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Policy strategy operations

Eric Leblanc, Fabrice Narducci, Lucie Bresson, Delphine Hudry
OBJECTIVE: To explore the feasibility of an oncologically acceptable management for an intermediate-risk endometrial cancer (EC) in an elderly, using the combination of transvaginal single-port laparoscopy and sentinel node policy. METHODS: For this 85-years old patient, BMI 32kg/m(2), with IB grade 2 endometrioid EC, a single vaginal approach was attempted [1] to perform a total hysterectomy, bilateral salpinago-oophorectomy and pelvic node assessment guided by SND [2]...
October 13, 2016: Gynecologic Oncology
Joël Ladner, Marie-Hélène Besson, Etienne Audureau, Mariana Rodrigues, Joseph Saba
BACKGROUND: Cervical cancer is the greatest cause of age-weighted years of life lost in the developing world. Human papillomavirus (HPV) infection is associated with a high proportion of cervical cancers, and HPV vaccination may help to reduce the incidence of cancer. The aim of the study was to identify barriers, obstacles, and strategies and to analyze key concerns and lessons learned with respect to the implementation of HPV vaccination program in low- and middle-income countries. METHODS: The Gardasil Access Program (GAP) is a donation program established to enable organizations and institutions in eligible low-resource countries to gain operational experience designing and implementing HPV vaccination programs...
October 13, 2016: BMC Health Services Research
Olatunde Adesoro, Constance Shumba, John Kpamor, Jane Achan, Harriet Kivumbi, John Dada, Kolawole Maxwell, James Tibenderana, Madeline Marasciulo, Prudence Hamade, Olusola Oresanya, Joanita Nankabirwa, Ebenezer Baba
BACKGROUND: Innovative strategies are needed to reduce malaria mortality in high burden countries like Nigeria. Given that one of the important reasons for this high malaria mortality is delay in receiving effective treatment, improved access to such treatment is critical. Intramuscular artesunate could be used at lower-level facilities given its proven efficacy, ease of use and excellent safety profile. The objective of this study was therefore to explore health workers' perspectives on the possible use of intramuscular artesunate as definitive treatment for severe malaria at lower-level facilities, especially when access to referral facilities is challenging...
October 12, 2016: BMC Health Services Research
Emmanuel Chanda, Birkinesh Ameneshewa, Magaran Bagayoko, John M Govere, Michael B Macdonald
The increasing global threat of emerging and re-emerging vector-borne diseases (VBDs) poses a serious health problem. The World Health Organization (WHO) recommends integrated vector management (IVM) strategy for combating VBD transmission. An IVM approach requires entomological knowledge, technical and infrastructure capacity, and systems facilitating stakeholder collaboration. In sub-Saharan Africa, successful operational IVM experience comes from relatively few countries. This article provides an update on the extent to which IVM is official national policy, the degree of IVM implementation, the level of compliance with WHO guidelines, and concordance in the understanding of IVM, and it assesses the operational impact of IVM...
October 3, 2016: Trends in Parasitology
Nicole Nathan, Sze Lin Yoong, Rachel Sutherland, Kathryn Reilly, Tessa Delaney, Lisa Janssen, Katie Robertson, Renee Reynolds, Li Kheng Chai, Christophe Lecathelinais, John Wiggers, Luke Wolfenden
BACKGROUND: The implementation of school nutrition policies, which govern the provision of food in schools, is recommended as a public health strategy to support the development of healthy dietary behaviours in school-aged children. Despite this, research internationally and in Australia indicates that few schools implement such policies. This study aims to examine whether a theoretically designed, multi-strategy intervention was effective in increasing the implementation of a healthy canteen policy in Australian primary schools...
October 7, 2016: International Journal of Behavioral Nutrition and Physical Activity
Pepijn Krielen, Barend A van den Beukel, Martijn W J Stommel, Harry van Goor, Chema Strik, Richard P G Ten Broek
BACKGROUND: Previous research on the costs of treatment for ASBO is outdated and often based on reimbursements, rather than true healthcare provider costs of the admission and related interventions. An accurate estimate of the true costs of treatment is necessary to understand the healthcare burden and to model cost-efficacy of adhesion strategies. The aim of this study was to provide an accurate cost estimate of the in-hospital costs for treatment of adhesive small bowel obstruction (ASBO) using micro-costing methods...
2016: World Journal of Emergency Surgery: WJES
Pei-Hsiou Ding, Gen-Shuh Wang, Bing-Yu Chen, Gwo-Hwa Wan
Urbanization causes air pollution in metropolitan areas, coupled with meteorological factors that affect air quality. Although previous studies focused on the relationships of urbanization, air pollution, and climate change in Western countries, this study evaluated long-term variations of air quality and meteorological factors in Taiwanese metropolitan areas (Taipei area, Taichung City, and Kaohsiung City) and a rural area (Hualien County) between 1993 and 2012. The influence of a mass rapid transit (MRT) system on air quality was also evaluated...
September 2016: Journal of Environmental Quality
Hector Eduardo Castro Jaramillo, Ornella Moreno-Mattar, Diana Osorio-Cuevas
BACKGROUND: Health technology assessment (HTA) examines the consequences of the application of health technologies and is aimed at better informing decision-makers. Over the past 30 years, different countries have implemented HTA organizations. Colombia established by law its own HTA agency (IETS) in 2011 which started operations in November 2012. The aim of this study was to assess the feasibility of conducting and using HTA to inform decision-making in this context. Through a qualitative approach, ten "drivers" emerged with the ability to help or hinder HTA development in this context: availability and quality of data, implementation strategy, cultural aspects, local capacity, financial support, policy/political support, globalization, stakeholder pressure, health system context, and usefulness perception...
October 3, 2016: International Journal of Technology Assessment in Health Care
Gail Tomblin Murphy, Stephen Birch, Adrian MacKenzie, Stephanie Bradish, Annette Elliott Rose
BACKGROUND: Recognition of the importance of effective human resources for health (HRH) planning is evident in efforts by the World Health Organization (WHO) and the Global Health Workforce Alliance (GHWA) to facilitate, with partner organizations, the development of a global HRH strategy for the period 2016-2030. As part of efforts to inform the development of this strategy, the aims of this study, the first of a pair, were (a) to conduct a rapid review of recent analyses of HRH requirements and labour market dynamics in high-income countries who are members of the Organisation for Economic Co-operation and Development (OECD) and (b) to identify a methodology to determine future HRH requirements for these countries...
September 29, 2016: Human Resources for Health
Harry E Cross, Omarzaman Sayedi, Laili Irani, Lauren C Archer, Kathleen Sears, Suneeta Sharma
BACKGROUND: Since 2003, Afghanistan's largely unregulated for-profit private health sector has grown at a rapid pace. In 2008, the Ministry of Public Health (MoPH) launched a long-term stewardship initiative to oversee and regulate private providers and align the sector with national health goals. AIM: We examine the progress the MoPH has made towards more effective stewardship, consider the challenges and assess the early impacts on for-profit performance. METHODS: We reviewed publicly available documents, publications and the grey literature to analyse the development, adoption and implementation of strategies, policies and regulations...
September 28, 2016: Health Policy and Planning
Guillermo Pardo, Raúl Moral, Agustín Del Prado
On-farm anaerobic digestion (AD) has been promoted due to its improved environmental performance, which is based on a number of life cycle assessments (LCA). However, the influence of site-specific conditions and practices on AD performance is rarely captured in LCA studies and the effects on C and N cycles are often overlooked. In this paper, a new model for AD (SIMSWASTE-AD) is described in full and tested against a selection of available measured data. Good agreement between modelled and measured values was obtained, reflecting the model capability to predict biogas production (r(2)=0...
September 21, 2016: Science of the Total Environment
Tsegahun Manyazewal, Martha J Oosthuizen, Mokgadi C Matlakala
OBJECTIVES: Many resource-limited countries have adopted and implemented healthcare reform to improve the quality of healthcare, but few have had much impact and strategies in support of these efforts remain limited. We aimed to explore and propose evidence-based strategies to strengthen implementation of healthcare reform in resource-limited settings. DESIGN: Descriptive and exploratory designs in two phases. Phase I involved assessing the effectiveness of the healthcare reform implemented in Ethiopia in the form of business process reengineering, with evidence compiled from healthcare professionals through a self-administered questionnaire; and phase II involved proposing strategies and seeking consensus from experts using Delphi method...
2016: BMJ Open
Sébastien Tremblay, Jean-François Gagnon, Daniel Lafond, Helen M Hodgetts, Maxime Doiron, Patrick P J M H Jeuniaux
While simple heuristics can be ecologically rational and effective in naturalistic decision making contexts, complex situations require analytical decision making strategies, hypothesis-testing and learning. Sub-optimal decision strategies - using simplified as opposed to analytic decision rules - have been reported in domains such as healthcare, military operational planning, and government policy making. We investigate the potential of a computational toolkit called "IMAGE" to improve decision-making by developing structural knowledge and increasing understanding of complex situations...
January 2017: Applied Ergonomics
Karishma Furtado, Kira Hudson Banks
The Ferguson Commission was an independent body of 16 commissioners in operation from November 2014 to December 2015 and appointed by Missouri governor Jay Nixon to examine the root causes underlying the death of Michael Brown Jr. Its report, "Forward Through Ferguson: A Path Toward Racial Equity," raises many issues on racial equity that public health is well suited to address, such as trends in police use of force, the health implications of the school-based discipline gap, and the health benefits of a coordinated housing strategy...
November 2016: American Journal of Public Health
Hector P Rodriguez, Rachel Mosher Henke, Salma Bibi, Patricia P Ramsay, Stephen M Shortell
UNLABELLED: Policy Points The rate of adoption of chronic care management processes (CMPs) by physician organizations has been fairly slow in spite of demonstrated effectiveness of CMPs in improving outcomes of chronic care. Exnovation (ie, removal of innovations) by physician organizations largely explains the slow population-level increases in practice use of CMPs over time. Expanded health information technology functions may aid practices in retaining CMPs. Low provider reimbursement by Medicaid programs, however, may contribute to disinvestment in CMPs by physician organizations...
September 2016: Milbank Quarterly
Anthony D Harries, Nathan Ford, Andreas Jahn, Erik J Schouten, Edwin Libamba, Frank Chimbwandira, Dermot Maher
The scale-up of antiretroviral therapy (ART) in Malawi was based on a public health approach adapted to its resource-poor setting, with principles and practices borrowed from the successful tuberculosis control framework. From 2004 to 2015, the number of new patients started on ART increased from about 3000 to over 820,000. Despite being a small country, Malawi has made a significant contribution to the 15 million people globally on ART and has also contributed policy and service delivery innovations that have supported international guidelines and scale up in other countries...
2016: BMC Public Health
Vicky W Y Lam, William W L Cheung, Gabriel Reygondeau, U Rashid Sumaila
Previous studies highlight the winners and losers in fisheries under climate change based on shifts in biomass, species composition and potential catches. Understanding how climate change is likely to alter the fisheries revenues of maritime countries is a crucial next step towards the development of effective socio-economic policy and food sustainability strategies to mitigate and adapt to climate change. Particularly, fish prices and cross-oceans connections through distant water fishing operations may largely modify the projected climate change impacts on fisheries revenues...
2016: Scientific Reports
John Koku Awoonor-Williams, Paulina Tindana, Philip Ayizem Dalinjong, Harry Nartey, James Akazili
BACKGROUND: In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universal health coverage (UHC)...
2016: BMC International Health and Human Rights
Chisato Hamashima, Akira Fukao
The Japanese government introduced endoscopic screening for gastric cancer in 2015 as a public policy based on the Japanese guidelines on gastric cancer screening. To provide appropriate endoscopic screening for gastric cancer in Japanese communities, we developed a quality assurance manual of endoscopic screening and recommend 10 strategies with their brief descriptions as follows: (i) Formulation of a committee responsible for implementing and managing endoscopic screening, and for deciding the suitable implementation methods in consideration of the local context; (ii) Development of an interpretation system that leads to a final judgement to standardize endoscopic examination and improve its accuracy; (iii) Preparation of management and reporting systems for adverse effects by the committee for safety management; (iv) Obtaining informed consent before operation following adequate explanations regarding the benefits and harms of endoscopic screening; (v) Avoidance of frequent screenings to reduce false-positive results and overdiagnosis...
September 2, 2016: Japanese Journal of Clinical Oncology
John Koku Awoonor-Williams, Paulina Tindana, Philip Ayizem Dalinjong, Harry Nartey, James Akazili
BACKGROUND: In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universal health coverage (UHC)...
2016: BMC International Health and Human Rights
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