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Jafree SR, Shah G, Zakar R, Muzamill A, Ahsan H, Burhan SK, Javed A, Durrani RR. Characterizing Social Determinants of Maternal and Child Health: A Qualitative Community Health Needs Assessment in Underserved Areas. Healthcare (Basel) 2023; 11:2224. [PMID: 37570465 PMCID: PMC10418942 DOI: 10.3390/healthcare11152224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 07/26/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
This study aimed to identify social determinants of maternal and child health (SDoH) in Pakistan. Using a qualitative study design, data were collected from community members in seven underserved areas of Lahore City, Pakistan. A total of 22 qualitative in-depth interviews and 10 focus group discussions (FGDs) were conducted. The participants included basic health unit healthcare staff, women of reproductive ages, male family members, mothers-in-law, and religious leaders. We found that maternal and child health is adversely affected by the following socioeconomic and environmental barriers: (i) poor housing quality and sanitation; (ii) inadequate food supply and safety; (iii) unsatisfactory public sector school services; (iv) a lack of safety and security; (v) scarce poverty alleviation efforts and loan schemes; (vi) unsatisfactory transport and internet services; and (vii) inadequate health services. The targets for maternal and child health in Pakistan cannot be met without close coordination between the primary health sector, local governance, and macro state structures, which collectively must monitor and improve housing adequacy, food security, public sector services (primary healthcare services, public schooling, public transport, and public internet access), overall safety, and poverty emergence.
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Affiliation(s)
- Sara Rizvi Jafree
- Department of Sociology, Forman Christian College University, Zahoor Elahi Road, Lahore 54600, Pakistan;
| | - Gulzar Shah
- Department of Health Policy and Community Health Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA
| | - Rubeena Zakar
- Institute of Social and Cultural Studies, University of the Punjab, Lahore 54590, Pakistan;
| | - Anam Muzamill
- Department of Mass Communications, Forman Christian College University, Lahore 54600, Pakistan;
| | - Humna Ahsan
- Department of Economics, Forman Christian College University, Lahore 54600, Pakistan;
| | - Syeda Khadija Burhan
- Department of Education, Forman Christian College University, Lahore 54600, Pakistan;
| | - Ambreen Javed
- Department of English, Forman Christian College University, Lahore 54600, Pakistan;
| | - Rana Rubab Durrani
- Center for Language Development, Forman Christian College University, Lahore 54600, Pakistan;
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Reforming the public health system in England. THE LANCET PUBLIC HEALTH 2022; 7:e797-e800. [PMID: 36057278 PMCID: PMC9432864 DOI: 10.1016/s2468-2667(22)00199-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
The abolition of Public Health England (PHE) during the COVID-19 pandemic has raised concerns about the future of the public health system in the UK, particularly in England. The two new bodies established in haste to replace PHE prompt reflection on the executive agency's fate and the need to identify any lessons to ensure that a public health system is put in place that is fit for purpose. The UK COVID-19 Inquiry provides an opportunity to make recommendations, but it will need to act quickly to avoid recommendations being ignored. Two areas of concern are highlighted in this Viewpoint: the respective remits of the new bodies and their governance arrangements. Both issues demand urgent attention if the new structures are to succeed and avoid a similar fate to that which befell PHE. But underlying these concerns is a much larger challenge arising from the UK's broken political system. The political system in the UK suffers from several systemic weaknesses, including departmentalism, poor implementation, an inability or unwillingness of those in power to listen to the truth, and chronic short-termism at the expense of long-term planning. Overhauling the UK's dysfunctional political system is a prerequisite for successfully improving the public health system.
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Keat R. COVID-19 lockdown and recovery: a dental public health perspective from Lancashire and South Cumbria. Prim Dent J 2021; 10:31-40. [PMID: 34727775 DOI: 10.1177/20501684211033395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has created novel barriers in providing and accessing all forms of healthcare, including dentistry. The national dental response during the first peak of the pandemic resulted in rapid changes in the provision of service, to safeguard providers and users of dental care.Such rapidly leveraged changes resulted in several issues in service delivery, requiring careful input from managers and commissioners within NHS England and Improvement, trainees and consultants in dental public health within Public Health England, and frontline dental teams working across the health and social care system. The local response from Lancashire and South Cumbria is outlined within this article.Teamwork, communication and reflexive, iterative learning from these groups ensured the delivery of an Urgent Dental Care service during the first lockdown of the pandemic.The impact of COVID-19 has enabled considerable learning which will inform future pandemic planning, alongside providing the opportunity to deliver meaningful change within NHS dentistry as the service continues to recover.
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Affiliation(s)
- Ross Keat
- Academic Clinical Fellow in Dental Public Health at the University of Manchester, UK
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Hinga AN, Molyneux S, Marsh V. Towards an appropriate ethics framework for Health and Demographic Surveillance Systems (HDSS): learning from issues faced in diverse HDSS in sub-Saharan Africa. BMJ Glob Health 2021; 6:bmjgh-2020-004008. [PMID: 33408190 PMCID: PMC7789450 DOI: 10.1136/bmjgh-2020-004008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction Health and Demographic Surveillance Systems (HDSS) collect data on births, deaths and migration from relatively small, geographically defined populations primarily in Africa and Asia. HDSS occupy a grey area between research, healthcare and public health practice and it is unclear how ethics guidance that rely on a research-practice distinction apply to HDSS. This topic has received little attention in the literature. In this paper, based on empirical research across sub-Saharan Africa, we map out key ethical issues for HDSS and assess the relevance of current ethics guidance in relation to these findings. Methods We conducted a qualitative study across seven HDSS sites in sub-Saharan Africa, including individual in-depth interviews and informal discussions with 68 research staff, document reviews and non-participant observations of surveillance activities. Qualitative data analysis drew on a framework approach led by a priori and emergent themes, drawing on the wider ethics and social science literature. Results There were diverse views on core ethical issues in HDSS, including regarding the strengths and challenges of community engagement, informed consent and data sharing processes. A key emerging issue was unfairness in the overall balance of benefits and burdens for residents and front-line staff when compared with other stakeholders, particularly given the socioeconomic contexts in which HDSS are generally conducted. Conclusion We argue that HDSS operate as non-traditional epidemiologic research projects but are often governed using ethics guidance developed for traditional forms of health research. There is a need for specific ethics guidance for HDSS which prioritises considerations around fairness, cost-effectiveness, ancillary care responsibilities, longitudinality and obligations of the global community to HDSS residents.
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Affiliation(s)
- Alex Nginyo Hinga
- Health Systems and Research Ethics, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Sassy Molyneux
- Health Systems and Research Ethics, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Vicki Marsh
- Health Systems and Research Ethics, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
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Affiliation(s)
| | - Tony Jewell
- Association of Directors of Public Health, London, UK
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Hilton Boon M, Thomson H, Shaw B, Akl EA, Lhachimi SK, López-Alcalde J, Klugar M, Choi L, Saz-Parkinson Z, Mustafa RA, Langendam MW, Crane O, Morgan RL, Rehfuess E, Johnston BC, Chong LY, Guyatt GH, Schünemann HJ, Katikireddi SV. Challenges in applying the GRADE approach in public health guidelines and systematic reviews: a concept article from the GRADE Public Health Group. J Clin Epidemiol 2021; 135:42-53. [PMID: 33476768 PMCID: PMC8352629 DOI: 10.1016/j.jclinepi.2021.01.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 12/29/2020] [Accepted: 01/12/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVE This article explores the need for conceptual advances and practical guidance in the application of the GRADE approach within public health contexts. METHODS We convened an expert workshop and conducted a scoping review to identify challenges experienced by GRADE users in public health contexts. We developed this concept article through thematic analysis and an iterative process of consultation and discussion conducted with members electronically and at three GRADE Working Group meetings. RESULTS Five priority issues can pose challenges for public health guideline developers and systematic reviewers when applying GRADE: (1) incorporating the perspectives of diverse stakeholders; (2) selecting and prioritizing health and "nonhealth" outcomes; (3) interpreting outcomes and identifying a threshold for decision-making; (4) assessing certainty of evidence from diverse sources, including nonrandomized studies; and (5) addressing implications for decision makers, including concerns about conditional recommendations. We illustrate these challenges with examples from public health guidelines and systematic reviews, identifying gaps where conceptual advances may facilitate the consistent application or further development of the methodology and provide solutions. CONCLUSION The GRADE Public Health Group will respond to these challenges with solutions that are coherent with existing guidance and can be consistently implemented across public health decision-making contexts.
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Affiliation(s)
- Michele Hilton Boon
- MRC/CSO Social and Public Health Sciences Unit, Berkeley Square, 99 Berkeley Street, University of Glasgow, Glasgow G3 7HR, UK.
| | - Hilary Thomson
- MRC/CSO Social and Public Health Sciences Unit, Berkeley Square, 99 Berkeley Street, University of Glasgow, Glasgow G3 7HR, UK
| | - Beth Shaw
- Center for Evidence-based Policy, Oregon Health & Science University, Portland, OR 97201 USA
| | - Elie A Akl
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street W, Hamilton, Ontario L8S 4K1, Canada; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Stefan K Lhachimi
- Department for Health Services Research, Institute of Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359 Bremen, Germany; Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
| | - Jesús López-Alcalde
- Department of Paediatrics, Obstetrics & Gynaecology and Preventative Medicine, Universitat Autònoma de Barcelona; Faculty of Health Sciences, Universidad Francisco de Vitoria (UFV)-Madrid; Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal (IRYCIS); CIBER Epidemiology and Public Health; Cochrane Associate Centre of Madrid, Madrid, Spain
| | - Miloslav Klugar
- Faculty of Medicine, Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, The Czech Republic Centre for Evidence-Based Healthcare; JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Masaryk University, 625 00 Brno, Czechia
| | - Leslie Choi
- The Department of Vector Biology, Partnership for Increasing the Impact of Vector Control, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Reem A Mustafa
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street W, Hamilton, Ontario L8S 4K1, Canada; Departments of Medicine and Biomedical & Health Informatics, University of Missouri-Kansas City, Kansas City, MO 66160 USA
| | - Miranda W Langendam
- Department of Clinical Epidemiology, Amsterdam University Medical Centres, University of Amsterdam, Biostatistics and Bioinformatics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Olivia Crane
- National Institute for Health and Care Excellence (NICE), Level 1A, City Tower, Piccadilly Plaza, Manchester M1 4BT, UK
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street W, Hamilton, Ontario L8S 4K1, Canada
| | - Eva Rehfuess
- Institute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
| | | | - Lee Yee Chong
- Cochrane Public Health and Health Systems Network, University of Oxford, Oxford, UK
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street W, Hamilton, Ontario L8S 4K1, Canada
| | - Holger J Schünemann
- Department of Health Research Methods, Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, and WHO Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Srinivasa Vittal Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, Berkeley Square, 99 Berkeley Street, University of Glasgow, Glasgow G3 7HR, UK
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Jarvis T, Scott F, El-Jardali F, Alvarez E. Defining and classifying public health systems: a critical interpretive synthesis. Health Res Policy Syst 2020; 18:68. [PMID: 32546163 PMCID: PMC7296190 DOI: 10.1186/s12961-020-00583-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background The introduction of the determinants of health has caused a shift towards understanding health from a holistic perspective as well as increased recognition of public health’s contributions to the health of the population. Several frameworks exist to conceptualise healthcare systems, highlighting the stark contrast of frameworks unique to public health systems. The objectives of this study were to define public health systems and assess differences between healthcare systems and public health systems within established health systems frameworks. Methods A critical interpretive synthesis was conducted. Databases searched included EBSCOhost, OVID, Scholars Portal, Web of Science, Cochrane Library and Health Systems Evidence. Data extraction, coding and analysis followed a best-fit framework analysis method. Initial codes were based on a current leading health systems and policy classification scheme – health systems arrangements (governance, financial and delivery arrangements). Results A total of 5933 unique documents were identified and 67 were included in the analysis. Definitions of public health and public health systems varied significantly as did their roles and functions across jurisdictions. Public health systems arrangements generally followed those of health systems, with the addition of partnerships (community and inter-sectoral) and communication playing a larger role in public health. A public health systems framework and conceptualisation of how public health currently fits within health systems are presented. Conclusions Public health systems are unique and vital entities within health systems. In addition to examining how public health and public health systems have been defined within the literature, this review suggests that establishing the scope of public health is crucial to understanding its role within the larger health system and adds to the discourse around the relationship between public health, healthcare and population health. More broadly, this study addresses an important gap in understanding public health systems and provides conceptual and practical contributions as well as areas for future research.
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Affiliation(s)
- Tamika Jarvis
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
| | - Fran Scott
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Fadi El-Jardali
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Elizabeth Alvarez
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
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ID-Viewer: a visual analytics architecture for infectious diseases surveillance and response management in Pakistan. Public Health 2016; 134:72-85. [PMID: 26880489 DOI: 10.1016/j.puhe.2016.01.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 12/31/2015] [Accepted: 01/11/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Globally, disease surveillance systems are playing a significant role in outbreak detection and response management of Infectious Diseases (IDs). However, in developing countries like Pakistan, epidemic outbreaks are difficult to detect due to scarcity of public health data and absence of automated surveillance systems. Our research is intended to formulate an integrated service-oriented visual analytics architecture for ID surveillance, identify key constituents and set up a baseline for easy reproducibility of such systems in the future. STUDY DESIGN This research focuses on development of ID-Viewer, which is a visual analytics decision support system for ID surveillance. It is a blend of intelligent approaches to make use of real-time streaming data from Emergency Departments (EDs) for early outbreak detection, health care resource allocation and epidemic response management. METHODS We have developed a robust service-oriented visual analytics architecture for ID surveillance, which provides automated mechanisms for ID data acquisition, outbreak detection and epidemic response management. Classification of chief-complaints is accomplished using dynamic classification module, which employs neural networks and fuzzy-logic to categorize syndromes. Standard routines by Center for Disease Control (CDC), i.e. c1-c3 (c1-mild, c2-medium and c3-ultra), and spatial scan statistics are employed for detection of temporal and spatio-temporal disease outbreaks respectively. Prediction of imminent disease threats is accomplished using support vector regression for early warnings and response planning. Geographical visual analytics displays are developed that allow interactive visualization of syndromic clusters, monitoring disease spread patterns, and identification of spatio-temporal risk zones. RESULTS We analysed performance of surveillance framework using ID data for year 2011-2015. Dynamic syndromic classifier is able to classify chief-complaints to appropriate syndromes with high classification accuracy. Outbreak detection methods are able to detect the ID outbreaks in start of epidemic time zones. Prediction model is able to forecast dengue trend for 20 weeks ahead with nominal normalized root mean square error of 0.29. Interactive geo-spatiotemporal displays, i.e. heat-maps, and choropleth are shown in respective sections. CONCLUSION The proposed framework will set a standard and provide necessary details for future implementation of such a system for resource-constrained regions. It will improve early outbreak detection attributable to natural and man-made biological threats, monitor spatio-temporal epidemic trends and provide assurance that an outbreak has, or has not occurred. Advanced analytics features will be beneficial in timely organization/formulation of health management policies, disease control activities and efficient health care resource allocation.
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Factors influencing publication of scientific articles derived from masters theses in public health. Int J Public Health 2015; 60:495-504. [PMID: 25740659 DOI: 10.1007/s00038-015-0664-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 02/03/2015] [Accepted: 02/09/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES To evaluate theses of a Masters program in Public Health (MPH), in terms of the students' and theses' characteristics that influence publication of the thesis as a scientific article. METHODS Longitudinal study of students who successfully completed the MPH at Universitat Pompeu Fabra and Universitat Autònoma de Barcelona (Spain) from 2006 to 2010. Participants completed an electronic survey and additional data were gathered from university files. RESULTS 162 students participated in the study (83 % response rate). 60.5 % had already published an article derived from their thesis at the time of the study or were in process of publishing it. The likelihood of publishing in a peer-reviewed journal was greater among women (aRR = 1.41), among those who had a bachelor's degree in sciences other than health (aRR = 1.40), had completed the MPH on time (aRR = 2.10), had enrolled in a doctoral program after the MPH (aRR = 1.44) or had a masters thesis score of ≥7 (aRR = 1.61). CONCLUSIONS The majority of MPH students published their thesis in a peer-reviewed journal. The strongest predictors of successful publication were related to academic performance.
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Tian X, Zhao G, Cao D, Wang D, Wang L. Health education and promotion at the site of an emergency: experience from the Chinese Wenchuan earthquake response. Glob Health Promot 2014; 23:15-26. [PMID: 25312769 DOI: 10.1177/1757975914547711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 07/11/2014] [Indexed: 11/16/2022]
Abstract
Theories and strategies of social mobilization, capacity building, mass and interpersonal communication, as well as risk communication and behavioral change were used to develop health education and promotion campaigns to decrease and prevent injuries and infectious diseases among the survivors of the Wenchuan earthquake in May 2008. We evaluated the effectiveness of the campaigns and short-term interventions using mixed-methods. The earthquake survivors' health knowledge, skills, and practice improved significantly with respect to injury protection, food and water safety, environmental and personal hygiene, and disease prevention. No infectious disease outbreaks were reported after the earthquake, and the epidemic level was lower than before the earthquake. After a short-term intervention among the students of Leigu Township Primary and Junior School, the proportion of those with personal hygiene increased from 59.7% to 98.3% (p< 0.01). Of the sampled survivors from Wenchuan County, 92.3% reported to have improved their health knowledge and 54.9% improved their health practice (p< 0.01). Thus, health education and promotion during public health emergencies such as earthquakes play an important role in preventing injuries and infectious diseases among survivors.
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Affiliation(s)
- Xiangyang Tian
- School of Public Health, Fudan University, Shanghai, China Chinese Center for Health Education, Beijing, China
| | - Genming Zhao
- School of Public Health, Fudan University, Shanghai, China
| | - Dequan Cao
- Chinese Association of Plastic and Aesthetic, Beijing, China
| | - Duoquan Wang
- Chinese National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
| | - Liang Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, USA
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Sim F, Mackie P. Breaching the dykes: bringing the best out of joined up public health. Public Health 2014; 128:307-8. [DOI: 10.1016/j.puhe.2014.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Saeed BII, Abdul-Aziz AR, Nguah SB, Zhao X. The impact of Preventive Health Behaviors and Risk Factors on Health Status of Ghanaians. Glob J Health Sci 2013; 5:124-30. [PMID: 23985114 PMCID: PMC4776838 DOI: 10.5539/gjhs.v5n5p124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 04/17/2013] [Indexed: 11/20/2022] Open
Abstract
The article here investigated the impact of Preventive Health Behaviors and Risk Factors as measures of Health Status of Ghanaians. We carry out a cross-sectional analysis of 5573 adults who participated and had indicated that they needed to state their health description in the three years prior to the phase 2007 World Health Organization, a study on Global Ageing and Adult health (SAGE) conducted in Ghana. The ordinal logistic regression model was employed for analysis using R. The results suggest that, there is incontrovertible evidence showing a strong relationship between preventive health behaviors and health status of Ghanaians. Again, the lifestyle of Ghanaians clearly manifests in their positive correlation with the good and moderate health state due to the high percentage (38.96% and 39.04%) respectively. The outcome points to a potential link with the Ghanaian social and health policies.
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Methods and tools for geographical mapping and analysis in primary health care. Prim Health Care Res Dev 2011; 13:10-21. [PMID: 22024314 DOI: 10.1017/s1463423611000417] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIM The purpose of this paper is to review methods and tools for mapping, visualising and exploring geographic information to aid in primary health care (PHC) research and development. BACKGROUND Mapping and spatial analysis of indicators of locality health profiles and healthcare needs assessment are well-established facets of health services research and development. However, while there are a range of different methods and tools used for these purposes, non-specialists responsible for managing the use of such information systems may find knowing where to start and what can be done a relatively steep learning curve. In this review, health and sociodemographic datasets are used to illustrate some key methods, tools and organisational issues, and builds upon two recent reviews in this journal, respectively, focusing on geographic data sources and geographic concepts. Those familiar with mapping and spatial analysis should find this a useful review of current matters. METHOD A thematic review is presented with illustrative case studies relevant to PHC. It begins with a section on visualising and interpreting geographic information. This is followed by a section critiquing analytical methods. Consideration is given to software and deployment issues in a third section. Content is based on domain knowledge of the authors as a team of geographic information scientists and a public health practitioner working in tandem, with its scope restricted to routine applications of mapping and analysis. Advanced techniques such as spatio-temporal modelling are not considered, neither are methodological technicalities, although guidance on further reading is provided. SUMMARY Geographical perspectives are now playing a significant role in PHC delivery, and for those engaged in informatics and/or managing population-level care, understanding key geographic information systems methods and terminologies are important as is gaining greater familiarity with institutional aspects of implementation.
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Social justice and social responsibility: towards a value-base for global public health. Public Health 2010; 124:620-5. [PMID: 20888612 DOI: 10.1016/j.puhe.2010.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Public health and social justice have been seen as one and the same thing, in that public health is - of its very nature - socially just. In this paper, the relationship between public health and social justice is explored through reflecting upon the definitions of the two. Work being undertaken in Scotland in relation to prison health shows that public health action can be intended to have a socially just consequence. However it is not always possible to show that social justice was always the intended outcome of a public health action, as economic intentions can often result in similar public health intervention. In seeking to set out a values base for Global Public Health, the reflection allows two overarching values to be proposed: equality and mutuality.
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Donnelly P. Health in the UK: Public Health's contribution to the future. Perspect Public Health 2009; 129:26-7. [DOI: 10.1177/1757913908101354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Peter Donnelly
- University of St Andrews, Bute Medical Buildings, Westburn Lane, St Andrews, Fife, KY16 9TS
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Griffiths S. One country, two systems: public health in China. Public Health 2008; 122:754-61. [PMID: 18556031 PMCID: PMC7118763 DOI: 10.1016/j.puhe.2008.04.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Accepted: 04/21/2008] [Indexed: 01/24/2023]
Abstract
This paper, presented in Lisbon in May 2007, uses the framework of the three domains of public health practice—namely, health protection, health improvement and health services—as a reference to outline some of the main current public health challenges in Hong Kong and Mainland China [Griffiths S, Jewell T, Donnelly P. Public health in practice: the three domains of public health. Public Health 2005;119:907–13.1].
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Thorpe A, Griffiths S, Jewell T, Adshead F. The three domains of public health: an internationally relevant basis for public health education? Public Health 2008; 122:201-10. [PMID: 17889089 PMCID: PMC7111666 DOI: 10.1016/j.puhe.2007.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2006] [Revised: 05/02/2007] [Accepted: 05/25/2007] [Indexed: 11/23/2022]
Abstract
By focusing on the Masters of Public Health course, this study took a pragmatic approach to exploring the interface between public health education and public health practice. The commonly utilized 'three domains of practice' framework could provide a robust and explicit link between educational provision and practice for public health. This model provides the workforce, the university, the students and the potential funders of the course with an easily comprehensible framework for understanding how the modules of an MSc can support the development of competency within the context of practice.
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Affiliation(s)
- Allison Thorpe
- National Social Marketing Centre, 20 Grosvenor Gardens, London SW1W 0DH, UK.
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Bécue-Bertaut M, Kern J, Hernández-Maldonado ML, Juresa V, Vuletic S. Health-risk behaviour in Croatia. Public Health 2007; 122:140-50. [PMID: 17826808 DOI: 10.1016/j.puhe.2007.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2006] [Revised: 04/27/2007] [Accepted: 05/24/2007] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To identify the health-risk behaviour of various homogeneous clusters of individuals. STUDY DESIGN The study was conducted in 13 of the 20 Croatian counties and in Zagreb, the Croatian capital. In the first stage, general practices were selected in each county. The second-stage sample was created by drawing a random subsample of 10% of the patients registered at each selected general practice. METHODS The sample was divided into seven homogenous clusters using statistical methodology, combining multiple factor analysis with a hybrid clustering method. RESULTS Seven homogeneous clusters were identified, three composed of males and four composed of females, based on statistically significant differences between selected characteristics (P<0.001). Although, in general, self-assessed health declined with age, significant variations were observed within specific age intervals. Higher levels of self-assessed health were associated with higher levels of education and/or socio-economic status. Many individuals, especially females, who self-reported poor health were heavy consumers of sleeping pills. Males and females reported different health-risk behaviours related to lifestyle, diet and use of the healthcare system. Heavy alcohol and tobacco use, unhealthy diet, risky physical activity and non-use of the healthcare system influenced self-assessed health in males. Females were slightly less satisfied with their health than males of the same age and educational level. Even highly educated females who took preventive healthcare tests and ate a healthy diet reported a less satisfactory self-assessed level of health than expected. CONCLUSION Sociodemographic characteristics, life style, self-assessed health and use of the healthcare system were used in the identification of seven homogeneous population clusters. A comprehensive analysis of these clusters suggests health-related prevention and intervention efforts geared towards specific populations.
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Affiliation(s)
- Mónica Bécue-Bertaut
- Department of Statistics and Operational Research, Polytechnical University of Catalonia, Barcelona, Spain
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Lee S, Ng AW, Zhang K. The quest to improve Chinese healthcare: some fundamental issues. Int J Health Care Qual Assur 2007. [DOI: 10.1108/09526860710763334] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
This article argues that public health historically evolved in Britain as a multidisciplinary project. The return to its multidisciplinary roots remains an essential but insufficient condition for its future success. Despite its part-emergence from the 'new public health', institutional public health is hampered by short-term strategies and a preoccupation with evidence when it requires a more powerful analysis of contemporary society, a more imaginative engagement with political structures culture and communications, and an embrace of ecological approaches in place of national public health strategies of surrogate consumerism.
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Affiliation(s)
- Geof Rayner
- GRAssociates Consultancy and City University, UK.
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Affiliation(s)
- T Lang
- Department of Health Management and Food Policy, Institute of Health Sciences, City University, London, UK.
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