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Integration of community health workers into health systems in developing countries:Opportunities and challenges

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Family Medicine and Community health 2016年第1期4卷 37-45页

作者： Collins Otieno Asweto Mohamed Ali Alzain Sebastian Andrea Rachel Alexander Wei Wang School of Public health Capital Medical UniversityBeijingChina School of health Sciences Great Lakes University of KisumuKenya Beijing Municipal Key Laboratory of Clinical Epidemiology BeijingChina Community Medicine Department Faculty of Medicine and Health SciencesUniversity of DongolaSudan systems and Intervention Research Centre for health School of Medical SciencesEdith Cowan UniversityPerthWAAustralia

Background:Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health work-ers(CHWs).It is imperative that health care systems focus on improving access to quality continu-ous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their ***:To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing ***:Six databases were examined for quantitative,qualitative,and mixed-methods stud-ies that included the integration of CHWs,their motivation and supervision,and CHW policy making and implementation in developing ***-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW *** coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was ***:CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of *** facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management *** integration of CHWs into the health care system requires the formulation and implementation of polices that support their work,as well as financial and nonfinancial incentives,motivation,collaborative and supportive supervision,and a manageable ***:For sustainable integration of CHWs into health care systems,high-performing health systems with sound governance,adequate financing,well-organized service delivery,and adequate supplies and equipment are ***,competent communities could contrib-ute to better CHW performance through sound governance of community resources,promotion of inclus

关键词： Community health workers health care systems and policy supportive supervi-sion developing countries

health systems Strengthening to Tackle the Global Burden of Pediatric and Congenital Heart Disease: A Diagonal Approach

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Congenital Heart Disease 2024年第2期19卷 131-138页

作者： Dominique Vervoort Amy Verstappen Sreehari Madhavankutty Nair Chong Chin Eu Bistra Zheleva Institute of health Policy Management and EvaluationUniversity of TorontoTorontoCanada Division of Cardiac Surgery University of TorontoTorontoCanada Global Alliance for Rheumatic and Congenital Hearts PhiladelphiaUSA Department of health Services Government of KeralaKeralaIndia Ministry of health PutrajayaMalaysia Children’s HeartLink MinneapolisUSA

1 Background Congenital heart disease(CHD)is the most common major congenital anomaly,affecting approximately one in every 100 live births[1].Among congenital anomalies,66%of preventable deaths are due to CHD,and 58%of the avertable morbidity and mortality due to congenital anomalies would result from scaling congenital heart surgery services[2].Every year,nearly 300,000 children and adults die from CHD,the majority of whom live in low-and middle-income countries(LMICs)[3].Approximately 49%of all individuals with CHD will require surgical or interventional care at some point in their lifetime[4];as a result of advances in access to and the delivery of such services,over 95%of children born with CHD in high-income countries now live into adulthood[3].Here,adults have surpassed children in the number of CHD cases at a ratio of 2:1[5].

关键词： Congenital heart disease pediatric heart disease global health health systems health policy

Prioritizing Strategies for Building the Resilience of Public health systems to Disasters Across Multiple Communities and Countries

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International Journal of Disaster Risk Science 2024年第1期15卷 1-17页

作者： Benjamin J.Ryan Mayumi Kako Shelby Garner Rok Fink Ismail Tayfur Jonathan Abrahams Sanjaya Bhatia Adriana Campelo Matthew Fendt Alicia Fontenot Nahuel Arenas Garcia Tim Hatch Ryoma Kayano LaShonda Malrey‑Horne Makiko MacDermot Md Moshiur Rahman Chaverle Noel Shuhei Nomura Jeremy P.Novak Maria Opazo Kendell Oliver Luciana Peters Sohel Rahman PerihanŞimşek Andrew Stricklin Raymond Swienton Bryan W.Brooks Frist College of Medicine Belmont UniversityNashvilleTN 37212USA Department of Environmental Science Environmental Health Science ProgramCollege of Arts and SciencesBaylor UniversityWacoTX 76798USA Division of Nursing Science School of Biomedical and Health SciencesHiroshima UniversityHiroshima 734-8553Japan Gordon E.Inman College of health Sciences and Nursing Belmont UniversityNashvilleTN 37212USA Faculty of health Sciences University of Ljubljana1000 LjubljanaSlovenia Department of Emergency Medicine University of Health Sciences34668 IstanbulTurkey Monash University Accident Research Center MelbourneVIC 3800Australia Global Education and Training Institute United Nations Ofce for Disaster Risk ReductionIncheon 22004Republic of Korea Regional Ofce for the Americas and Caribbean United Nations Ofce for Disaster Risk ReductionPanama City 0843-03441Panama Engineering and Computer Science Baylor UniversityWacoTX 76798USA Department of Public health Robbins College of Health and Human SciencesBaylor UniversityWacoTX 76798USA Alabama Department of Public health MontgomeryAL 36092USA World health Organization Centre for health Development(WHO Kobe Centre) Kobe 651-0073Japan Waco-McLennan County Public health District WacoTX 76707USA Department of health Policy and Management School of MedicineKeio UniversityTokyo 160-8582Japan Department of Global health Policy Graduate School of MedicineThe University of TokyoTokyo 113-0033Japan Tokyo Foundation for Policy Research Tokyo 106-6234Japan Global Development College BrisbaneQLD 4000Australia Municipality of Pudahuel 13124 PudahuelChile City Hall of Porto Alegre Porto Alegre 90010-170Brazil Ministry of health and Family Welfare Government of the People’s Republic of BangladeshDhaka 1000Bangladesh Department of Emergency Aid and Disaster Management Trabzon University61335 TrabzonTurkey Department of Emergency Medicine UT SouthwesternDallasTX 75390USA

The COVID-19 pandemic highlighted the urgent need to strengthen public health *** response,the United Nations Disaster Risk Reduction(UNDRR) Public health System Resilience Scorecard(Scorecard) was applied in workshops across multiple *** aim of our research was to explore the workshop findings to develop priority strategies for strengthening public health system *** conducted a workshop from 14 to 16 March 2023,at the UNDRR Global Education and Training Institute in Incheon,Republic of Korea.A sequential modified Delphi method was utilized to develop a set of prioritized resilience *** were drawn from 70 strategies identified from 13 distinct workshops in eight *** two surveys,23 strategies were *** received ratings of "High" or Very High" from89% of *** related to the inclusion of public health risks in emergency plans,integrating multidisciplinary teams into public health,enabling local transport mechanisms,and improving the ability to manage an influx of *** Scorecard provides an adaptable framework to identify and prioritize strategies for strengthening public health system *** leveraging this methodology,our study demonstrated how resilience strategies could inform disaster risk reduction funding,policies,and actions.

关键词： health system resilience Public policy Resilience scorecard Workshops

Differences between British and Japanese perspectives on forensic mental health systems:A preliminary study

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World Journal of Psychiatry 2017年第1期7卷 8-11页

作者： Akihiro Shiina Aika Tomoto Soichiro Omiya Aiko Sato Masaomi Iyo Yoshito Igarashi Division of Medical Treatment and Rehabilitation Chiba University Center for Forensic Mental Health Division of Law and Psychiatry Chiba University Center for Forensic Mental Health Social Psychiatry and Mental health Faculty of MedicineUniversity of Tsukuba Chiba University Graduate School of Medicine

AIM To clarify the differences in views on forensic mental health(FMH) systems between the United Kingdom and *** We conducted a series of semi-structured interviews with six leading forensic psychiatrists. Based on a discussion by the research team, we created an interview form. After we finished conducting all the interviews, we qualitatively analyzed their content. RESULTS In the United Kingdom the core domain of FMH was risk assessment and management; however, in Japan, the core domain of FMH was psychiatric testimony. In the United Kingdom, forensic psychiatrists were responsible for ensuring public safety, and psychopathy was identified as a disease but deemed as not suitable for medical treatment. On the other hand, in Japan, psychopathy was not considered a mental illness. CONCLUSION In conclusion, there are considerable differences between the United Kingdom and Japan with regard to the concepts of FMH. Some ideas taken from both cultures for better FMH practice were suggested.

关键词： Forensic mental health Medical treatment and supervision act Psychopathy International comparison Qualitative research

Coronavirus disease 2019 (COVID-19) pandemic: how countries shouldbuild more resilient health systems for preparedness and response

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Global health Journal 2020年第4期4卷 139-145页

作者： Zhebin Wang Yuqi Duan Yinzi Jin Zhi-Jie Zheng Department of Global health School of Public HealthPeking University38 Xueyuan RoadHaidian DistrictBeijing 100191China Institute for Global health Peking University38 Xueyuan RoadHaidian DistrictBeijing 100191China

Objective: A resilient health system plays a crucial role in pandemic preparedness and response. Althoughthe World health Organization (WHO) has required all states parties to strengthen core capacities to respondto public health emergencies under the International health Regulations (2005), the actions of most countriesto combating coronavirus disease 2019 (COVID-19) has showed that they are not well-prepared. This crosssectionalstudy aimed to examine the health system resilience of selected countries and analyze their strategiesand measures in response to the COVID-19 ***: This study selected five countries including the Iran, Japan, Republic of Korea (South Korea), the U.K.,and the U.S., based on the severity of the national epidemic, the geographical location, and the developmentlevel. Cumulative number of death cases derived from WHO COVID-19 dashboard was used to measure theseverity of the impact of the pandemic in each country;WHO State Parties Self-Assessment Annual Reporting (SPAR)Scores and Global health Security (GHS) Index were applied to measure the national health system resilience;and research articles and press materials were summarized to identify the strategies and measures adopted bycountries during response to COVID-19. This study applied the resilient health systems framework to analyzehealth system resilience in the selected countries from five dimensions, including awareness, diversity, selfregulation,integration and ***: The SPAR Scores and GHS Index of the four developed countries, Japan, South Korea, the U.K. and theU.S. were above the global and regional averages;the SPAR Scores of Iran were above the global average whilethe GHI Index lain below the global average. In terms of response strategies, Japan, the U.K. and the U.S. investedmore health resources in the treatment of severe patients, while South Korea and Iran had adopted a strategyof extensive testing and identification of suspected patients. In terms o

关键词： Coronavirus disease 2019 COVID-19 Pandemic Resilient health systems Preparedness and response Global health security health system strengthening

Infectious disease control:from health security strengthening to health systems improvement at global level

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Global health Research and Policy 2023年第1期8卷 160-167页

作者： Xiao-Xi Zhang Yin-Zi Jin Yi-Han Lu Lu-Lu Huang Chuang-Xin Wu Shan Lv Zhuo Chen Hao Xiang Xiao-Nong Zhou School of Global health Chinese Center for Tropical Diseases ResearchShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China One health Center Shanghai Jiao Tong University-The University of EdinburghShanghaiPeople’s Republic of China Department of Global health School of Public HealthWuhan UniversityWuhanPeople’s Republic of China Global health Institute Wuhan UniversityWuhanPeople’s Republic of China Department of Global health School of Public HealthPeking UniversityBeijingPeople’s Republic of China Institute for Global health and Development Peking UniversityBeijingPeople’s Republic of China School of Public health Fudan UniversityShanghaiPeople’s Republic of China Global health Institute Fudan UniversityShanghaiPeople’s Republic of China National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention(Chinese Center for Tropical Diseases Research) NHC Key Laboratory of Parasite and Vector BiologyWHO Collaborating Centre for Tropical DiseasesShanghaiPeople’s Republic of China Department of health Policy and Management College of Public HealthUniversity of GeorgiaAthensGAUSA School of Economics Faculty of Humanities and Social SciencesUniversity of Nottingham Ningbo ChinaNingboZhejiangPeople’s Republic of China

Since the twenty first century,the outbreaks of global infectious diseases have caused several public health emergencies of international concern,imposing an enormous impact on population health,the economy,and social *** COVID-19 pandemic has once again exposed deficiencies in existing global health systems,emergency management,and disease surveillance,and highlighted the importance of developing effective evaluation *** article outlines current challenges emerging from infectious disease control from the perspective of global health,elucidated through influenza,malaria,tuberculosis,and neglected tropical *** discordance among government actors and absent data sharing platforms or tools has led to unfulfilled targets in health system resilience and a capacity gap in infectious disease *** current situation calls for urgent action to tackle these threats of global infectious diseases with joined forces through more in-depth international cooperation and breaking governance barriers from the purview of global ***,a systematic redesign should be considered to enhance the resilience of health systems,which warrants a great need to sustain capacity-building efforts in emergency preparedness and response and raises an emerging concern of data integration in the concept of One health that aims to address shared health threats at the human-animal-environment interface.

关键词： Infectious disease control Global health health security health system

The need for adaptable global guidance in health systems strengthening for musculoskeletal health:a qualitative study of international key informants

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Global health Research and Policy 2021年第1期6卷 247-268页

作者： Andrew M.Briggs Joanne E.Jordan Deborah Kopansky-Giles Saurab Sharma Lyn March Carmen Huckel Schneider Swatee Mishrra James J.Young Helen Slater Curtin School of Allied health Curtin UniversityPerthAustralia healthSense(Aust)Pty Ltd MelbourneAustralia Department of Research Canadian Memorial Chiropractic CollegeTorontoCanada Department of Family&Community Medicine University of TorontoTorontoCanada Department of Physiotherapy Kathmandu University School of Medical SciencesDhulikhelNepal Department of Rheumatology Royal North Shore HospitalSydneyAustralia Sydney Musculoskeletal Bone&Joint Health AllianceFaculty of Medicine and HealthUniversity of SydneySydneyAustralia Menzies Centre for health Policy and Economics Faculty of Medicine and HealthUniversity of SydneySydneyAustralia Center for Muscle and Joint health Department of Sports Science and Clinical BiomechanicsUniversity of Southern DenmarkOdenseDenmark

Background:Musculoskeletal(MSK)conditions,MSK pain and MSK injury/trauma are the largest contributors to the global burden of disability,yet global guidance to arrest the rising disability burden is *** aimed to explore contemporary context,challenges and opportunities at a global level and relevant to health systems strengthening for MSK health,as identified by international key informants(KIs)to inform a global MSK health strategic ***:An in-depth qualitative study was undertaken with international KIs,purposively sampled across highincome and low and middle-income countries(LMICs).KIs identified as representatives of peak global and international organisations(clinical/professional,advocacy,national government and the World health Organization),thought leaders,and people with lived experience in advocacy *** transcripts of individual semi-structured interviews were analysed inductively using a grounded theory *** were organised into categories describing 1)contemporary context;2)goals;3)guiding principles;4)accelerators for action;and 5)strategic priority areas(pillars),to build a data-driven logic ***,we report on categories 1–4 of the logic ***:Thirty-one KIs from 20 countries(40%LMICs)affiliated with 25 organisations *** themes described contemporary context(category 1):1)MSK health is afforded relatively lower priority status compared with other health conditions and is poorly legitimised;2)improving MSK health is more than just healthcare;3)global guidance for country-level system strengthening is needed;4)impact of COVID-19 on MSK health;5)multiple inequities associated with MSK health;and 6)complexity in health service delivery for MSK *** guiding principles(category 3)focussed on adaptability;inclusiveness through co-design;prevention and reducing disability;a lifecourse approach;and equity and value-based ***(category 2)and seven accelerators for action(category 4)were al

关键词： Global health Disability Rehabilitation Musculoskeletal Strategy systems strengthening

COVID-19 and beyond:how lessons and evidence from implementation research can benefit health systems’response and preparedness for COVID-19 and future epidemics

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Family Medicine and Community health 2021年第4期9卷 5-9页

作者： Nafissatou Diop Montasser Kamal Marie Renaud Sana Naffa Global health Division International Development Research CentreOttawaOntarioCanada

Early in the COVID-19 pandemic—and based on limited data on the novel coronavirus—it was projected that African countries will be ravaged and the health systems ***,Africa has so far defied these dire *** factors account for the less dramatic outcome,in particular the local know-how gained through dealing with previous epidemics,such as Ebola,and the early and coordinated political and public health response,applying a combination of containment and mitigation ***,these same measures,exacerbated by existing inequalities,have had negative impacts on vulnerable populations,notably women and ***,the observed deterioration of access to and provision of essential health services will likely continue and worsen in countries experiencing future waves of COVID-19 and lacking access to *** impact of the pandemic on health systems may be one of Africa’s main COVID-19 challenges and women and children its greatest *** this article,we argue that just as learning from previous epidemics and coordinated preparation informed Africa’s response to COVID-19,knowledge,innovations and resources from recent implementation research can be leveraged to mitigate the pandemic’s effects and inform recovery *** an example,we present the proven model and multifaceted approach of the Innovating for Maternal and Child health in Africa Initiative and describe how such a model could be readily applied to building the robust and equitable systems needed to tackle future stresses and shocks,such as epidemics,on health systems while maintaining essential routine services.

关键词： COV services gained

health systems as Complex systems

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American Journal of Operations Research 2013年第1期3卷 113-126页

作者： Mireya Martínez-García Enrique Hernández-Lemus Computational Genomics Department National Institute of Genomic Medicine México DF México&Complexity in Systems Biology Center for Complexity Sciences National Autonomous University of México México DF México Graduate Program in health System’s Management National Autonomous University of México México DF Mexico

health systems are paradigmatic examples of human organizations that blend a multitude of different professional and disciplinary features within a critically performance environment. Communication failure and defective processes in health systems have a tremendous impact in society, both in the financial and human aspects. Traditionally, health systems have been regarded as linear hierarchic structures. However, recent developments in the sciences of complexity point out to health systems as complex entities governed by non-linear interaction laws, self-organization and emergent phenomena. In this work we review some aspects of complexity behind health systems and how they can be applied to improve the performance of healthcare organizations.

关键词： health systems Complexity Self-organization