program, we have shown through this article, examples of this contribution in two countries of the African region: Côte d'Ivoire and the Democratic Republic of Congo. Descriptive studies were carried out in Côte d'Ivoire (RCI) and Democratic Republic of Congo (DRC) from October to December 2014. Questionnaires and self-administered and in-depth interviews and group discussions as well as records and observation were used to collect information during laboratory visits and assessments. The PEI financial support allows to maintain the majority of the 14 (DRC) and 12 (RCI) staff involved in the polio laboratory as full or in part time members. Through laboratory technical staff training supported by the PEI, skills and knowledge were gained to reinforce laboratories capacity and performance in quality laboratory functioning, processes and techniques such as cell culture. In the same way, infrastructure was improved and equipment provided. General laboratory quality standards, including the entire laboratory key elements was improved through the PEI accreditation process. The Polio Eradication Initiative (PEI) is a good example of contribution in strengthening public health laboratories systems in the African region. It has established strong Polio Laboratory network that contributed to the

  14. 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.

  15. 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.

  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

    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%, 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. PMID:27431474

  17. 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.

  18. Mass Drug Administration and beyond: how can we strengthen health systems to deliver complex interventions to eliminate neglected tropical diseases?

    Science.gov (United States)

    Macpherson, Eleanor E; Adams, Emily R; Bockarie, Moses J; Hollingsworth, T Deirdre; Kelly-Hope, Louise A; Lehane, Mike; Kovacic, Vanja; Harrison, Robert A; Paine, Mark Ji; Reimer, Lisa J; Torr, Stephen J

    2015-01-01

    Achieving the 2020 goals for Neglected Tropical Diseases (NTDs) requires scale-up of Mass Drug Administration (MDA) which will require long-term commitment of national and global financing partners, strengthening national capacity and, at the community level, systems to monitor and evaluate activities and impact. For some settings and diseases, MDA is not appropriate and alternative interventions are required. Operational research is necessary to identify how existing MDA networks can deliver this more complex range of interventions equitably. The final stages of the different global programmes to eliminate NTDs require eliminating foci of transmission which are likely to persist in complex and remote rural settings. Operational research is required to identify how current tools and practices might be adapted to locate and eliminate these hard-to-reach foci. Chronic disabilities caused by NTDs will persist after transmission of pathogens ceases. Development and delivery of sustainable services to reduce the NTD-related disability is an urgent public health priority. LSTM and its partners are world leaders in developing and delivering interventions to control vector-borne NTDs and malaria, particularly in hard-to-reach settings in Africa. Our experience, partnerships and research capacity allows us to serve as a hub for developing, supporting, monitoring and evaluating global programmes to eliminate NTDs.

  19. Interconnected national system

    International Nuclear Information System (INIS)

    Cespedes, Jose Renato

    2000-01-01

    The paper is about the panorama of Colombia with relationship to the electric system, which is compound for hydroelectric and thermal systems; it also includes other topics on their development like expansion plan to year 2010

  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. Health system strengthening in Myanmar during political reforms: perspectives from international agencies.

    Science.gov (United States)

    Risso-Gill, Isabelle; McKee, Martin; Coker, Richard; Piot, Peter; Legido-Quigley, Helena

    2014-07-01

    Myanmar has undergone a remarkable political transformation in the last 2 years, with its leadership voluntarily transitioning from an isolated military regime to a quasi-civilian government intent on re-engaging with the international community. Decades of underinvestment have left the country underdeveloped with a fragile health system and poor health outcomes. International aid agencies have found engagement with the Myanmar government difficult but this is changing rapidly and it is opportune to consider how Myanmar can engage with the global health system strengthening (HSS) agenda. Nineteen semi-structured, face-to-face interviews were conducted with representatives from international agencies working in Myanmar to capture their perspectives on HSS following political reform. They explored their perceptions of HSS and the opportunities for implementation. Participants reported challenges in engaging with government, reflecting the disharmony between actors, economic sanctions and barriers to service delivery due to health system weaknesses and bureaucracy. Weaknesses included human resources, data and medical products/infrastructure and logistical challenges. Agencies had mixed views of health system finance and governance, identifying problems and also some positive aspects. There is little consensus on how HSS should be approached in Myanmar, but much interest in collaborating to achieve it. Despite myriad challenges and concerns, participants were generally positive about the recent political changes, and remain optimistic as they engage in HSS activities with the government.

  2. People-centred science: strengthening the practice of health policy and systems research

    Science.gov (United States)

    2014-01-01

    Health policy and systems research (HPSR) is a transdisciplinary field of global importance, with its own emerging standards for creating, evaluating, and utilizing knowledge, and distinguished by a particular orientation towards influencing policy and wider action to strengthen health systems. In this commentary, we argue that the ability of the HPSR field to influence real world change hinges on its becoming more people-centred. We see people-centredness as recognizing the field of enquiry as one of social construction, requiring those conducting HPSR to locate their own position in the system, and conduct and publish research in a manner that foregrounds human agency attributes and values, and is acutely attentive to policy context. Change occurs at many layers of a health system, shaped by social, political, and economic forces, and brought about by different groups of people who make up the system, including service users and communities. The seeds of transformative practice in HPSR lie in amplifying the breadth and depth of dialogue across health system actors in the conduct of research – recognizing that these actors are all generators, sources, and users of knowledge about the system. While building such a dialogic practice, those conducting HPSR must strive to protect the autonomy and integrity of their ideas and actions, and also clearly explain their own positions and the value-basis of their work. We conclude with a set of questions that health policy and systems researchers may wish to consider in making their practice more people-centred, and hence more oriented toward real-world change. PMID:24739525

  3. 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

  4. 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

  5. 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...

  6. 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....

  7. 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

  8. 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.

  9. Research priority setting for health policy and health systems strengthening in Nigeria: the policymakers and stakeholders perspective and involvement.

    Science.gov (United States)

    Uneke, Chigozie Jesse; Ezeoha, Abel Ebeh; Ndukwe, Chinwendu Daniel; Oyibo, Patrick Gold; Onwe, Friday; Aulakh, Bhupinder Kaur

    2013-01-01

    Nigeria is one of the low and middle income countries (LMICs) facing severe resource constraint, making it impossible for adequate resources to be allocated to the health sector. Priority setting becomes imperative because it guides investments in health care, health research and respects resource constraints. The objective of this study was to enhance the knowledge and understanding of policymakers on research priority setting and to conduct a research priority setting exercise. A one-day evidence-to-policy research priority setting meeting was held. The meeting participants included senior and middle level policymakers and key decision makers/stakeholders in the health sector in Ebonyi State southeastern Nigeria. The priorities setting meeting involved a training session on priority setting process and conduction of priority setting exercise using the essential national health research (ENHR) approach. The focus was on the health systems building blocks (health workforce; health finance; leadership/governance; medical products/technology; service delivery; and health information/evidence). Of the total of 92 policymakers invited 90(97.8%) attended the meeting. It was the consensus of the policymakers that research should focus on the challenges of optimal access to health products and technology; effective health service delivery and disease control under a national emergency situation; the shortfalls in the supply of professional personnel; and the issues of governance in the health sector management. Research priority setting exercise involving policymakers is an example of demand driven strategy in the health policymaking process capable of reversing inequities and strengthening the health systems in LMICs.

  10. 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

  11. Health system strengthening: prospects and threats for its sustainability on the global health policy agenda.

    Science.gov (United States)

    Naimoli, Joseph F; Saxena, Sweta; Hatt, Laurel E; Yarrow, Kristina M; White, Trenton M; Ifafore-Calfee, Temitayo

    2018-01-01

    In 2013, Hafner and Shiffman applied Kingdon's public policy process model to explain the emergence of global attention to health system strengthening (HSS). They questioned, however, HSS's sustainability on the global health policy agenda, citing various concerns. Guided by the Grindle and Thomas interactive model of policy implementation, we advance and elaborate a proposition: a confluence of developments will contribute to maintaining HSS's prominent place on the agenda until at least 2030. Those developments include (1) technical, managerial, financial, and political responses to unpredictable public health crises that imperil the routine functioning of health systems, such as the 2014-2015 Ebola virus disease (Ebola) epidemic in West Africa; (2) similar responses to non-crisis situations requiring fully engaged, robust health systems, such as the pursuit of the new Sustainable Development Goal for health (SDG3); and (3) increased availability of new knowledge about system change at macro, meso, and micro levels and its effects on people's health and well-being. To gauge the accuracy of our proposition, we carried out a speculative assessment of credible threats to our premise by discussing all of the Hafner-Shiffman concerns. We conclude that (1) the components of our proposition and other forces that have the potential to promote continuing attention to HSS are of sufficient strength to counteract these concerns, and (2) prospective monitoring of HSS agenda status and further research on agenda sustainability can increase confidence in our threat assessment. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Strengthening eHealth systems to reduce maternal and infant mortality

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

    The Mos@n project, part of the SEARCH initiative, leveraged the widespread use of mobile phones to monitor patients and their use of healthcare services in 26 villages. The mobile phone-based system — with content in five local languages — in addition to the training of midwives and engagement with national and ...

  13. 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…

  14. 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.

  15. 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.

  16. 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…

  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. 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 ...

  19. 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.

  20. 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

  1. 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

  2. National Energy Outlook Modelling System

    Energy Technology Data Exchange (ETDEWEB)

    Volkers, C.M. [ECN Policy Studies, Petten (Netherlands)

    2013-12-15

    For over 20 years, the Energy research Centre of the Netherlands (ECN) has been developing the National Energy Outlook Modelling System (NEOMS) for Energy projections and policy evaluations. NEOMS enables 12 energy models of ECN to exchange data and produce consistent and detailed results.

  3. UN Women’s experience with strengthening evaluation systems in Africa: Enhancing quantity, quality and use of evaluations

    Directory of Open Access Journals (Sweden)

    Caspar Merkle

    2016-12-01

    Full Text Available Background: Following the adoption of the Women Evaluation Policy in 2012, a series of systems and mechanisms were introduced in the organisation to strengthen the evaluation function at both central and decentralised levels. They were based on a systemic approach and a Theory of Change for building an enabling environment for evaluation in UN Women. Objectives: The purpose of this article was to analyse progress made and challenges with respect to establishing evaluation systems and institutionalising an evaluation culture in the UN Women Africa region. Method: The article draws on UN Women evaluation performance data collected over the past five years, discussions and practical experience by the author of working on evaluation with UN Women since 2009. It also analyses UN Women documents and the broader literature on the topic. Results: The findings illustrate that the different mechanisms to strengthen the evaluation function in UN Women show progress in the Africa region on four out of the five selected evaluation performance indicators. The Theory of Change to strengthen the UN Women evaluation function is largely validated by the wider literature on evaluation use. External assessments confirm that the UN Women evaluation function is sound overall. Conclusion: The article concludes that evaluation performance indicators only provide a partial snapshot of the many different factors that help or undermine evaluative thinking and a learning culture within an organisation. Institutional systems and mechanisms are necessary but not sufficient for nurturing an evaluation culture and ensuring utilisation of evaluation for better development effectiveness.

  4. 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.

  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. 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

  7. 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

  8. Health service planning contributes to policy dialogue around strengthening district health systems: an example from DR Congo 2008-2013.

    Science.gov (United States)

    Rajan, Dheepa; Kalambay, Hyppolite; Mossoko, Mathias; Kwete, Dieudonné; Bulakali, Joseph; Lokonga, Jean-Pierre; Porignon, Denis; Schmets, Gerard

    2014-10-31

    This case study from DR Congo demonstrates how rational operational planning based on a health systems strengthening strategy (HSSS) can contribute to policy dialogue over several years. It explores the operationalization of a national strategy at district level by elucidating a normative model district resource plan which details the resources and costs of providing an essential health services package at district level. This paper then points to concrete examples of how the results of this exercise were used for Ministry of Health (MoH) decision-making over a time period of 5 years. DR Congo's HSSS and its accompanying essential health services package were taken as a base to construct a normative model health district comprising of 10 Health Centres (HC) and 1 District Hospital (DH). The normative model health district represents a standard set by the Ministry of Health for providing essential primary health care services. The minimum operating budget necessary to run a normative model health district is $17.91 per inhabitant per year, of which $11.86 is for the district hospital and $6.05 for the health centre. The Ministry of Health has employed the results of this exercise in 4 principal ways: 1.Advocacy and negotiation instrument; 2. Instrument to align donors; 3. Field planning; 4. Costing database to extract data from when necessary. The above results have been key in the policy dialogue on affordability of the essential health services package in DR Congo. It has allowed the MoH to provide transparent information on financing needs around the HSSS; it continues to help the MoH negotiate with the Ministry of Finance and bring partner support behind the HSSS.

  9. 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

  10. Vertical funding, non-governmental organizations, and health system strengthening: perspectives of public sector health workers in Mozambique.

    Science.gov (United States)

    Mussa, Abdul H; Pfeiffer, James; Gloyd, Stephen S; Sherr, Kenneth

    2013-06-14

    In the rapid scale-up of human immunodeficiency virus (HIV) care and acquired immunodeficiency syndrome (AIDS) treatment, many donors have chosen to channel their funds to non-governmental organizations and other private partners rather than public sector systems. This approach has reinforced a private sector, vertical approach to addressing the HIV epidemic. As progress on stemming the epidemic has stalled in some areas, there is a growing recognition that overall health system strengthening, including health workforce development, will be essential to meet AIDS treatment goals. Mozambique has experienced an especially dramatic increase in disease-specific support over the last eight years. We explored the perspectives and experiences of key Mozambican public sector health managers who coordinate, implement, and manage the myriad donor-driven projects and agencies. Over a four-month period, we conducted 41 individual qualitative interviews with key Ministry workers at three levels in the Mozambique national health system, using open-ended semi-structured interview guides. We also reviewed planning documents. All respondents emphasized the value and importance of international aid and vertical funding to the health sector and each highlighted program successes that were made possible by recent increased aid flows. However, three serious concerns emerged: 1) difficulties coordinating external resources and challenges to local control over the use of resources channeled to international private organizations; 2) inequalities created within the health system produced by vertical funds channeled to specific services while other sectors remain under-resourced; and 3) the exodus of health workers from the public sector health system provoked by large disparities in salaries and work. The Ministry of Health attempted to coordinate aid by implementing a "sector-wide approach" to bring the partners together in setting priorities, harmonizing planning, and coordinating

  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. The Jordanian National Tourism System

    OpenAIRE

    Alrawadieh, Ziad

    2009-01-01

    Summary The study of National Tourism System in Jordan aims to shed some light on the structure of tourism industry in Jordan by illustrating the real resources present in the country, assessing the quality of services, and then exploring the management efficiency, ie. Governance dimension. The work has been based on the structure provided by the Resource-based Theory (RBT) which gives a significant weight to the existed resources in the territory and considers them as an important fac...

  13. 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.

  14. Strengthening the Health System to Better Confront Noncommunicable Diseases in India

    Directory of Open Access Journals (Sweden)

    Antonio Duran

    2011-01-01

    Full Text Available The paper emphasizes the vital need to address the rising burden of noncommunicable diseases (NCDs in India with a health systems approach. The authors argue that adoption of such approach may soon be imperative. Applying the health systems framework developed by the WHO in 2000 to NCDs means in summary re-examining the planning and organization of the entire health system, from service provision to financing, from information generation to ensuring adequate supply of pharmaceuticals/technologies or human resources, from improving facility management to performance monitoring. Using this framework the authors seek to highlight core issues and identify possible policy actions required. The challenge is to ensure the best implementation of what works, aligning the service provision function with the financial incentives, ensuring leadership/stewardship by the government across local/municipal, state or regional and national level while involving stakeholders. A health system perspective would also ensure that action against NCD goes hand in hand with tackling the remaining burden from communicable diseases, maternal, child health and nutrition issues.

  15. 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.

  16. 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

  17. 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.

  18. 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

  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. 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

  1. 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

  2. Polycrystalline strengthening

    DEFF Research Database (Denmark)

    Hansen, Niels

    1985-01-01

    for the understanding of polycrystalline strengthening is obtained mainly from surface relief patterns and from bulk structures observed by transmission electron microscopy of thin foils. The results obtained by these methods are discussed and correlations are proposed. A number of features characterizing the deformed...... structure are summarized and the behavior of a number of metals and alloys is reviewed with emphasis on the structural changes in the interior of the grains and in the vicinity of the grain boundaries. The models for strain accommodation during deformation are discussed on the basis of the microstructures...

  3. 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.

  4. 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.

  5. 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

  6. Dispersion strengthening

    International Nuclear Information System (INIS)

    Scattergood, R.O.; Das, E.S.P.

    1976-01-01

    Using digital computer-based methods, models for dispersion strengthening can now be developed which take into account many of the important effects that have been neglected in the past. In particular, the self interaction of a dislocation can be treated, and a computer simulation method was developed to determine the flow stress of a random distribution of circular, impenetrable obstacles, taking into account all such interactions. The flow stress values depended on the obstacle sizes and spacings, over and above the usual 1/L dependence where L is the average obstacle spacing. From an analysis of the results, it was found that the main effects of the self interactions can be captured in a line tension analogue in which the obstacles appear to be penetrable

  7. Reforming the reform: the Greek National Health System in transition.

    Science.gov (United States)

    Tountas, Yannis; Karnaki, Panagiota; Pavi, Elpida

    2002-10-01

    The National Health System (ESY) in Greece, which was established in 1983, is in a state of continuous crisis. This situation is caused mainly by the system's problematic administration, low productivity and inadequate Primary Health Care. These have led the re-elected PASOK government to introduce by the end of 2000 a radical reform of the health system. The 200 reform measures announced by the new Minister of Health and Welfare include changes aiming at: the decentralization of the ESY, the creation of a unified financing system for the social insurance funds, a new management structure in public hospitals, the organization of a Primary Health System in urban areas, and the strengthening of Public Health and Health Promotion. These changes are presented and discussed in this paper.

  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. Preventive Treatments of Iron Deficiency Anaemia in Pregnancy: A Review of Their Effectiveness and Implications for Health System Strengthening

    Directory of Open Access Journals (Sweden)

    Kayode O. Osungbade

    2012-01-01

    Full Text Available Objectives. We conducted a review of effectiveness of preventive treatments of iron deficiency anaemia in pregnancy in developing countries and highlighted their constraints as well as interventions required to strengthen the health services. Methods. Literature from Pubmed (MEDLINE, AJOL, Google Scholar, and Cochrane database was reviewed. Results. Evidence-based preventive treatment options for iron deficiency anaemia in pregnancy include prophylaxis iron supplements and food fortification with iron. Evidence abounds on their effectiveness in reducing the prevalence of iron deficiency anaemia in pregnancy. However, these prospects are threatened by side effects of iron supplements, low utilization of maternal health service in developing countries, partial implementation of preventive treatments, and weak infrastructure and political commitment to implement mass fortification of local staple foods by national governments. Conclusion. Sustainability of effectiveness of preventive treatments of iron deficiency anaemia in pregnancy could be achieved if the identified threats are adequately addressed.

  10. 76 FR 81359 - National Security Personnel System

    Science.gov (United States)

    2011-12-28

    ... Security Personnel System AGENCY: Department of Defense; Office of Personnel Management. ACTION: Final rule... concerning the National Security Personnel System (NSPS). Section 1113 of the National Defense Authorization... National Security Personnel System (NSPS) in regulations jointly prescribed by DOD and OPM (Office of...

  11. 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

  12. 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…

  13. The Role of Non-State Actors in Strengthening Health Systems ...

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

    Home · What we do ... The services they provide vary immensely in complexity and national importance. ... for achieving universal health coverage in the form of quality health services that are accessible without the risk of financial hardship.

  14. 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

  15. "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

  16. 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.

  17. Strengthening preventive care programs: a permanent challenge for healthcare systems; lessons from PREVENIMSS México

    Directory of Open Access Journals (Sweden)

    Cantón Sonia

    2010-07-01

    Full Text Available Abstract Background In 2001, the Instituto Mexicano del Seguro Social (IMSS carried out a major reorganization to provide comprehensive preventive care to reinforce primary care services through the PREVENIMSS program. This program divides the population into programmatic age groups that receive specific preventive services: children (0-9 years, adolescents (10-19 years, men (20-59 years, women (20-59 years and older adults (> = 60 years. The objective of this paper is to describe the improvement of the PREVENIMSS program in terms of the increase of coverage of preventive actions and the identification of unmet needs of unsolved and emergent health problems. Methods From 2003 to 2006, four nation-wide cross-sectional probabilistic population based surveys were conducted using a four stage sampling design. Thirty thousand households were visited in each survey. The number of IMSS members interviewed ranged from 79,797 respondents in 2003 to 117,036 respondents in 2006. Results The four surveys showed a substantial increase in coverage indicators for each age group: children, completed schemes of vaccination (> 90%, iron supplementation (17.8% to 65.5%, newborn screening for metabolic disorders (60.3% to 81.6%. Adolescents, measles - rubella vaccine (52.4% to 71.4%, hepatitis vaccine (9.3% to 46.2%, use of condoms (17.9% to 59.9%. Women, measles-rubella vaccine (28.5% to 59-2%, cervical cancer screening (66.7% to 75%, breast cancer screening (> 2.1%. Men, type 2 diabetes screening (38.6% to 57.8% hypertension screening (48-4% to 64.0%. Older adults, pneumococcal vaccine (13.2% to 24.9%, influenza vaccine (12.6% to 52.9 Regarding the unmet needs, the prevalence of anemia in children was 30% and a growing prevalence of overweight and obesity, type 2 diabetes, and hypertension was found in men, women and older adults. Conclusion PREVENIMSS showed an important increase in the coverage of preventive services and stressed the magnitude of the old and

  18. 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.

  19. 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...... Advantage of Nations" (Porter, 1990). The paper develops a discussion of time, space and place in order to discuss critically the different theories. It is asserted that a process of globalization is leading to a new production of time-space perceptions and practices where localization and globalization...... is becoming increasingly important....

  20. The national system of nuclear material control development and challenges. Vol. 3

    International Nuclear Information System (INIS)

    Badawy, I.

    1996-01-01

    This paper presents the major factors which may affect the implementation of the National System of Nuclear Material Accounting and Safeguards in Egypt. Developments of this National System-being a division of the Nuclear Regulatory Body in the country-are discussed. Also, recent requirements of the International Atomic Energy Agency within the policy of strengthening its regime of international nuclear control are reviewed. The challenges facing the National System are indicated taking in consideration the anticipated growth in the nuclear field in Egypt by the year 2000 and after. 2 figs

  1. The national system of nuclear material control development and challenges. Vol. 3

    Energy Technology Data Exchange (ETDEWEB)

    Badawy, I [National Centre for Nuclear Safety and Radiation Control, Atomic Energy Authority, Cairo (Egypt)

    1996-03-01

    This paper presents the major factors which may affect the implementation of the National System of Nuclear Material Accounting and Safeguards in Egypt. Developments of this National System-being a division of the Nuclear Regulatory Body in the country-are discussed. Also, recent requirements of the International Atomic Energy Agency within the policy of strengthening its regime of international nuclear control are reviewed. The challenges facing the National System are indicated taking in consideration the anticipated growth in the nuclear field in Egypt by the year 2000 and after. 2 figs.

  2. 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...

  3. Challenges to implementing Gavi's health system strengthening support in Chad and Cameroon: results from a mixed-methods evaluation.

    Science.gov (United States)

    Dansereau, Emily; Miangotar, Yodé; Squires, Ellen; Mimche, Honoré; El Bcheraoui, Charbel

    2017-11-16

    Since 2005, Gavi has provided health system strengthening (HSS) grants to address bottlenecks affecting immunization services. This study is the first to evaluate the Gavi HSS implementation process in either Cameroon or Chad, two countries with significant health system challenges and poor achievement on the child and maternal health Millennium Development Goals. We triangulated quantitative and qualitative data including financial records, document review, field visit questionnaires, and key informant interviews (KII) with representatives from the Ministries of Health, Gavi, and other partners. We conducted a Root Cause Analysis of key implementation challenges, guided by the Consolidated Framework for Implementation Research. We conducted 124 field visits and 43 KIIs in Cameroon, and 57 field visits and 39 KIIs in Chad. Cameroon's and Chad's HSS programs were characterized by delayed disbursements, significant deviations from approved expenditures, and reprogramming of funds. Nearly a year after the programs were intended to be complete, many district and facility-level activities were only partially implemented and significant funds remained unabsorbed. Root causes of these challenges included unpredictable Gavi processes and disbursements, poor communication between the countries and Gavi, insufficient country planning without adequate technical assistance, lack of country staff and leadership, and weak country systems to manage finances and promote institutional memory. Though Chad and Cameroon both critically needed support to strengthen their weak health systems, serious challenges drastically limited implementation of their Gavi HSS programs. Implementation of future HSS programs in these and similar settings can be improved by transparent and reliable procedures and communication from Gavi, proposals that account for countries' programmatic capacity and the potential for delayed disbursements, implementation practices that foster learning and adaptation

  4. 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

  5. From bouncing back, to nurturing emergence: reframing the concept of resilience in health systems strengthening.

    Science.gov (United States)

    Barasa, Edwine W; Cloete, Keith; Gilson, Lucy

    2017-11-01

    Recent health system shocks such as the Ebola disease outbreak have focused global health attention on the notion of resilient health systems. In this commentary, we reflect on the current framing of the concept of resilience in health systems discourse and propose a reframing. Specifically, we propose that: (1) in addition to sudden shocks, health systems face the ongoing strain of multiple factors. Health systems need the capacity to continue to deliver services of good quality and respond effectively to wider health challenges. We call this capacity everyday resilience; (2) health system resilience entails more than bouncing back from shock. In complex adaptive systems (CAS), resilience emerges from a combination of absorptive, adaptive and transformative strategies; (3) nurturing the resilience of health systems requires understanding health systems as comprising not only hardware elements (such as finances and infrastructure), but also software elements (such as leadership capacity, power relations, values and appropriate organizational culture). We also reflect on current criticisms of the concept of resilient health systems, such as that it assumes that systems are apolitical, ignoring actor agency, promoting inaction, and requiring that we accept and embrace vulnerability, rather than strive for stronger and more responsive systems. We observe that these criticisms are warranted to the extent that they refer to notions of resilience that are mismatched with the reality of health systems as CAS. We argue that the observed weaknesses of resilience thinking can be addressed by reframing and applying a resilience lens that is better suited to the attributes of health systems as CAS. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. 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...

  7. Energy Systems | Argonne National Laboratory

    Science.gov (United States)

    Nissan spins up new plant to give second life to EV batteries Yemen News National Lab Licensing Hydrogen Computing Center Centers, Institutes, and Programs RISCRisk and Infrastructure Science Center Other

  8. Strengthening the effectiveness and improving the efficiency of the IAEA safeguards system (Programme 93+2)

    International Nuclear Information System (INIS)

    Tani, Hiroshi

    1999-01-01

    Present safeguards systems against nuclear proliferation as well as their improvement activities for more effective results are reviewed. First, the mechanism of the NPT Safeguards System is explained, which is the grasp of inventories of nuclear materials through change and transfer booking starting with actual investigation. Then, other various safeguards systems are described, including TLATELOCO (Treaty for the prohibition of nuclear weapons in Latin America), VO (Voluntary Offer), OCA (Other Comprehensive Safeguards Agreement), PA (Project Agreement), US (Unilateral Submission), and OSA (Other Safeguards Agreement). Thirdly, the present status and problems of the nuclear proliferation prevention in the world are described, including competitive nuclear weapon development in India and Pakistan, and Iraq and North Korea problems. Lastly, the 93 + 2 plan to improve the present system is explained. (M.M.)

  9. Global Surgery System Strengthening: It Is All About the Right Metrics.

    Science.gov (United States)

    Watters, David A; Guest, Glenn D; Tangi, Viliami; Shrime, Mark G; Meara, John G

    2018-04-01

    Progress in achieving "universal access to safe, affordable surgery, and anesthesia care when needed" is dependent on consensus not only about the key messages but also on what metrics should be used to set goals and measure progress. The Lancet Commission on Global Surgery not only achieved consensus on key messages but also recommended 6 key metrics to inform national surgical plans and monitor scale-up toward 2030. These metrics measure access to surgery, as well as its timeliness, safety, and affordability: (1) Two-hour access to the 3 Bellwether procedures (cesarean delivery, emergency laparotomy, and management of an open fracture); (2) Surgeon, Anesthetist, and Obstetrician workforce >20/100,000; (3) Surgical volume of 5000 procedures/100,000; (4) Reporting of perioperative mortality rate; and (5 and 6) Risk rates of catastrophic expenditure and impoverishment when requiring surgery. This article discusses the definition, validity, feasibility, relevance, and progress with each of these metrics. The authors share their experience of introducing the metrics in the Pacific and sub-Saharan Africa. We identify appropriate messages for each potential stakeholder-the patients, practitioners, providers (health services and hospitals), public (community), politicians, policymakers, and payers. We discuss progress toward the metrics being included in core indicator lists by the World Health Organization and the World Bank and how they have been, or may be, used to inform National Surgical Plans in low- and middle-income countries to scale-up the delivery of safe, affordable, and timely surgical and anesthesia care to all who need it.

  10. 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

  11. 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.…

  12. Dedicated health systems strengthening of the Global Fund to Fight AIDS, Tuberculosis, and Malaria: an analysis of grants.

    Science.gov (United States)

    Fan, Victoria Y; Tsai, Feng-Jen J; Shroff, Zubin C; Nakahara, Branden; Vargha, Nabil; Weathers, Scott

    2017-01-01

    This study aims to understand the determinants of the Global Fund to Fight AIDS, Tuberculosis, and Malaria's dedicated channel for health systems strengthening (HSS) funding across countries and to analyze their health system priorities expressed in budgets and performance indicators. We obtained publicly available data for disease-specific and HSS grants from the Global Fund over 2004-2013 prior to the new funding model. Regression analysis was employed to assess the determinants of dedicated HSS funding across 111 countries. Documents for 27 dedicated HSS grants including budgets and performance indicators were collected, and activities were analyzed by health system functions. HSS funding per capita is significantly associated with TB and HIV funding per capita, but not per capita income and health worker density. Of 27 dedicated HSS grants, 11 had line-item budgets publicly available, in which health workforce and medical products form the majority (89% or US$132 million of US$148 million) of funds. Yet these areas accounted for 41.7% (215) of total 516 performance indicators. Health worker densities were not correlated with HSS funding, despite the emphasis on health workforce in budgets and performance indicators. Priorities in health systems in line-item budgets differ from the numbers of indicators used. © The Author 2016. 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.

  13. 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

  14. 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…

  15. Nepal - Country Environmental Analysis : Strengthening Institutions and Management Systems for Enhanced Environmental Governance

    OpenAIRE

    World Bank

    2007-01-01

    The main objective of the Country Environmental Analysis (CEA) in Nepal is to identify opportunities for enhancing the overall performance of select environmental management systems through improvements in the effectiveness of institutions, policies, and processes. CEA has been built upon the following three primary study components: (a) an examination of the environmental issues associate...

  16. The Use of High Performance Computing (HPC) to Strengthen the Development of Army Systems

    Science.gov (United States)

    2011-11-01

    changes in what the warfighter wants – in the middle of an acquisition cycle such changes create havoc in terms of delays, recycling of the research...A little bit later the first personal computers (PCs) came on the market, mostly as curiosities . The operating systems were either ms-dos or cp/m

  17. 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

  18. Fixing Our National Accountability System

    Science.gov (United States)

    Tucker, Marc S.

    2014-01-01

    No Child Left Behind radically shifted the balance of power in American education policy-making from the states to the federal government, not because a new consensus had emerged to make such a shift, but because both Democrats and Republicans were angry with the nation's teachers, holding them responsible for a massive increase in the costs of…

  19. 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...

  20. Drivers of health system strengthening: learning from implementation of maternal and child health programmes in Mozambique, Nepal and Rwanda.

    Science.gov (United States)

    Samuels, Fiona; Amaya, Ana B; Balabanova, Dina

    2017-09-01

    There is a growing understanding that strong health systems are crucial to sustain progress. Health systems, however, are complex and much of their success depends on factors operating at different levels and outside the health system, including broader governance and political commitment to health and social development priorities. Recognizing these complexities, this article offers a pragmatic approach to exploring the drivers of progress in maternal and child health in Mozambique, Nepal and Rwanda. To do this, the article builds on a semi-systematic literature review and case study findings, designed and analysed using a multi-level framework. At the macro level, governance with effective and committed leaders was found to be vital for achieving positive health outcomes. This was underpinned by clear commitment from donors coupled by a significant increase in funding to the health sector. At the meso level, where policies are operationalized, inter-sectoral partnerships as well as decentralization and task-shifting emerged as critical. At micro (service interface) level, community-centred models and accessible and appropriately trained and incentivized local health providers play a central role in all study countries. The key drivers of progress are multiple, interrelated and transversal in terms of their operation; they are also in a constant state of flux as health systems and contexts develop. Without seeking to offer a blueprint, the study demonstrates that a 'whole-system' approach can help elicit the key drivers of change and potential pathways towards desirable outcomes. Furthermore, understanding the challenges and opportunities that are instrumental to progress at each particular level of a health system can help policy-makers and implementers to navigate this complexity and take action to strengthen health systems. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights

  1. 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)

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. Degree-of-Freedom Strengthened Cascade Array for DOD-DOA Estimation in MIMO Array Systems.

    Science.gov (United States)

    Yao, Bobin; Dong, Zhi; Zhang, Weile; Wang, Wei; Wu, Qisheng

    2018-05-14

    In spatial spectrum estimation, difference co-array can provide extra degrees-of-freedom (DOFs) for promoting parameter identifiability and parameter estimation accuracy. For the sake of acquiring as more DOFs as possible with a given number of physical sensors, we herein design a novel sensor array geometry named cascade array. This structure is generated by systematically connecting a uniform linear array (ULA) and a non-uniform linear array, and can provide more DOFs than some exist array structures but less than the upper-bound indicated by minimum redundant array (MRA). We further apply this cascade array into multiple input multiple output (MIMO) array systems, and propose a novel joint direction of departure (DOD) and direction of arrival (DOA) estimation algorithm, which is based on a reduced-dimensional weighted subspace fitting technique. The algorithm is angle auto-paired and computationally efficient. Theoretical analysis and numerical simulations prove the advantages and effectiveness of the proposed array structure and the related algorithm.

  7. Health system strengthening in Cambodia-a case study of health policy response to social transition.

    Science.gov (United States)

    Grundy, John; Khut, Qiu Yi; Oum, Sophal; Annear, Peter; Ky, Veng

    2009-10-01

    Cambodia, following decades of civil conflict and social and economic transition, has in the last 10 years developed health policy innovations in the areas of health contracting, health financing and health planning. This paper aims to outline recent social, epidemiological and demographic health trends in Cambodia, and on the basis of this outline, to analyse and discuss these policy responses to social transition. Sources of information included a literature review, participant observation in health planning development in Cambodia between 1993 and 2008, and comparative analysis of demographic health surveys between 2000 and 2005. In Cambodia there have been sharp but unequal improvements in child mortality, and persisting high maternal mortality rates. Data analysis demonstrates associations between location, education level and access to facility based care, suggesting the dominant role of socio-economic factors in determining access to facility based health care. These events are taking place against a background of rapid social transition in Cambodian history, including processes of decentralization, privatization and the development of open market economic systems. Primary policy responses of the Ministry of Health to social transition and associated health inequities include the establishment of health contracting, hospital health equity funds and public-private collaborations. Despite the internationally recognized health policy flexibility and innovation demonstrated in Cambodia, policy response still lags well behind the reality of social transition. In order to minimize the delay between transition and response, new policy making tactics are required in order to provide more flexible and timely responses to the ongoing social transition and its impacts on population health needs in the lowest socio-economic quintiles.

  8. National Recordal System IK holder catalogue process

    CSIR Research Space (South Africa)

    Pretorius, R

    2012-10-01

    Full Text Available good, based on IK.? Subsequently, the South African Department of Science and Technology (DST) created a National Indigenous Knowledge Systems Office (NIKSO) that is taking the lead on interfacing IKS with other recognised knowledge holders... is to illustrate the South African National Recordal Systems (NRS) process whereby Indigenous Knowledge (IK) holder?s information is captured in a registry, as specified in South Africa?s Indigenous Knowledge Systems (IKS) Policy, through an IK cataloguing...

  9. 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

  10. National Bridge Inventory System (NBI)

    Data.gov (United States)

    Department of Transportation — The NBI System is the collection of bridge inspection information and costs associated with bridge replacements of structurally deficient bridges on and off the NHS....

  11. 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

  12. 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)

    2013-01-01

    Background 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. Methods 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. Results 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

  13. Global health partnerships in practice: taking stock of the GAVI Alliance's new investment in health systems strengthening.

    Science.gov (United States)

    Naimoli, Joseph F

    2009-01-01

    Despite a burgeoning literature on global health partnerships (GHPs), there have been few studies of how GHPs, particularly those trying to build a bridge between horizontal and vertical modes of delivering essential health services, operate at global and country levels. This paper will help address this knowledge gap by describing and analyzing the GAVI Alliance's early experience with health systems strengthening (HSS) to improve immunization coverage and other maternal-child health outcomes. To date, the strengths of HSS reside in its potential to optimize GAVI's overall investment in immunization, efforts to harmonize with other initiatives, willingness to acknowledge risk and identify mitigation strategies, engagement of diverse stakeholders, responsiveness to country needs, and effective management of an ambitious grant-making enterprise. The challenges have been forging a common vision and approach, governance, balancing pressure to move money with incremental learning, managing partner roles and relationships, managing the "value for money" risk, and capacity building. This mid-point stock-taking makes recommendations for moving GAVI forward in a thoughtful manner. The findings should be of interest to other GHPs because of their larger significance. This is a story about how a successful alliance that decided to broaden its mandate has responded to the technical, organizational, and political complexities that challenge its traditional business model. Copyright (c) 2009 John Wiley & Sons, Ltd.

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

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

    Building National Health Research Information Systems (COHRED). This grant will allow the Council on Health Research for Development (COHRED) to create, host and maintain a web-based resource on national health research in low- and middle-income countries in partnership with institutions in the South. Called ...

  15. 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.

    Directory of Open Access Journals (Sweden)

    Philomena Raftery

    2018-01-01

    Full Text Available 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

  16. 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

  17. 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

  18. 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...

  19. 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...

  20. 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...

  1. 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.

  2. 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.

  3. 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

  4. A National MagLev Transportation System

    Science.gov (United States)

    Wright, Michael R.

    2003-01-01

    The case for a national high-speed magnetic-levitation (MagLev) transportation system is presented. Focus is on current issues facing the country, such as national security, the economy, transportation, technology, and the environment. NASA s research into MagLev technology for launch assist is also highlighted. Further, current socio-cultural norms regarding motor-vehicle-based transportation systems are questioned in light of the problems currently facing the U.S. The multidisciplinary benefits of a long-distance MagLev system support the idea that such a system would be an important element of a truly multimodal U.S. transportation infrastructure.

  5. 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

  6. 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.

  7. Strengthening nuclear security

    International Nuclear Information System (INIS)

    Kurihara, Hiroyoshi

    2003-01-01

    The international situation after the end of the Cold-War has been quite unstable, due to the occurrence of frequent regional conflicts and domestic wars based on ethnic, religious or racial reasons. Further, threats to the would peace and security by non-state actors, like international terrorist groups, have been recognized after 9.11 terrorist attacks to the World Trade Center buildings and to the Pentagon. Utilization of nuclear energy, which encompasses both peaceful uses and military ones, required an establishment of regulatory system, by which risks associated with the development of nuclear energy can be controlled. Accordingly, nuclear safety control system, and then non-proliferation control system has been developed, both in the international level and notional level. In recognition of the present unstable international situations, it is required to establish, maintain and strengthen a system which control nuclear security aspect, in addition to the present systems. (author)

  8. Development of a new national innovation system

    Directory of Open Access Journals (Sweden)

    Domazet Dragan S.

    2003-01-01

    Full Text Available The paper describes a reference model of the national innovation system of Serbia planned to be gradually developed. The model presented is not complete, but is sufficient to illustrate its usage. The development of a national innovation system may be achieved by implementing a phased and segmented approach. This means that parts of the innovation system that are related to specific industrial sectors may be developed separately according to national priorities. Also, the system may be improved and expanded in later phases of its development. The approach suggested is demonstrated in the case of the innovation system of the software industry. The necessary programs and measures for supporting the development of the software industry are listed. Once these programs and measures are implemented, the software industry in Serbia may be able to reach global competitiveness.

  9. Is the HIV sentinel surveillance system adequate in China? Findings from an evaluation of the national HIV sentinel surveillance system

    Directory of Open Access Journals (Sweden)

    Marc Bulterys

    2012-11-01

    Full Text Available Background: An external evaluation was conducted to assess the performance of the national HIV sentinel surveillance system (HSS, identify operational challenges at national and local levels and provide recommendations for improvement.Methods: The United States Centers for Disease Control and Prevention’s (CDC Updated Guidelines for Evaluating Public Health Surveillance Systems were followed to assess the key attributes of HSS. Comprehensive assessment activities were conducted, including: using a detailed checklist to review surveillance guidelines, protocols and relevant documents; conducting self-administered, anonymous surveys with 286 local China CDC staff; and carrying out field observations in 32 sentinel sites in four provinces.Results: China has built an extensive HSS with 1888 sentinel sites to monitor HIV epidemic trends by population groups over time. The strengths of HSS lie in its flexibility, simplicity, usefulness and increase in coverage in locations and populations. With its rapid expansion in 2010, HSS faces challenges in maintaining acceptability, timeliness, data quality, representativeness and sustainability.Recommendations: Implementation of the national guidelines should be standardized by strengthening training, monitoring and supervision of all staff involved, including community-based organizations. National surveillance guidelines need to be revised to strengthen data quality and representativeness, particularly to include specific instructions on HIV testing result provision, collection of identifying information, sample size and sampling methods particularly for men who have sex with men (MSM, collection of refusal information, and data interpretation. Sustainability of China’s HSS could be strengthened by applying locally tailored surveillance strategies, strengthening coordination and cooperation among government agencies and ensuring financial and human resources.

  10. 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.

  11. 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.

  12. 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.

  13. [The national health system in Peru].

    Science.gov (United States)

    Sánchez-Moreno, Francisco

    2014-01-01

    In 1975, a group of professionals in Peru who were experts on national health systems began a process that led the country to be the first in South America to initiate a modern organization of the health system. This pioneering development meant that the creation of the National Health Services System [in Peru] in 1978 occurred before the health system reforms in Chile (1980), Brazil (1990), Colombia (1993), and Ecuador (2008). This encouraging start has had permanent reformist fluctuations since then, with negative development because of the lack of a State policy. Current features of the Peruvian system are inefficient performance, discontinuity, and lack of assessment, which creates a major setback in comparison with other health systems in America. In the 21st century, significant technical efforts have been missed to modernize the system and its functions. The future is worrying and the role of new generations will be decisive.

  14. National Recordal System IK holder catalogue process

    CSIR Research Space (South Africa)

    Pretorius, R

    2011-11-01

    Full Text Available The aim of this poster is to illustrate the South African National Recordal Systems (NRS) process whereby Indigenous Knowledge (IK) holder’s information is captured in a registry, as specified in South Africa’s Indigenous Knowledge Systems Policy...

  15. 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

  16. 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.

  17. 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.

  18. Strengthening of Shear Walls

    DEFF Research Database (Denmark)

    Hansen, Christian Skodborg

    The theory for concrete structures strengthened with fiber reinforced polymer materials has been developing for approximately two decades, and there are at the present time numerous guidelines covering strengthening of many commonly encountered structural building elements. Strengthening of in...... that describes a unit width strip of a strengthened disk. The unit width strip is named a strengthened concrete tension member and contains a single tensile crack and four debonding cracks. Analysis of the member results in closed form expressions for the load-crack opening relationship. Further analysis...... of the response, results in the ability to determine and characterize the two-way crack propagation, i.e. the relationship between tensile cracking in the concrete and interface debonding between strengthening and concrete. Using the load-crack opening relationship from the strengthened concrete tension member...

  19. 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.

  20. 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

  1. EuReCa Serbia Subotica 2015-2016: Does the system strengthening lead to better results?

    Directory of Open Access Journals (Sweden)

    Momirović-Stojković Milena

    2017-01-01

    Full Text Available Aims and goals: Comparing the data’s of EuReCa-Serbia project conducted during 2015 and 2016 and it’s mutual analysis in Subotica research center. Methodology: Prospective study of an observational trail of the European Resuscitation Council registered Clinical Trial NCT02236819 and approved by the US healthcare authorities. The analyzed data’s are collected in the EMS Subotica center during 2015 and 2016 and has been uploaded by lead investigator of a participating center into an online database and application at www. eureca.rs. Results: During 2015 cardiac arrest has been confirmed by the physician of the EMS in 63.6 cases per 100.000 citizens, while in 2016 the number of cases was 82,6/100.000 citizens. Cardiopulmonary resuscitation was attempted in 58,7/100.000 citizens in 2015., and in 77,7 /100.000 citizens during 2016. The most common aetiology of cardiac arrest has cardiac cause for both years; 21,6/100.000 in 2015, and 27,5/100.000 in 2016. The place of cardiac arrest for both years in most cases is place of residence; 40,2/100.000 in 2015 and 58/100.000 during 2016. In 3,5/100.000 cases CPR was dispatcher assisted during 2015. and for 2016 in 8,5/100.000 cases. OHCA is witnessed in 38.8 /100.000 during 2015. and in55/100.000 cases for 2016. During 2015 in 5,6/100.000 cases the bystanders initiated CPR. For 2016, this happened in 14/100.000 cases. The initial rhythm was shockable in 15,5/100.000 cases for the year of 2015 and in 17/100.000 during 2016. Before the EMS arrival AED has not been used during 2015, but in 2016 AED was in use twice. ROSC was achieved in 7,8 patients per 100.000 citizens in 2015. In 2016 the incidence of ROSC was 23,3/100.000 Conclusion: Thanks to the two-year follow-up of the data’s in the observed period, we can conclude that the number of patients with shockable rhythm and achieved ROSC has significantly increased. Strengthening the system via continuous education of each link of the Chain of

  2. 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.

  3. 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

  4. Strengthening rural health placements for medical students ...

    African Journals Online (AJOL)

    Strengthening rural health placements for medical students: Lessons for South Africa ... rural health, primary healthcare and National Health Insurance strategies. ... preferential selection of students with a rural background, positioning rural ...

  5. Development of a Unifying Target and Consensus Indicators for Global Surgical Systems Strengthening: Proposed by the Global Alliance for Surgery, Obstetric, Trauma, and Anaesthesia Care (The G4 Alliance).

    Science.gov (United States)

    Haider, Adil; Scott, John W; Gause, Colin D; Meheš, Mira; Hsiung, Grace; Prelvukaj, Albulena; Yanocha, Dana; Baumann, Lauren M; Ahmed, Faheem; Ahmed, Na'eem; Anderson, Sara; Angate, Herve; Arfaa, Lisa; Asbun, Horacio; Ashengo, Tigistu; Asuman, Kisembo; Ayala, Ruben; Bickler, Stephen; Billingsley, Saul; Bird, Peter; Botman, Matthijs; Butler, Marilyn; Buyske, Jo; Capozzi, Angelo; Casey, Kathleen; Clayton, Charles; Cobey, James; Cotton, Michael; Deckelbaum, Dan; Derbew, Miliard; deVries, Catherine; Dillner, Jeanne; Downham, Max; Draisin, Natalie; Echinard, David; Elneil, Sohier; ElSayed, Ahmed; Estelle, Abigail; Finley, Allen; Frenkel, Erica; Frykman, Philip K; Gheorghe, Florin; Gore-Booth, Julian; Henker, Richard; Henry, Jaymie; Henry, Orion; Hoemeke, Laura; Hoffman, David; Ibanga, Iko; Jackson, Eric V; Jani, Pankaj; Johnson, Walter; Jones, Andrew; Kassem, Zeina; Kisembo, Asuman; Kocan, Abbey; Krishnaswami, Sanjay; Lane, Robert; Latif, Asad; Levy, Barbara; Linos, Dimitrios; Linz, Peter; Listwa, Louis A; Magee, Declan; Makasa, Emmanuel; Marin, Michael L; Martin, Claude; McQueen, Kelly; Morgan, Jamie; Moser, Richard; Neighbor, Robert; Novick, William M; Ogendo, Stephen; Omigbodun, Akinyinka; Onajin-Obembe, Bisola; Parsan, Neil; Philip, Beverly K; Price, Raymond; Rasheed, Shahnawaz; Ratel, Marjorie; Reynolds, Cheri; Roser, Steven M; Rowles, Jackie; Samad, Lubna; Sampson, John; Sanghvi, Harshadkumar; Sellers, Marchelle L; Sigalet, David; Steffes, Bruce C; Stieber, Erin; Swaroop, Mamta; Tarpley, John; Varghese, Asha; Varughese, Julie; Wagner, Richard; Warf, Benjamin; Wetzig, Neil; Williamson, Susan; Wood, Joshua; Zeidan, Anne; Zirkle, Lewis; Allen, Brendan; Abdullah, Fizan

    2017-10-01

    After decades on the margins of primary health care, surgical and anaesthesia care is gaining increasing priority within the global development arena. The 2015 publications of the Disease Control Priorities third edition on Essential Surgery and the Lancet Commission on Global Surgery created a compelling evidenced-based argument for the fundamental role of surgery and anaesthesia within cost-effective health systems strengthening global strategy. The launch of the Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care in 2015 has further coordinated efforts to build priority for surgical care and anaesthesia. These combined efforts culminated in the approval of a World Health Assembly resolution recognizing the role of surgical care and anaesthesia as part of universal health coverage. Momentum gained from these milestones highlights the need to identify consensus goals, targets and indicators to guide policy implementation and track progress at the national level. Through an open consultative process that incorporated input from stakeholders from around the globe, a global target calling for safe surgical and anaesthesia care for 80% of the world by 2030 was proposed. In order to achieve this target, we also propose 15 consensus indicators that build on existing surgical systems metrics and expand the ability to prioritize surgical systems strengthening around the world.

  6. National high-level waste systems analysis

    International Nuclear Information System (INIS)

    Kristofferson, K.; O'Holleran, T.P.

    1996-01-01

    Previously, no mechanism existed that provided a systematic, interrelated view or national perspective of all high-level waste treatment and storage systems that the US Department of Energy manages. The impacts of budgetary constraints and repository availability on storage and treatment must be assessed against existing and pending negotiated milestones for their impact on the overall HLW system. This assessment can give DOE a complex-wide view of the availability of waste treatment and help project the time required to prepare HLW for disposal. Facilities, throughputs, schedules, and milestones were modeled to ascertain the treatment and storage systems resource requirements at the Hanford Site, Savannah River Site, Idaho National Engineering Laboratory, and West Valley Demonstration Project. The impacts of various treatment system availabilities on schedule and throughput were compared to repository readiness to determine the prudent application of resources. To assess the various impacts, the model was exercised against a number of plausible scenarios as discussed in this paper

  7. Status of national system of accounting for and control of nuclear materials in Turkey

    International Nuclear Information System (INIS)

    Yucel, A.

    1999-01-01

    Regulating the nuclear activities in Turkey is at the responsibility of Turkish Atomic Energy Authority (TAEA). Under the TAEA Act, the Authority is responsible for national security and protection of the peaceful uses of nuclear energy. After signing the Safeguards Agreement with the IAEA for the application of safeguards in connection with the NPT, a State System of Accounting for and Control of Nuclear Materials (SSAC) has been established. This paper covers national safeguards activities and implementation of SSAC and activities for upgrading of national system. These activities are the part of the IAEA programme on strengthening the effectiveness and improving the efficiency of the safeguards system and on combating illicit trafficking of nuclear materials and other radioactive sources. (author)

  8. 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

  9. 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...

  10. 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...

  11. 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

  12. Application of selected modern technology systems to strengthen the damaged masonry dome of historical St. Anna’s Church in Wilanów (Poland

    Directory of Open Access Journals (Sweden)

    Ryszard Chmielewski

    2015-12-01

    Full Text Available The aim of the paper is to present a study on the cracked brick masonry dome of the historical church of St. Anna in Wilanów (Poland, founded in 1772 and entered in the Polish register of monuments in 1965. The calculation of static-strength for strengthening the dome was carried out taking into account the characteristics of the vaulted construction works and a relevant existing structure with designed elements of the strengthening construction works based on using carbon tape SIKA CarboDur and spiral steel rods in the HELIFIX system. The use of a three-dimensional structural model of the masonry dome allowed a detailed determination of the internal force distribution and the adoption of an appropriate repair and strengthening regime for this load-bearing structure. The correctness of the design solutions and calculation assumptions is reflected in the fact that, after a period of more than three years, no damage to the repaired elements of the masonry dome occurred.

  13. 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.

  14. National Breeding System of Dairy Cattle Husbandry

    Directory of Open Access Journals (Sweden)

    Anneke Anggraeni

    1999-05-01

    Full Text Available The husbandry of domestic dairy cattle as one of the components of livestock sub-sector development is hopefully to increase numerously the capacity and the quality on its milk production, to gradually meet national milk demand and face the competitiveness at the global. The achievement of this purpose should be supported by the production of dairy breeding stock in good quality and sufficient number to increase efficiency of both quantity and quality of domestic milk production. One of important aspect that should be prepared is in determining national breeding system of dairy cattle that can function effectively as guidance and regulation for producing, distributing, and using dairy cattle as “domestic breeding stock”. As in other livestock, breeding system of dairy cattle basically constituted of three main subsystems, i.e. production , distribution and marketing, and quality establishment subsystem. The paper discusses some aspects of these three subsystems to give considerable input in preparing the national concept of dairy cattle breeding system. enterprise (Animal Production 1(2: 43-55 (1999 KeyWords: dairy cattle, breeding stock, milk production.

  15. National Breeding System of Dairy Cattle Husbandry

    Directory of Open Access Journals (Sweden)

    K Diwyanto

    1999-05-01

    Full Text Available The husbandry of domestic dairy cattle as one of the components of  livestock sub-sector development is hopefully to increase numerously the capacity and the quality on its milk production, to gradually meet national milk demand and face the competitiveness at the global. The achievement of this purpose should be supported by the production of dairy breeding stock in good quality and sufficient number to increase efficiency of both quantity and quality of domestic milk production. One of important aspect that should be prepared is in determining national breeding system of dairy cattle that can function effectively as guidance and regulation for producing, distributing, and using dairy cattle as “domestic breeding stock”. As in other livestock, breeding system of dairy cattle basically constituted of three main subsystems, i.e. production , distribution and marketing, and quality establishment subsystem. The paper discusses some aspects of these three subsystems to give considerable input in preparing the national concept of dairy cattle breeding system. enterprise (Animal Production 1(2: 43-55 (1999   KeyWords: dairy cattle, breeding stock, milk production.

  16. 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.

  17. 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

  18. Radiometric system for clinical applications in the National Health System

    International Nuclear Information System (INIS)

    Mesa Perez, G.; Arteche Diaz, R.; Camejo Batista, A.; Fonfria Bragado, C.

    2013-01-01

    In this paper it is presented the radiometric detection system SRNIC-02, manufactured at CEADEN. The system has three major components: a well-type Nal(TI) scintillator detector with its collimator, a measurement module, and the application software, which allows fixing the working parameters of the system, as well as the acquisition and processing of data. The system has two main applications in the National Health System, one for the quality control in Radiopharmacy, and in RIA/IRMA blood tests. There are 16 systems installed, in 13 provinces of the country up to this date. (Author)

  19. 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

  20. 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

  1. 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

  2. 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...

  3. Health system strengthening and hypertension awareness, treatment and control: data from the China Health and Retirement Longitudinal Study.

    Science.gov (United States)

    Feng, Xing Lin; Pang, Mingfan; Beard, John

    2014-01-01

    To monitor hypertension prevalence, awareness, treatment and control in China two to three years after major reform of the health system. Data from a national survey conducted in 2011-2012 among Chinese people aged 45 years or older - which included detailed anthropometric measurements - were used to estimate the prevalence of hypertension and the percentages of hypertensive individuals who were unaware of, receiving no treatment for, and/or not controlling their hypertension well. Modified Poisson regressions were used to estimate relative risks (RRs). At the time of the survey, nearly 40% of Chinese people aged 45 years or older had a hypertensive disorder. Of the individuals with hypertension, more than 40% were unaware of their condition, about 50% were receiving no medication for it and about 80% were not controlling it well. Compared with the other hypertensive individuals, those who were members of insurance schemes that covered the costs of outpatient care were more likely to be aware of their hypertension (adjusted RR, aRR: 0.737; 95% confidence interval, CI: 0.619-0.878) to be receiving treatment for it (aRR: 0.795; 95% CI: 0.680-0.929) and to be controlling it effectively (aRR: 0.903; 95% CI: 0.817-0.996). In China many cases of hypertension are going undetected and untreated, even though the health system appears to deliver effective care to individuals who are aware of their hypertension. A reduction in the costs of outpatient care to patients would probably improve the management of hypertension in China.

  4. Management Certainly Matters, and There Are Multiple Ways to Conceptualize the Process; Comment on “Management Matters: A Leverage Point for Health Systems Strengthening in Global Health”

    Directory of Open Access Journals (Sweden)

    Beaufort B. Longest

    2015-11-01

    Full Text Available The authors of “Management matters: a leverage point for health systems strengthening in global health,” raise a crucial issue. Because more effective management can contribute to better performing health systems, attempts to strengthen health systems require attention to management. As a guide toward management capacity building, the authors outline a comprehensive set of core management competencies needed for managing global health efforts. Although, I agree with the authors’ central premise about the important role of management in improving global health and concur that focusing on competencies can guide management capacity building, I think it is important to recognize that a set of relevant competencies is not the only way to conceptualize and organize efforts to teach, learn, practice, or conduct research on management. I argue the added utility of also viewing management as a set of functions or activities as an alternative paradigm and suggest that the greatest utility could lie in some hybrid that combines various ways of conceptualizing management for study, practice, and research.

  5. 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.

  6. 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)

  7. 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.

  8. TOP TAX SYSTEM - A common tax system for all nations

    OpenAIRE

    VIJAYA KRUSHNA VARMA

    2011-01-01

    TOP Tax system is a new tax system which can be used as a common tax system for all nations. This new tax system will be without present tax system’s all Direct and Indirect taxes accompanied by tax laws, tax exemptions, multiple tax collection departments to relieve 7 billion people of the world from the cobweb of ambiguous and complex tax structures, plethora of tax laws, mandatory and cumbersome accounting, auditing, tax returns and consequent quagmire of all tax related cases. Taxation, t...

  9. Sandia National Laboratories: National Security Missions: Defense Systems

    Science.gov (United States)

    ; Technology Defense Systems & Assessments About Defense Systems & Assessments Program Areas Audit Sandia's Economic Impact Licensing & Technology Transfer Browse Technology Portfolios ; Culture Work-Life Balance Special Programs Nuclear Weapons Defense Systems Global Security Energy Facebook

  10. National Space Transportation System (NSTS) technology needs

    Science.gov (United States)

    Winterhalter, David L.; Ulrich, Kimberly K.

    1990-01-01

    The National Space Transportation System (NSTS) is one of the Nation's most valuable resources, providing manned transportation to and from space in support of payloads and scientific research. The NSTS program is currently faced with the problem of hardware obsolescence, which could result in unacceptable schedule and cost impacts to the flight program. Obsolescence problems occur because certain components are no longer being manufactured or repair turnaround time is excessive. In order to achieve a long-term, reliable transportation system that can support manned access to space through 2010 and beyond, NASA must develop a strategic plan for a phased implementation of enhancements which will satisfy this long-term goal. The NSTS program has initiated the Assured Shuttle Availability (ASA) project with the following objectives: eliminate hardware obsolescence in critical areas, increase reliability and safety of the vehicle, decrease operational costs and turnaround time, and improve operational capability. The strategy for ASA will be to first meet the mandatory needs - keep the Shuttle flying. Non-mandatory changes that will improve operational capability and enhance performance will then be considered if funding is adequate. Upgrade packages should be developed to install within designated inspection periods, grouped in a systematic approach to reduce cost and schedule impacts, and allow the capability to provide a Block 2 Shuttle (Phase 3).

  11. 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.

  12. 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

  13. A Study on the cooperation policy in multilateral nuclear control regimes and the advancing of national export control system

    International Nuclear Information System (INIS)

    Lee, Byung Wook; Oh, K. B.; Yang, M. H.; Lee, H. M.; Lee, K. S.; Ko, H. S.; Ryu, J. S.; Kim, J. S.

    2004-08-01

    This study carried out the analysis of trends of the multilateral nuclear control in four aspects. First, this study analyzes the past trends of the international nuclear non-proliferation regime, which includes the NPT, the IAEA safeguards system, the international nuclear export control regime and the physical protection of nuclear materials. Second, this study establishes the multilateral cooperation strategies for the effective cooperation in the process of strengthening the nuclear control regimes. Third, this study reviews the major agenda of nuclear control regimes and establishes national positions on each agenda. Fourth, this study also analyzes outstanding issues in nuclear control regimes and derives some factors to reflect national nuclear control system

  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. 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

  16. 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

    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 delivery

  17. 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.

  18. 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 ...

  19. 77 FR 21161 - National Forest System Land Management Planning

    Science.gov (United States)

    2012-04-09

    ... 219 National Forest System Land Management Planning; Final Rule #0;#0;Federal Register / Vol. 77 , No... Forest Service 36 CFR Part 219 RIN 0596-AD02 National Forest System Land Management Planning AGENCY... Agriculture is adopting a new National Forest System land management planning rule (planning rule). The new...

  20. 36 CFR 261.55 - National Forest System trails.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false National Forest System trails... PROHIBITIONS Prohibitions in Areas Designated by Order § 261.55 National Forest System trails. When provided by... National Forest System trail: (a) Being on a trail. (b) Using any type of vehicle prohibited by the order...

  1. Accountable priority setting for trust in health systems--the need for research into a new approach for strengthening sustainable health action in developing countries

    DEFF Research Database (Denmark)

    Byskov, Jens; Bloch, Paul; Blystad, Astrid

    2009-01-01

    Despite multiple efforts to strengthen health systems in low and middle income countries, intended sustainable improvements in health outcomes have not been shown. To date most priority setting initiatives in health systems have mainly focused on technical approaches involving information derived...... from burden of disease statistics, cost effectiveness analysis, and published clinical trials. However, priority setting involves value-laden choices and these technical approaches do not equip decision-makers to address a broader range of relevant values - such as trust, equity, accountability...... and fairness - that are of concern to other partners and, not least, the populations concerned. A new focus for priority setting is needed.Accountability for Reasonableness (AFR) is an explicit ethical framework for legitimate and fair priority setting that provides guidance for decision-makers who must...

  2. 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.

  3. 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.

  4. 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)

  5. 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.

  6. 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

  7. 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)

  8. Technical Review of Operator's Destructive Analyses at the Rokkasho Reprocessing Plant: Strengthening the Transparency of the Operator's Measurement System

    International Nuclear Information System (INIS)

    Sato, N.; Katchi, T.; Niitsu, Y.; Duhamel, G.; Decaillon, J.-G.; Toervenyi, A.; Sayama, H.; Hara, S.

    2015-01-01

    The Rokkasho Reprocessing Plant is a large-scale nuclear facility in Japan. For the purposes of process control, product management and nuclear material accountancy for safeguards purposes, the laboratory of the facility operator analyzes thousands of samples from various process streams and with a multitude of matrices. Transparency of operational procedures, quality control measures and sample analytical results among the facility operator and state and international safeguards authorities are required to assess the facility operator's measurement system, and thus to assure a credible safeguards approach. The facility operator, Japan Nuclear Fuel, Limited (JNFL), is engaged in continuous improvement of its nuclear material analyzes. For the declarations to the inspectorates, it is important that JNFL and the safeguards authorities be able to confirm that the analytical methods used by JNFL are reliable and meet the latest version of the International Target Values. Since 2012 JNFL, the IAEA and the SSAC have carried out several technical reviews of the destructive analysis (DA) processes as a means of strengthening the transparency of the DA measurement systems. The goal of the DA technical reviews is to (1) assess past commitments of the JNFL plan for analytical improvement, (2) review the JNFL Quality System by means of documentation reviews and in-field demonstrations, and (3) review the analytical performance of the JNFL lab through its own results or from inter-laboratory comparison exercises. Throughout this process, subject-matter experts from all organizations met with JNFL laboratory staff and discussed analytical concerns and solutions. The outcome of these technical reviews was a series of recommendations to JNFL for strengthening its plan for continuous improvement. This paper presents the methodology of the DA technical reviews, the communication scheme and some examples of the outcome for JNFL to improve its DA methods and analytical

  9. 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…

  10. 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

  11. 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

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

    Directory of Open Access Journals (Sweden)

    Gopal K. Singh

    2013-01-01

    Full Text Available 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.

  13. 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.

  14. The National Ignition Facility Neutron Imaging System

    International Nuclear Information System (INIS)

    Wilke, Mark D.; Batha, Steven H.; Bradley, Paul A.; Day, Robert D.; Clark, David D.; Fatherley, Valerie E.; Finch, Joshua P.; Gallegos, Robert A.; Garcia, Felix P.; Grim, Gary P.; Jaramillo, Steven A.; Montoya, Andrew J.; Morgan, George L.; Oertel, John A.; Ortiz, Thomas A.; Payton, Jeremy R.; Pazuchanics, Peter; Schmidt, Derek W.; Valdez, Adelaida C.; Wilde, Carl H.

    2008-01-01

    The National Ignition Facility (NIF) is scheduled to begin deuterium-tritium (DT) shots possibly in the next several years. One of the important diagnostics in understanding capsule behavior and to guide changes in Hohlraum illumination, capsule design, and geometry will be neutron imaging of both the primary 14 MeV neutrons and the lower-energy downscattered neutrons in the 6-13 MeV range. The neutron imaging system (NIS) described here, which we are currently building for use on NIF, uses a precisely aligned set of apertures near the target to form the neutron images on a segmented scintillator. The images are recorded on a gated, intensified charge coupled device. Although the aperture set may be as close as 20 cm to the target, the imaging camera system will be located at a distance of 28 m from the target. At 28 m the camera system is outside the NIF building. Because of the distance and shielding, the imager will be able to obtain images with little background noise. The imager will be capable of imaging downscattered neutrons from failed capsules with yields Y n >10 14 neutrons. The shielding will also permit the NIS to function at neutron yields >10 18 , which is in contrast to most other diagnostics that may not work at high neutron yields. The following describes the current NIF NIS design and compares the predicted performance with the NIF specifications that must be satisfied to generate images that can be interpreted to understand results of a particular shot. The current design, including the aperture, scintillator, camera system, and reconstruction methods, is briefly described. System modeling of the existing Omega NIS and comparison with the Omega data that guided the NIF design based on our Omega results is described. We will show NIS model calculations of the expected NIF images based on component evaluations at Omega. We will also compare the calculated NIF input images with those unfolded from the NIS images generated from our NIS numerical

  15. 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

  16. 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

  17. Strengthening Mechanisms in Microtruss Metals

    Science.gov (United States)

    Ng, Evelyn K.

    Microtrusses are hybrid materials composed of a three-dimensional array of struts capable of efficiently transmitting an externally applied load. The strut connectivity of microtrusses enables them to behave in a stretch-dominated fashion, allowing higher specific strength and stiffness values to be reached than conventional metal foams. While much attention has been given to the optimization of microtruss architectures, little attention has been given to the strengthening mechanisms inside the materials that make up this architecture. This thesis examines strengthening mechanisms in aluminum alloy and copper alloy microtruss systems with and without a reinforcing structural coating. C11000 microtrusses were stretch-bend fabricated for the first time; varying internal truss angles were selected in order to study the accumulating effects of plastic deformation and it was found that the mechanical performance was significantly enhanced in the presence of work hardening with the peak strength increasing by a factor of three. The C11000 microtrusses could also be significantly reinforced with sleeves of electrodeposited nanocrystalline Ni-53wt%Fe. It was found that the strength increase from work hardening and electrodeposition were additive over the range of structures considered. The AA2024 system allowed the contribution of work hardening, precipitation hardening, and hard anodizing to be considered as interacting strengthening mechanisms. Because of the lower formability of AA2024 compared to C11000, several different perforation geometries in the starting sheet were considered in order to more effectively distribute the plastic strain during stretch-bend fabrication. A T8 condition was selected over a T6 condition because it was shown that the plastic deformation induced during the final step was sufficient to enhance precipitation kinetics allowing higher strengths to be reached, while at the same time eliminating one annealing treatment. When hard anodizing

  18. 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

  19. 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

  20. 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...

  1. 77 FR 60107 - National Estuarine Research Reserve System

    Science.gov (United States)

    2012-10-02

    ... awareness and community involvement in stewardship, incompatible use by visitors, and ecological impacts of... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration National Estuarine Research Reserve System AGENCY: Estuarine Reserves Division, Office of Ocean and Coastal Resource Management...

  2. 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...

  3. 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...

  4. 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.

  5. 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.

  6. 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.

  7. 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”.

  8. 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.

  9. 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)

  10. 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

  11. Modernisation strategy for National Irrigation Systems in the Philippines

    NARCIS (Netherlands)

    Delos Reyes, Mona Liza Fortunado

    2017-01-01

    The performance of publicly funded canal irrigation systems or more commonly called national irrigation systems (NIS) in the Philippines remained below expectations despite considerable system rehabilitation and improvement efforts. The continued suboptimal performances were attributed to

  12. 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)

  13. Numerical Investigation of Masonry Strengthened with Composites

    Directory of Open Access Journals (Sweden)

    Giancarlo Ramaglia

    2018-03-01

    Full Text Available In this work, two main fiber strengthening systems typically applied in masonry structures have been investigated: composites made of basalt and hemp fibers, coupled with inorganic matrix. Starting from the experimental results on composites, the out-of-plane behavior of the strengthened masonry was assessed according to several numerical analyses. In a first step, the ultimate behavior was assessed in terms of P (axial load-M (bending moment domain (i.e., failure surface, changing several mechanical parameters. In order to assess the ductility capacity of the strengthened masonry elements, the P-M domain was estimated starting from the bending moment-curvature diagrams. Key information about the impact of several mechanical parameters on both the capacity and the ductility was considered. Furthermore, the numerical analyses allow the assessment of the efficiency of the strengthening system, changing the main mechanical properties. Basalt fibers had lower efficiency when applied to weak masonry. In this case, the elastic properties of the masonry did not influence the structural behavior under a no tension assumption for the masonry. Conversely, their impact became non-negligible, especially for higher values of the compressive strength of the masonry. The stress-strain curve used to model the composite impacted the flexural strength. Natural fibers provided similar outcomes, but a first difference regards the higher mechanical compatibility of the strengthening system with the substrate. In this case, the ultimate condition is due to the failure mode of the composite. The stress-strain curves used to model the strengthening system are crucial in the ductility estimation of the strengthened masonry. However, the behavior of the composite strongly influences the curvature ductility in the case of higher compressive strength for masonry. The numerical results discussed in this paper provide the base to develop normalized capacity models able to

  14. 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.

  15. 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.

  16. A Call for National Security System Transformation

    Science.gov (United States)

    2012-06-01

    Gabriel Marcella . Carlisle, PA: Strategic Studies Institute, U.S. Army War College, 2008. Fox News Corporation. “Last American Troops Leave Iraq...by Gabriel Marcella . Carlisle, PA: Strategic Studies Institute, U.S. Army War College, 2008. Stewart, Douglas. “Constructing the Iron Cage: The...1947 National Security Act.” In Affairs of State: The Interagency and National Security. Edited by Gabriel Marcella . Carlisle, PA: Strategic

  17. Bridging evidence, policy, and practice to strengthen health systems for improved maternal and newborn health in Pakistan.

    Science.gov (United States)

    Hirose, Atsumi; Hall, Sarah; Memon, Zahid; Hussein, Julia

    2015-11-25

    Policy and decision making should be based on evidence, but translating evidence into policy and practice is often sporadic and slow. It is recognised that the relationship between research and policy uptake is complex and that dissemination of research findings is necessary, but insufficient, for policy uptake. Political, social, and economic context, use of (credible) data and dialogues between and across networks of researchers and policymakers play important roles in evidence uptake. Advocacy is the process of mobilising political and public opinions to achieve specific aims and its role is crucial in mobilising key actors to push for policy uptake. Advocacy and research groups (i.e. those who would like to see research evidence used by policymakers) may use different approaches and tools to stimulate the diffusion of research findings. The use of mass- and social media, communication with study participants, and the involvement of stakeholders at the early stages of research development are examples of the approaches that can be employed to stimulate diffusion of evidence and increase evidence uptake. The Research and Advocacy Fund (RAF) for Maternal and Newborn Health (MNH) worked within the health system context in Pakistan with the aim of espousing the principles of evidence, advocacy, and dissemination to improve MNH outcomes. The articles included in this special issue are outputs of RAF and highlight where RAF's approaches contributed to MNH policy reforms. The papers discuss critical health system issues facing Pakistan, including service delivery components, demand creation, equitable access, transportation interventions for improved referrals, availability of medicines and equipment, and health workforce needs. In addition to these tangible elements, the health system 'software', i.e. the power and the political and social contexts, is also represented in the collection. These articles highlight three considerations for the future: the growing

  18. 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.

  19. 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

  20. 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.

  1. 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)

  2. Does Management Really Matter? And If so, to Who?: Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

    Science.gov (United States)

    Dovlo, Delanyo

    2015-12-03

    The editorial is commendable and I agree with many of the points raised. Management is an important aspect of health system strengthening which is often overlooked. In order to build the capacity of management, we need to consider other factors such as, the environment within which managers work, their numbers, support systems and distribution. Effective leadership is an issue which cannot be overemphasized as part of management capacity in resource deprived settings as difficult settings require leadership skills in order to achieve managerial success. A primary issue of importance highlighted in the editorial is country ownership of management effectiveness initiatives, which may be very difficult when the health sector is dependent on support and funding from donors and influential partners, who drive change often without a good understanding of the context. How partners finance health programmes is another dilemma as it can distract from locally determined priorities. Further research should help us to understand better what works and under different settings. © 2016 by Kerman University of Medical Sciences.

  3. Does Management Really Matter? And If so, to Who?; Comment on “Management Matters: A Leverage Point for Health Systems Strengthening in Global Health”

    Directory of Open Access Journals (Sweden)

    Delanyo Dovlo

    2016-02-01

    Full Text Available The editorial is commendable and I agree with many of the points raised. Management is an important aspect of health system strengthening which is often overlooked. In order to build the capacity of management, we need to consider other factors such as, the environment within which managers work, their numbers, support systems and distribution. Effective leadership is an issue which cannot be overemphasized as part of management capacity in resource deprived settings as difficult settings require leadership skills in order to achieve managerial success. A primary issue of importance highlighted in the editorial is country ownership of management effectiveness initiatives, which may be very difficult when the health sector is dependent on support and funding from donors and influential partners, who drive change often without a good understanding of the context. How partners finance health programmes is another dilemma as it can distract from locally determined priorities. Further research should help us to understand better what works and under different settings.

  4. Sandia National Laboratories: Integrated Military Systems

    Science.gov (United States)

    Defense Systems & Assessments About Defense Systems & Assessments Program Areas Accomplishments Audit Sandia's Economic Impact Licensing & Technology Transfer Browse Technology Portfolios ; Culture Work-Life Balance Special Programs Integrated Military Systems (IMS) Capabilities Facilities

  5. 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....

  6. 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.

  7. Child malnutrition in Ifanadiana district, Madagascar: associated factors and timing of growth faltering ahead of a health system strengthening intervention.

    Science.gov (United States)

    McCuskee, Sarah; Garchitorena, Andres; Miller, Ann C; Hall, Lara; Ouenzar, Mohammed Ali; Rabeza, Victor R; Ramananjato, Ranto H; Razanadrakato, Hery-Tiana Rahaniraka; Randriamanambintsoa, Marius; Barry, Michele; Bonds, Matthew H

    2018-01-01

    Child malnutrition, a leading cause of death and disability worldwide, is particularly severe in Madagascar, where 47% of children under 5 years are stunted (low height-for-age) and 8% are wasted (low weight-for-height). Widespread poverty and a weak health system have hindered attempts to implement life-saving malnutrition interventions in Madagascar during critical periods for growth faltering. This study aimed to shed light on the most important factors associated with child malnutrition, both acute and chronic, and the timing of growth faltering, in Ifanadiana, a rural district of Madagascar. We analyzed data from a 2014 district-representative cluster household survey, which had information on 1175 children ages 6 months to 5 years. We studied the effect of child health, birth history, maternal and paternal health and education, and household wealth and sanitation on child nutritional status. Variables associated with stunting and wasting were modeled separately in multivariate logistic regressions. Growth faltering was modeled by age range. All analyses were survey-adjusted. Stunting was associated with increasing child age (OR = 1.03 (95%CI 1.02-1.04) for each additional month), very small birth size (OR = 2.32 (1.24-4.32)), low maternal weight (OR = 0.94 (0.91-0.97) for each kilogram, kg) and height (OR = 0.95 (0.92-0.99) for each centimeter), and low paternal height (OR = 0.95 (0.92-0.98)). Wasting was associated with younger child age (OR = 0.98 (0.97-0.99)), very small birth size (OR = 2.48 (1.23-4.99)), and low maternal BMI (OR = 0.84 (0.75-0.94) for each kg/m 2 ). Height-for-age faltered rapidly before 24 months, then slowly until age 5 years, whereas weight-for-height faltered rapidly before 12 months, then recovered gradually until age 5 years but did not reach the median. Intergenerational transmission of growth faltering and early life exposures may be important determinants of malnutrition in Ifanadiana. Timing of growth

  8. 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...

  9. 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.

  10. 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.

  11. 36 CFR 261.54 - National Forest System roads.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false National Forest System roads... PROHIBITIONS Prohibitions in Areas Designated by Order § 261.54 National Forest System roads. When provided by...) Use by any type of traffic prohibited by the order. (c) Using a road for commercial hauling without a...

  12. Building an integrative framework for national systems of innovation

    DEFF Research Database (Denmark)

    Wang, Yuandi; Zhou, Zhao

    2011-01-01

    development of functional view of national systems of innovation, and the effective approach. Design/methodology/approach – As a theoretical research paper, the paper reviews and analyses intensive literature on national system of innovation from the perspectives of functional, structural, and effectiveness......Purpose – This paper proposes a way to integrate three different analytical approaches into a consistent framework of national systems of innovation that can benefit academia and policy makers. The approaches include the traditional structural method of national systems of innovation, the new...... approaches. Findings – The paper argues that these three approaches reflect different perspectives of national systems of innovation. Instead of contradicting each other, they could be integrated into a coherent framework. Originality/value – The paper builds an integrative framework to bring different...

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. Strengthening of oral health systems

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2014-01-01

    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......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...

  18. 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...

  19. 77 FR 472 - National Advisory Committee for Implementation of the National Forest System Land Management...

    Science.gov (United States)

    2012-01-05

    ... DEPARTMENT OF AGRICULTURE Forest Service National Advisory Committee for Implementation of the National Forest System Land Management Planning Rule; Correction AGENCY: USDA Forest Service. ACTION... for the deaf (TDD) may call the Federal Information Relay Service (FIRS) at 1 (800) 877-8339 between 8...

  20. 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)

  1. Status of Data Base Management Systems at Argonne National Laboratory

    International Nuclear Information System (INIS)

    Fuja, P.M.; Lindeman, A.J.

    1978-01-01

    Argonne National Laboratory has been using the System 2000 data base management system for the past two years. It has been used for technical as well as administrative applications. This paper describes some of the experience gained relating to advantages and disadvantages of data base management systems as well as of System 2000 in particular

  2. 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.

  3. 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.

  4. 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.

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

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

    Samdrup Jongkhar Initiative : a Model of Integrated Ecologically-friendly Development. The Samdrup Jongkhar Initiative is a civil society project in southeastern Bhutan designed to foster ecologically friendly development in harmony with Bhutan's holistic philosophy, which... View moreSamdrup Jongkhar Initiative : a Model ...

  6. Unconquerable Nation: Knowing Our Enemy, Strengthening Ourselves

    Science.gov (United States)

    2006-06-01

    calculation, and here we have at times miscalculated. We have been able to degrade al Qaeda’s capabilities, eliminate its planners, chase its leaders, and...The United States has not been able to crush al Qaeda. We have been able to degrade its capabilities, eliminate its planners, chase its leaders, and...and Magnus Ranstorp (eds.), Terrorism in the Information Age—New Frontiers? Stockholm: Forsvarshogskolan, 2004. Parfrey, Adam (ed.), Extreme Islam

  7. Origins of a national seismic system in the United States

    Science.gov (United States)

    Filson, John R.; Arabasz, Walter J.

    2016-01-01

    This historical review traces the origins of the current national seismic system in the United States, a cooperative effort that unifies national, regional, and local‐scale seismic monitoring within the structure of the Advanced National Seismic System (ANSS). The review covers (1) the history and technological evolution of U.S. seismic networks leading up to the 1990s, (2) factors that made the 1960s and 1970s a watershed period for national attention to seismology, earthquake hazards, and seismic monitoring, (3) genesis of the vision of a national seismic system during 1980–1983, (4) obstacles and breakthroughs during 1984–1989, (5) consensus building and convergence during 1990–1992, and finally (6) the two‐step realization of a national system during 1993–2000. Particular importance is placed on developments during the period between 1980 and 1993 that culminated in the adoption of a charter for the Council of the National Seismic System (CNSS)—the foundation for the later ANSS. Central to this story is how many individuals worked together toward a common goal of a more rational and sustainable approach to national earthquake monitoring in the United States. The review ends with the emergence of ANSS during 1999 and 2000 and its statutory authorization by Congress in November 2000.

  8. Accountable priority setting for trust in health systems - the need for research into a new approach for strengthening sustainable health action in developing countries

    Directory of Open Access Journals (Sweden)

    Olsen Øystein E

    2009-10-01

    Full Text Available Abstract Despite multiple efforts to strengthen health systems in low and middle income countries, intended sustainable improvements in health outcomes have not been shown. To date most priority setting initiatives in health systems have mainly focused on technical approaches involving information derived from burden of disease statistics, cost effectiveness analysis, and published clinical trials. However, priority setting involves value-laden choices and these technical approaches do not equip decision-makers to address a broader range of relevant values - such as trust, equity, accountability and fairness - that are of concern to other partners and, not least, the populations concerned. A new focus for priority setting is needed. Accountability for Reasonableness (AFR is an explicit ethical framework for legitimate and fair priority setting that provides guidance for decision-makers who must identify and consider the full range of relevant values. AFR consists of four conditions: i relevance to the local setting, decided by agreed criteria; ii publicizing priority-setting decisions and the reasons behind them; iii the establishment of revisions/appeal mechanisms for challenging and revising decisions; iv the provision of leadership to ensure that the first three conditions are met. REACT - "REsponse to ACcountable priority setting for Trust in health systems" is an EU-funded five-year intervention study started in 2006, which is testing the application and effects of the AFR approach in one district each in Kenya, Tanzania and Zambia. The objectives of REACT are to describe and evaluate district-level priority setting, to develop and implement improvement strategies guided by AFR and to measure their effect on quality, equity and trust indicators. Effects are monitored within selected disease and programme interventions and services and within human resources and health systems management. Qualitative and quantitative methods are being

  9. Accountable priority setting for trust in health systems--the need for research into a new approach for strengthening sustainable health action in developing countries.

    Science.gov (United States)

    Byskov, Jens; Bloch, Paul; Blystad, Astrid; Hurtig, Anna-Karin; Fylkesnes, Knut; Kamuzora, Peter; Kombe, Yeri; Kvåle, Gunnar; Marchal, Bruno; Martin, Douglas K; Michelo, Charles; Ndawi, Benedict; Ngulube, Thabale J; Nyamongo, Isaac; Olsen, Oystein E; Onyango-Ouma, Washington; Sandøy, Ingvild F; Shayo, Elizabeth H; Silwamba, Gavin; Songstad, Nils Gunnar; Tuba, Mary

    2009-10-24

    Despite multiple efforts to strengthen health systems in low and middle income countries, intended sustainable improvements in health outcomes have not been shown. To date most priority setting initiatives in health systems have mainly focused on technical approaches involving information derived from burden of disease statistics, cost effectiveness analysis, and published clinical trials. However, priority setting involves value-laden choices and these technical approaches do not equip decision-makers to address a broader range of relevant values - such as trust, equity, accountability and fairness - that are of concern to other partners and, not least, the populations concerned. A new focus for priority setting is needed.Accountability for Reasonableness (AFR) is an explicit ethical framework for legitimate and fair priority setting that provides guidance for decision-makers who must identify and consider the full range of relevant values. AFR consists of four conditions: i) relevance to the local setting, decided by agreed criteria; ii) publicizing priority-setting decisions and the reasons behind them; iii) the establishment of revisions/appeal mechanisms for challenging and revising decisions; iv) the provision of leadership to ensure that the first three conditions are met.REACT - "REsponse to ACcountable priority setting for Trust in health systems" is an EU-funded five-year intervention study started in 2006, which is testing the application and effects of the AFR approach in one district each in Kenya, Tanzania and Zambia. The objectives of REACT are to describe and evaluate district-level priority setting, to develop and implement improvement strategies guided by AFR and to measure their effect on quality, equity and trust indicators. Effects are monitored within selected disease and programme interventions and services and within human resources and health systems management. Qualitative and quantitative methods are being applied in an action research

  10. 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.

  11. 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

  12. Status of national health research systems in ten countries of the WHO African Region

    Directory of Open Access Journals (Sweden)

    Kirigia Joses M

    2006-10-01

    Full Text Available Abstract Background The World Health Organization (WHO Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4 which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. Methods A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. Results The key findings were as follows: the response rate was 21.7% (10/46; three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS; two countries confirmed the existence of a functional national health research management forum (NHRMF; six countries had a functional ethical review committee (ERC; five countries had a scientific review committee (SRC; five countries reported the existence of health institutions with institutional review committees (IRC; two countries had a health research programme; and three countries had a national health research institute (NHRI and a faculty of health sciences in the national university that conducted health research

  13. 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...

  14. 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

  15. Review of the FAA 1982 National Airspace System plan

    Science.gov (United States)

    1982-08-01

    The National Airspace (NAS) Plan outlines the Federal Aviation Administration's most recent proposals for modernizing the facilities and equipment that make up the air traffic control (ATC) system. This review of the NAS Plan examines the Plan at two...

  16. 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

  17. 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...

  18. 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)

  19. 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.

  20. Biodiversity information system of the national parks administration of Argentina

    Directory of Open Access Journals (Sweden)

    Leonidas Lizarraga

    2014-06-01

    Full Text Available Introduction The Biodiversity Information System (BIS of the National Parks Administration of Argentina (NPA was launched in 2002, with the support of the Global Environmental Fund (GEF through the Biodiversity Conservation Project in Argentina. The BIS consists of a set of thematic databases and Geographic Information System (GIS set to support management decisions, and to provide information to the general public on the national protected areas of Argentina. Currently, the BIS-NPA progr...

  1. Strengthening safeguards information evaluation

    International Nuclear Information System (INIS)

    Harry, J.; Hudson, P.

    2001-01-01

    The strengthening of safeguards should not be limited to the verification of explicit declarations made by the States. Additional information should guide the IAEA to set priorities for further investigations. Not only all aspects of the State's nuclear programme, including the application of safe, secure and transparent nuclear management, but also the level of compliance with other verifiable treaties, political motivation, economic capabilities, international relations and ties, co-operative attitude to safeguards, and general openness and transparency should be included. The evaluation of the diverse forms of information from different sources requires new reliable processes that will result in a high credibility and detection probability. The IAEA uses the physical model for the evaluation of the technical information, and proposed also Fuzzy Logic, or Calculation with Words, to handle the information. But for the evaluation it is questioned whether fuzziness could lead to a crisp judgement. In this paper an objective method of information evaluation is proposed, which allows to integrate different kinds of information and to include calibration and tests in the establishment of the evaluation process. This method, Delta, uses elicitation of a syndicate of experienced inspectors to integrate obvious indicators together with apparently innocent indicators, into a database that forms the core of the evaluation process. Nominal or ordinal scales could be applied to come to an objective and quantifiable result. Experience with this method can in the course of time result in predictive conclusions. 9 refs

  2. Strengthening 4-H by Analyzing Enrollment Data

    Science.gov (United States)

    Hamilton, Stephen F.; Northern, Angela; Neff, Robert

    2014-01-01

    The study reported here used data from the ACCESS 4-H Enrollment System to gain insight into strengthening New York State's 4-H programming. Member enrollment lists from 2009 to 2012 were analyzed using Microsoft Excel to determine trends and dropout rates. The descriptive data indicate declining 4-H enrollment in recent years and peak enrollment…

  3. 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.)

  4. Networked National Occupational Dose Registry System (NODRS)

    International Nuclear Information System (INIS)

    Sapra, B.K.

    2016-01-01

    Recording of occupational doses received by radiation workers during their working life is a mandatory aspect of radiation protection. Maintaining of life-time dose data of these radiation workers is also necessary for (i) ensuring and reviewing radiation safety of workers, (ii) certification and other legal purposes, and (iii) for statistical analysis and epidemiological studies. Centralized dose records are being maintained by BARC since the inception of Directorate of Radiation Protection in late sixties. The dose records were computerized since 1975 and the systems were upgraded from time to time. The requirement of personnel data information was made a pre-requisite for allotment of personnel number to new persons for TLD Badge services since 1992

  5. 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.

  6. 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

  7. 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

  8. 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.

  9. A multi-center prospective cohort study to evaluate the effect of differential pricing and health systems strengthening on access to medicines and management of hypertension and diabetes in Ghana: A study protocol.

    Science.gov (United States)

    Mobula, Linda Meta; Sarfo, Stephen; Arthur, Lynda; Burnham, Gilbert; Plange-Rhule, Jacob; Ansong, Daniel; Gavor, Edith; Ofori-Adjei, David

    2018-02-07

    Background: There is evidence to suggest that the prevalence of non-communicable diseases (NCDs), in particular cardiovascular diseases and diabetes, are being recognized as forming a substantial proportion of the burden of disease among populations in Low- and Middle-Income Countries (LMICs).  Access to treatment is likely a key barrier to the control and prevention of NCD outcomes.  Differential pricing, an approach used to price drugs based on the purchasing power of patients in different socioeconomic segments, has been shown to be beneficial and leads to improved access and affordability. Methods: This is a quasi-experimental study, with a pragmatic trial design, to be conducted over the course of three years. A mixed methods design will be used to evaluate the effects of health systems strengthening and differential pricing on the management of diabetes, hypertension and selected cancers in Ghana. A public private partnership was established between all sites that will receive multi-level interventions, including health systems strengthening  and access to medicines interventions. Study populations and sites: Study participants will include individuals with new or recently diagnosed hypertension and diabetes (n=3,300), who present to two major referral hospitals, Komfo Anokye Teaching Hospital and Tamale Teaching Hospital, as well as three district hospitals, namely Kings Medical Centre, Agogo Presbyterian District Hospital, and Atua Government Hospital. Discussion: The objective of this study aims to test approaches intended to improve access to drugs for the treatment of hypertension and diabetes, and improve disease control. Patients with these conditions will benefit from health systems strengthening interventions (education, counseling, improved management of disease), and increased access to innovative medicines via differential pricing. Pilot programs also will facilitate health system strengthening at the participating institutions, which includes

  10. 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…

  11. 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.

  12. 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.

  13. 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

  14. 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 ...

  15. 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.

  16. Major Components of the National TRU Waste System Optimization Project

    International Nuclear Information System (INIS)

    Moody, D.C.; Bennington, B.; Sharif, F.

    2002-01-01

    The National Transuranic (TRU) Program (NTP) is being optimized to allow for disposing of the legacy TRU waste at least 10 years earlier than originally planned. This acceleration will save the nation an estimated $713. The Department of Energy's (DOE'S) Carlsbad Field Office (CBFO) has initiated the National TRU Waste System Optimization Project to propose, and upon approvaI, implement activities that produce significant cost saving by improving efficiency, thereby accelerating the rate of TRU waste disposal without compromising safety. In its role as NTP agent of change, the National TRU Waste System Optimization Project (the Project) (1) interacts closely with all NTP activities. Three of the major components of the Project are the Central Characterization Project (CCP), the Central Confirmation Facility (CCF), and the MobiIe/Modular Deployment Program.

  17. Strengthening Science Departments

    Science.gov (United States)

    Campbell, Todd; Melville, Wayne; Bartley, Anthony

    2012-01-01

    Teachers do not work in a vacuum. They are, in most cases, part of a science department in which teachers and the chairperson have important roles in science education reform. Current reform is shaped by national standards documents that emphasize the pedagogical and conceptual importance of best practices framed by constructivism and focused on…

  18. National Ignition Facility system design requirements Laser System SDR002

    International Nuclear Information System (INIS)

    Larson, D.W.; Bowers, J.M.; Bliss, E.S.; Karpenko, V.P.; English, E.

    1996-01-01

    This System Design Requirement document establishes the performance, design, development, and test requirements for the NIP Laser System. The Laser System generates and delivers high-power optical pulses to the target chamber, and is composed of all optical puke creating and transport elements from Puke Generation through Final Optics as well as the special equipment that supports, energizes and controls them. The Laser System consists of the following WBS elements: 1.3 Laser System 1.4 Beam Transport System 1.6 Optical Components 1.7 Laser Control 1.8.7 Final Optics

  19. 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.

  20. Integrating the Unmanned Aircraft System into the National Airspace System

    Science.gov (United States)

    2011-06-18

    HALE High Altitude Long Endurance IFR Instrument Flight Rules ISR Intelligence, Surveillance, and Reconnaissance JFC Joint Force Commander JP...many advantages and disadvantages of unmanned aircraft now made national headlines as UAS executed missions, once reserved for manned aircraft...of this research. To operate above 18,000 feet MSL the UAS must be filed under Instrument Flight Rules, or IFR flight plan. Additionally, the

  1. 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.

  2. South-South cooperation as a mechanism to strengthen public ...

    African Journals Online (AJOL)

    South-South cooperation as a mechanism to strengthen public health services in Africa: ... PROMOTING ACCESS TO AFRICAN RESEARCH ... Implementation of new models of development cooperation have been on the increase ... health system strengthening, aid effectiveness, sustainable development goals, Africa ...

  3. 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

  4. 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.

  5. 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…

  6. 76 FR 81911 - National Advisory Committee for Implementation of the National Forest System Land Management...

    Science.gov (United States)

    2011-12-29

    ...; and 7. Offer recommendations for integrating the land management planning process with landscape scale... National Forest System Land Management Planning Rule AGENCY: USDA Forest Service. ACTION: Notice of intent... Management Planning Rule (Committee). In accordance with provisions of the Federal Advisory Committee Act...

  7. 78 FR 68811 - National Advisory Committee for Implementation of the National Forest System Land Management...

    Science.gov (United States)

    2013-11-15

    ... following business will be conducted: 1. Present finalized recommendations; 2. Look back on what has been... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of... Management Planning Rule will meet in Arlington, VA, on November 21, 2013. Attendees may also participate via...

  8. 77 FR 50985 - National Advisory Committee for Implementation of the National Forest System Land Management...

    Science.gov (United States)

    2012-08-23

    ... following business will be conducted: (1) Determine the scope and initial tasks of the committee, (2) ethics... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of... Management Planning Rule will meet in Washington, DC. The committee operates in compliance with the Federal...

  9. 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.

  10. National high-level waste systems analysis report

    International Nuclear Information System (INIS)

    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

  11. 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,...

  12. 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

  13. 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

  14. 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

  15. 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...

  16. Top tax system: a common taxation system for all nations

    OpenAIRE

    Varma, Vijaya Krushna Varma

    2009-01-01

    I am suggesting new methods, and innovative and alternative policies in the areas of optimal taxation, tax collection, money supply and banking financial system to help remove corruption, tax evasion, economic recession, black money, fake currency and societal inequalities. In my opinion, the proposed TOP Tax system may usher in good governance, 100% tax compliance and corruption free environment. It suggests a single tax called “TOP Tax” (Transfer Or Purchase Tax) for both Centre and States ...

  17. China's numerical management system for reducing national energy intensity

    International Nuclear Information System (INIS)

    Li, Huimin; Zhao, Xiaofan; Yu, Yuqing; Wu, Tong; Qi, Ye

    2016-01-01

    In China, the national target for energy intensity reduction, when integrated with target disaggregation and information feedback systems, constitutes a numerical management system, which is a hallmark of modern governance. This paper points out the technical weaknesses of China's current numerical management system. In the process of target disaggregation, the national target cannot be fully disaggregated to local governments, sectors and enterprises without omissions. At the same time, governments at lower levels face pressure for reducing energy intensity that exceeds their respective jurisdictions. In the process of information feedback, information failure is inevitable due to statistical inaccuracy. Furthermore, the monitoring system is unable to correct all errors, and data verification plays a limited role in the examination system. To address these problems, we recommend that the government: use total energy consumption as the primary indicator of energy management; reform the accounting and reporting of energy statistics toward greater consistency, timeliness and transparency; clearly define the responsibility of the higher levels of government. - Highlights: •We assess drawbacks of China's numerical management system for energy intensity. •The national energy intensity target cannot be fully disaggregated without omissions. •Data distortion is due to failures in statistics, monitoring and examination system. •Lower-level governments’ ability to meet energy target is weaker than their pressure. •We provide three policy recommendations for China's policy-makers.

  18. A data automation system at Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Betts, S.E.; Schneider, C.M.; Pickrell, M.M.

    2001-01-01

    Idaho National Engineering and Environmental Laboratory (INEEL) has developed an automated computer program, Data Review Expert System (DRXS), for reviewing nondestructive assay (NDA) data. DRXS significantly reduces the data review time needed to meet characterization requirements for the Waste Isolation Pilot Plant (WIPP). Los Alamos National Laboratory (LANL) is in the process of developing a computer program, Software System Logic for Intelligent Certification (SSLIC), to automate other tasks associa ted with characterization of Transuranic Waste (TRU) samples. LANL has incorporated a version of DRXS specific to LANL's isotopic data into SSLIC. This version of SSLIC was audited by the National Transuranic Program on October, 24, 2001. This paper will present the results of the audit, and discuss future plans for SSLIC including the integration on the INEELLANL developed Rule Editor.

  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. 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...

  1. 76 FR 40338 - National Estuarine Research Reserve System

    Science.gov (United States)

    2011-07-08

    ... coastal issues of the reserve related to water quality (non-point source pollution), invasive species... Reserve System AGENCY: Estuarine Reserves Division, Office of Ocean and Coastal Resource Management.... ACTION: Notice of Approval and Availability for Revised Management Plans for ACE Basin, SC National...

  2. 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...

  3. 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 ...

  4. National Innovation Systems in Brazil, Russia, India, China and ...

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

    They will characterize and compare the five national innovation systems, pointing out convergences, divergences and synergies, as well as current and potential connections. They will endeavor to identify possible paths to achieving their socioeconomic development potential. And, they will generate policy implications of ...

  5. 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

  6. 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.

  7. 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

  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. Training Sessions Provide Working Knowledge of National Animal Identification System

    Science.gov (United States)

    Glaze, J. Benton, Jr.; Ahola, Jason K.

    2010-01-01

    One in-service and two train-the-trainer workshops were conducted by University of Idaho Extension faculty, Idaho State Department of Agriculture personnel, and allied industry representatives to increase Extension educators' knowledge and awareness of the National Animal Identification System (NAIS) and related topics. Training sessions included…

  10. 78 FR 50038 - National Estuarine Research Reserve System

    Science.gov (United States)

    2013-08-16

    ....33(c), the revised plan meets the reserve's requirements for compliance. The Wells Reserve Management... Reserve System AGENCY: Estuarine Reserves Division, Office of Ocean and Coastal Resource Management.... ACTION: Notice of Public Comment Period for the Wells, Maine National Estuarine Research Reserve...

  11. Why We Should Establish a National System of Standards.

    Science.gov (United States)

    Hennen, Thomas J., Jr.

    2000-01-01

    Explains the need to establish a national system of standards for public libraries. Discusses local standards, state standards, and international standards, and suggests adopting a tiered approach including three levels: minimum standards; target standards; and benchmarking standards, as found in total quality management. (LRW)

  12. 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,...

  13. 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

  14. Different Tax Systems among Nations and International Tax Avoidance

    OpenAIRE

    栗原, 克文

    2008-01-01

    As economic globalization proceeds, tax policies of one nation influence others more and greater pressures are imposed on tax systems and tax administrations.The possibility of tax avoidance will expand if cross-border transactions are abused.Specifically, tax system differentials among countries increase the opportunity for tax avoidance.Under some tax avoidance schemes, foreign entities which have no or little economic substance are used to create artificial losses, so that they can minimiz...

  15. PC based Thyroid uptake system for the National Health System

    International Nuclear Information System (INIS)

    Arista Romeo, Eduardo; Ateche Diaz, Raul; Alonso Abad, Dolores

    2003-01-01

    a measurement detection system is presented to be used in Iodine Thyroid Uptake Studies. It consists of three elements the detector with its collimator, a blind measurement module and the application software. The measurements module communications through a RS-232 serial interface to the PC where the applications software Detect resides. The software was designed according to the principles ob object oriented programming using C++ language. It automatically fixes spectrometric measurement parameters and besides patient measurement also performs statistical analysis of a batch of samples, It possesses a Paradox database with all information of measured patients and an on line help with the system options

  16. 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.

  17. A study on strengthening measures of non-proliferation regime through the export control system of sensitive materials, equipment and technology related to nuclear activities

    International Nuclear Information System (INIS)

    Kikuchi, Masahiro; Kurosawa, Mitsuru; Komizo, Yasuyoshi

    2004-01-01

    The strengthened safeguards caused from safeguards experiences to Iraq and DPRK leads to the expansion of the IAEA's activities for verification of all nuclear activities as well as verification of nuclear material in the States. The purpose of the activities, of course, includes detection of undeclared exports and imports of specified equipment and non-nuclear material. The Additional Protocol to the agreements between States and the IAEA for the application of safeguards requires to the States to declare the exports and imports information regarding specified equipment and non-nuclear material corresponding to the export control list that is established by the nuclear suppliers group. The Additional Protocol also insists the IAEA's right to access to the location identified by the State to resolve a question related to the declarations. Recently, the IAEA detected the black market group of the sensitive materials, equipment and technologies relevant to the nuclear proliferation through the safeguards activities to Iran and Libya. International community stated deeply concerns to the indecent facts. This paper would discuss and propose the supplemental strengthening measures of non-proliferation regime by effective combination of the safeguards activities under additional protocol and the export control regime. (author)

  18. 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)

  19. 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

  20. 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.

  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

    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.

  2. Mechanical behavior and strengthening mechanisms in ultrafine grain precipitation-strengthened aluminum alloy

    International Nuclear Information System (INIS)

    Ma, Kaka; Wen, Haiming; Hu, Tao; Topping, Troy D.; Isheim, Dieter; Seidman, David N.; Lavernia, Enrique J.; Schoenung, Julie M.

    2014-01-01

    To provide insight into the relationships between precipitation phenomena, grain size and mechanical behavior in a complex precipitation-strengthened alloy system, Al 7075 alloy, a commonly used aluminum alloy, was selected as a model system in the present study. Ultrafine-grained (UFG) bulk materials were fabricated through cryomilling, degassing, hot isostatic pressing and extrusion, followed by a subsequent heat treatment. The mechanical behavior and microstructure of the materials were analyzed and compared directly to the coarse-grained (CG) counterpart. Three-dimensional atom-probe tomography was utilized to investigate the intermetallic precipitates and oxide dispersoids formed in the as-extruded UFG material. UFG 7075 exhibits higher strength than the CG 7075 alloy for each equivalent condition. After a T6 temper, the yield strength (YS) and ultimate tensile strength (UTS) of UFG 7075 achieved 734 and 774 MPa, respectively, which are ∼120 MPa higher than those of the CG equivalent. The strength of as-extruded UFG 7075 (YS: 583 MPa, UTS: 631 MPa) is even higher than that of commercial 7075-T6. More importantly, the strengthening mechanisms in each material were established quantitatively for the first time for this complex precipitation-strengthened system, accounting for grain-boundary, dislocation, solid-solution, precipitation and oxide dispersoid strengthening contributions. Grain-boundary strengthening was the predominant mechanism in as-extruded UFG 7075, contributing a strength increment estimated to be 242 MPa, whereas Orowan precipitation strengthening was predominant in the as-extruded CG 7075 (∼102 MPa) and in the T6-tempered materials, and was estimated to contribute 472 and 414 MPa for CG-T6 and UFG-T6, respectively

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. Elements of a national emergency response system for nuclear accidents

    International Nuclear Information System (INIS)

    Dickerson, M.H.

    1987-01-01

    The purpose of this paper is to suggest elements for a general emergency response system, employed at a national level, to detect, evaluate and assess the consequences of a radiological atmospheric release occurring within or outside of national boundaries. These elements are focused on the total aspect of emergency response ranging from providing an initial alarm to a total assessment of the environmental and health effects. Elements of the emergency response system are described in such a way that existing resources can be directly applied if appropriate; if not, newly developed or an expansion of existing resources can be employed. The major thrust of this paper is toward a philosophical discussion and general description of resources that would be required to implementation. If the major features of this proposal system are judged desirable for implementation, then the next level of detail can be added. The philosophy underlying this paper is preparedness - preparedness through planning, awareness and the application of technology. More specifically, it is establishment of reasonable guidelines including the definition of reference and protective action levels for public exposure to accidents involving nuclear material; education of the public, government officials and the news media; and the application of models and measurements coupled to computer systems to address a series of questions related to emergency planning, response and assessment. It is the role of a proven national emergency response system to provide reliable, quality-controlled information to decision makers for the management of environmental crises

  8. Initiatives to strengthen physical protection in Japan

    International Nuclear Information System (INIS)

    Kurihara, H.; Yagi, T.; Endo, M.; Murajiri, M.

    2001-01-01

    Full text: The Nuclear Material Control Center (NMCC) was established under the approval of the Japanese Government in 1972 to function as an important organization to implement national safeguards system together with the Government. It has been also working on R and D of physical protection of nuclear materials and facilities, and enhancing the awareness of the importance of the physical protection among physical protection related people. Japan has now 52 nuclear power reactors, accounting for about one-third of the nations electricity generation. Also nuclear fuel cycle facilities as enrichment plants, radioactive waste disposal facilities and reprocessing plant are either in operation or under construction at Rokkasho-Mura, Aomori prefecture. NMCC is doing several initiatives to strengthen and increase the understanding of the physical protection in Japan by disseminating necessary information to people which are described in the following: 1. Physical protection seminar for the physical protection specialists and management people - It is very important for the physical protection specialists as well as management people who are working at nuclear facilities to be able to get access to the related sophisticated information on the information on the global physical protection issues, physical protection regulations, physical protection systems and equipment etc. This kind of seminar was started in 19xx and is held once a year for two days in Tokyo. The curriculum includes global physical protection issues, physical protection related activities such as terrorism, current R and D, and application of equipment, experiences gained at nuclear facilities. About 70 people participate in the seminar every year. 2. Physical protection seminar for the physical protection related local people - It is more and more important for the nuclear industry to disseminate information to the local people about the nuclear facility operation. Such local people as local government

  9. 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.

  10. 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...

  11. 76 FR 37356 - 2011 Scientific Meeting of the National Antimicrobial Resistance Monitoring System; Public...

    Science.gov (United States)

    2011-06-27

    ... animal and retail sampling methods for the National Antimicrobial Resistance Monitoring System (NARMS... Web site at http://www.fda.gov/AnimalVeterinary/SafetyHealth/AntimicrobialResistance/National...] 2011 Scientific Meeting of the National Antimicrobial Resistance Monitoring System; Public Meeting...

  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. 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)

  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. Conceptual design of the national nuclear emergency management information system

    International Nuclear Information System (INIS)

    Wang Xingyu; Shi Zhongqi

    2003-01-01

    A Conceptual Design of the National Nuclear Emergency Management Information System was brought forward in this paper, based on the summarization of some emergency management information systems used in China and some other countries. The conceptual system should have four basic characteristics, that are (1) a graphic displaying and querying interface based on GIS (2) data and results shared with the assessment software of nuclear accident (3) a complete set of databases and (4) the capability of on-line data receiving or real-time distributing of the commands and information for emergency response

  18. 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.

  19. National safeguards system operations at a bulk-handling facility

    International Nuclear Information System (INIS)

    Anon.

    1981-01-01

    The presentation centers on the State System of Accounting and Control (SSAC) for bulk-handling facilities in the licenses sector of the US nuclear community. Details of those material control and accounting measures dealing with the national safeguards program are discussed in Session 6a. The concept and role of the Fundamental Nuclear Material Control (FNMC) Plan are discussed with the participants. In Session 6b, the lecture focusses on the international safeguards program of the US SSAC. The relationship of the national and international requirements is discussed as they relate to the IAEA INFCIRC/153 document. The purpose of this session is to enable participants to: (1) understand the basic MC and A elements in an SSAC; (2) understand which MC and A elements serve the country's national interests and those that serve IAEA safeguards

  20. 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)

  1. 1 The West Africa Initiative to Strengthen Capacities through Health ...

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

    Afekwo Mbonu

    2012-08-31

    ) governance and governance structures of health systems. .... Strengthened evidence base from the awarded research projects complemented by a set of ..... Canadian recipients which purchase equipment using IDRC funds ...

  2. 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

  3. 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

  4. 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.

  5. 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

  6. Approach for Establishing a National Nuclear Forensics System

    International Nuclear Information System (INIS)

    Kim, Jaekwang; Hyung, Sangcheol

    2014-01-01

    The increasing number could give rise to posing a potential threat to national infrastructure which is very vulnerable to radiological sabotage with the materials. International community has been emphasizing the importance of nuclear forensics through the Nuclear Security Summit process as a countermeasure against nuclear terrorism. Global Initiative to Combat Nuclear Terrorism(GICNT) and nuclear forensics International Technology Working Group(ITWG) suggest the establishment of national nuclear forensics system which has a law enforcement for forensic management and maintenance of nuclear forensics database including nuclear material and other radioactive materials. We suggest the legal and institutional system through this paper in an effort to set up a multi expert group and the nuclear forensics DB which can contribute to effective Core capabilities

  7. Approach for Establishing a National Nuclear Forensics System

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jaekwang; Hyung, Sangcheol [Korea Institute of Nuclear Nonproliferation and Control, Daejeon (Korea, Republic of)

    2014-05-15

    The increasing number could give rise to posing a potential threat to national infrastructure which is very vulnerable to radiological sabotage with the materials. International community has been emphasizing the importance of nuclear forensics through the Nuclear Security Summit process as a countermeasure against nuclear terrorism. Global Initiative to Combat Nuclear Terrorism(GICNT) and nuclear forensics International Technology Working Group(ITWG) suggest the establishment of national nuclear forensics system which has a law enforcement for forensic management and maintenance of nuclear forensics database including nuclear material and other radioactive materials. We suggest the legal and institutional system through this paper in an effort to set up a multi expert group and the nuclear forensics DB which can contribute to effective Core capabilities.

  8. 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

  9. Characterization optimization for the National TRU waste system

    International Nuclear Information System (INIS)

    Basabilvazo, George T.; Countiss, S.; Moody, D.C.; Jennings, S.G.; Lott, S.A.

    2002-01-01

    On March 26, 1999, the Waste Isolation Pilot Plant (WIPP) received its first shipment of transuranic (TRU) waste. On November 26, 1999, the Hazardous Waste Facility Permit (HWFP) to receive mixed TRU waste at WIPP became effective. Having achieved these two milestones, facilitating and supporting the characterization, transportation, and disposal of TRU waste became the major challenges for the National TRU Waste Program. Significant challenges still remain in the scientific, engineering, regulatory, and political areas that need to be addressed. The National TRU Waste System Optimization Project has been established to identify, develop, and implement cost-effective system optimization strategies that address those significant challenges. Fundamental to these challenges is the balancing and prioritization of potential regulatory changes with potential technological solutions. This paper describes some of the efforts to optimize (to make as functional as possible) characterization activities for TRU waste.

  10. 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

  11. Ion exchange for glass strengthening

    International Nuclear Information System (INIS)

    Gy, Rene

    2008-01-01

    This paper presents a short overview of silicate glass strengthening by exchange of alkali ions in a molten salt, below the glass transition temperature (chemical tempering). The physics of alkali inter-diffusion is briefly explained and the main parameters of the process, which control the glass reinforcement, are reviewed. Methods for characterizing the obtained residual stress state and the strengthening are described, along with the simplified modelling of the stress build-up. The fragmentation of chemically tempered glass is discussed. The concept of engineered stress profile glass is presented, and finally, the effect of glass and salt compositions is overviewed

  12. 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.

  13. 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...

  14. Protecting Commercial Space Systems: A Critical National Security Issue

    Science.gov (United States)

    1999-04-01

    systems. Part two will describe, at the operational level , this author’s theory for space protection and recommend a course of action to work...minimal loss of life. These factors force us to conclude this is a critical national security issue just as many in high- level government positions...Command and Staff College Operational Forces Coursebook (Academic Year 1999), 35. 3 The USCG is not a Title 10 Service, thus Posse Comitatus is not a

  15. Study on Korean Radiological Emergency System-Care System- and National Nuclear Emergency Preparedness System Development

    International Nuclear Information System (INIS)

    Akhmad Khusyairi; Yudi Pramono

    2008-01-01

    Care system; Radiological Emergency Supporting System. Environmental radiology level is the main aspect that should be concerned deal with the utilization of nuclear energy. The usage of informational technology in nuclear area gives significant contribution to anticipate and to protect human and environment. Since 1960, South Korea has developed environment monitoring system as the effort to protect the human and environment in the radiological emergency condition. Indonesia has possessed several nuclear installations and planned to build and operate nuclear power plants (PLTN) in the future. Therefore, Indonesia has to prepare the integrated system, technically enables to overcome the radiological emergency. Learning from the practice in South Korea, the system on the radiological emergency should be prepared and applied in Indonesia. However, the government regulation draft on National Radiological Emergency System, under construction, only touches the management aspect, not the technical matters. Consequently, when the regulation is implemented, it will need an additional regulation on technical aspect including the consideration on the system (TSS), the organization of operator and the preparation of human resources development of involved institution. For that purpose, BAPETEN should have a typical independence system in regulatory frame work. (author)

  16. 77 FR 3123 - Special Regulations, Areas of the National Park System, Cape Hatteras National Seashore-Off-Road...

    Science.gov (United States)

    2012-01-23

    ..., Areas of the National Park System, Cape Hatteras National Seashore--Off-Road Vehicle Management AGENCY: National Park Service, Interior. ACTION: Final rule. SUMMARY: This rule designates off-road vehicle (ORV... operation of motor vehicles off of roads within areas [[Page 3124

  17. 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)

  18. Domesday 2000 - a National Land Information System for Britain

    DEFF Research Database (Denmark)

    Sabel, C. E.; Ralphs, M. P.

    1992-01-01

    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......-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...

  19. Assessment of Malawi's success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluation.

    Science.gov (United States)

    Doherty, Tanya; Zembe, Wanga; Ngandu, Nobubelo; Kinney, Mary; Manda, Samuel; Besada, Donela; Jackson, Debra; Daniels, Karen; Rohde, Sarah; van Damme, Wim; Kerber, Kate; Daviaud, Emmanuelle; Rudan, Igor; Muniz, Maria; Oliphant, Nicholas P; Zamasiya, Texas; Rohde, Jon; Sanders, David

    2015-12-01

    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.

  20. 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.

  1. National Ignition Facility Control and Information System Operational Tools

    International Nuclear Information System (INIS)

    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.

    2009-01-01

    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 ∼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.

  2. 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

  3. 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.

  4. The Lawrence Livermore National Laboratory Intelligent Actinide Analysis System

    International Nuclear Information System (INIS)

    Buckley, W.M.; Carlson, J.B.; Koenig, Z.M.

    1993-07-01

    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 the authors' 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 3 as the isotopic analysis code. The design of the IAAS reduces the need for operator intervention, operator training, and operator exposure

  5. 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

  6. National healthcare systems and the need for health information governance.

    Science.gov (United States)

    Hovenga, Evelyn J S

    2013-01-01

    This chapter gives an overview of health data, information and knowledge governance needs and associated generic principles so that information systems are able to automate such data collections from point-of-care operational systems. Also covered are health information systems' dimensions and known barriers to the delivery of quality health services, including environmental, technology and governance influences of any population's health status within the context of national health systems. This is where health information managers and health informaticians need to resolve the many challenges associated with eHealth implementations where data are assets, efficient information flow is essential, the ability to acquire new knowledge desirable, and where the use of data and information needs to be viewed from a governance perspective to ensure reliable and quality information is obtained to enhance decision making.

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. Filter-fluorescer diagnostic system for the National Ignition Facility

    International Nuclear Information System (INIS)

    McDonald, J.W.; Kauffman, R.L.; Celeste, J.R.; Rhodes, M.A.; Lee, F.D.; Suter, L.J.; Lee, A.P.; Foster, J.M.; Slark, G.

    2004-01-01

    An early filter-fluorescer diagnostic system is being fielded at the National Ignition Facility (NIF) at Lawrence Livermore National Laboratory (LLNL) to measure the amount of hard x rays (20< hν<150 keV) generated in laser fusion experiments. From these measurements we hope to quantify the number of hot electrons produced in laser fusion experiments. The measurement of hot electron production is important for ignition experiments because these electrons can preheat the fuel capsule. Hot electrons can also be employed in experimentation by preheating hydrodynamic packages or by driving plasmas out of equilibrium. The experimental apparatus, data collection, analysis and calibration issues are discussed. Expected data signal levels are predicted and discussed

  13. 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 +.

  14. Development of an analysis capability for the National Transportation System

    Energy Technology Data Exchange (ETDEWEB)

    Anson, D.; Nelson, R.

    1997-10-24

    The purpose of this report is to examine the Department of Transportation`s (DOT) National Transportation System (NTS) initiative, to document what has been learned, and to outline a National Transportation Network Analysis Capability (NTNAC) based on a ``TRANSIMS-like`` approach. This study was conducted over a two month period at the end of FY1997. The scope of the effort was carefully defined to accommodate the short time horizon and to provide focus to a very large analytical problem. The objectives were to: (1) define the NTS and the NTS problem; (2) identify problem characteristics; (3) describe an analytical solution based on the TRANSIMS approach; (4) identify data requirements and availability; (5) develop criteria for a scenario to be used in a prototype demonstration; and (6) select a scenario for the prototype demonstration.

  15. 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

  16. 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)

  17. 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.

  18. Explaining implementation behaviour of the National Incident Management System (NIMS).

    Science.gov (United States)

    Jensen, Jessica; Youngs, George

    2015-04-01

    This paper explains the perceived implementation behaviour of counties in the United States with respect to the National Incident Management System (NIMS). The system represents a massive and historic policy mandate designed to restructure, standardise and thereby unify the efforts of a wide variety of emergency management entities. Specifically, this study examined variables identified in the NIMS and policy literature that might influence the behavioural intentions and actual behaviour of counties. It found that three key factors limit or promote how counties intend to implement NIMS and how they actually implement the system: policy characteristics related to NIMS, implementer views and a measure of local capacity. One additional variable-inter-organisational characteristics-was found to influence only actual behaviour. This study's findings suggest that the purpose underlying NIMS may not be fulfilled and confirm what disaster research has long suggested: the potential for standardisation in emergency management is limited. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

  19. 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.

  20. 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.