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Dallera G, Palladino R, Filippidis FT. Corruption In Health Care Systems: Trends In Informal Payments Across Twenty-Eight EU Countries, 2013-19. Health Aff (Millwood) 2022; 41:1342-1352. [PMID: 36067438 DOI: 10.1377/hlthaff.2021.01931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Corruption is a major challenge in health care systems across the European Union (EU), where it manifests most visibly as informal payments from patients to providers. A higher prevalence of informal payments has been associated with lower public health care expenditure. EU member states have experienced significant changes in public health care expenditure throughout the 2000s. Given the lack of research on the topic, we explored trends in informal payments using representative data from twenty-eight EU member states during the period 2013-19 and in relation to changes in public health care expenditure. Overall, we found that informal payments increased in 2019 compared with 2013, whereas the perception of corruption decreased. Although higher public health care expenditure was associated with less corruption, we found a smaller effect size between informal payments and this expenditure throughout the study period. Our results suggest that informal payments may be driven by other factors, although the directionality of this relationship requires further investigation. Moreover, additional public health care investments may be insufficient to confront corruption unless coupled with measures to limit wasteful spending and increase transparency. Policy makers should understand that factors external to health systems, including media coverage and cultural and political factors, should be explored to explain country-level differences in corruption.
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Affiliation(s)
- Giulia Dallera
- Giulia Dallera , Imperial College London, London, England
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Islam MS, Huq S, Cunningham S, Schwarze J, Islam ASMDA, Amin M, Raza F, Satpathy R, Rauta PR, Ahmed S, Mahmood H, Fernandes G, Baloch B, Nisar I, Soofi S, Panigrahi P, Juvekar S, Bavkedar A, Baqui AH, Saha S, Campbell H, Sheikh A, Nair H, Saha SK. Community-based asthma assessment in young children: adaptations for a multicentre longitudinal study in South Asia. Ther Adv Infect Dis 2022; 9:20499361221103876. [PMID: 35875810 PMCID: PMC9297457 DOI: 10.1177/20499361221103876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 05/09/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Systematic assessment of childhood asthma is challenging in low- and middle-income country (LMIC) settings due to the lack of standardised and validated methodologies. We describe the contextual challenges and adaptation strategies in the implementation of a community-based asthma assessment in four resource-constrained settings in Bangladesh, India, and Pakistan. Method: We followed a group of children of age 6–8 years for 12 months to record their respiratory health outcomes. The study participants were enrolled at four study sites of the ‘Aetiology of Neonatal Infection in South Asia (ANISA)’ study. We standardised the research methods for the sites, trained field staff for uniform data collection and provided a ‘Child Card’ to the caregiver to record the illness history of the participants. We visited the children on three different occasions to collect data on respiratory-related illnesses. The lung function of the children was assessed in the outreach clinics using portable spirometers before and after 6-minute exercise, and capillary blood was examined under light microscopes to determine eosinophil levels. Results: We enrolled 1512 children, 95.5% (1476/1512) of them completed the follow-up, and 81.5% (1232/1512) participants attended the lung function assessment tests. Pre- and post-exercise spirometry was performed successfully in 88.6% (1091/1232) and 85.7% (1056/1232) of children who attempted these tests. Limited access to health care services, shortage of skilled human resources, and cultural diversity were the main challenges in adopting uniform procedures across all sites. Designing the study implementation plan based on the local contexts and providing extensive training of the healthcare workers helped us to overcome these challenges. Conclusion: This study can be seen as a large-scale feasibility assessment of applying spirometry and exercise challenge tests in community settings of LMICs and provides confidence to build capacity to evaluate children’s respiratory outcomes in future translational research studies.
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Affiliation(s)
- Mohammad Shahidul Islam
- Usher Institute, College of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Samin Huq
- Child Health Research Foundation, Dhaka, Bangladesh
| | - Steven Cunningham
- Child Life and Health, Centre for Inflammation Research, The University of Edinburgh, Edinburgh, UK
| | - Jurgen Schwarze
- Child Life and Health, Centre for Inflammation Research, The University of Edinburgh, Edinburgh, UK
| | | | | | | | | | | | - Salahuddin Ahmed
- Usher Institute, College of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | | | - Genevie Fernandes
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Edinburgh, UK
| | | | | | | | | | | | | | - Abdullah H Baqui
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Senjuti Saha
- Child Health Research Foundation, Dhaka, Bangladesh
| | - Harry Campbell
- Usher Institute, College of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Usher Institute, College of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Harish Nair
- Usher Institute, College of Medicine & Veterinary Medicine, The University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Samir K Saha
- Child Health Research Foundation, 23/2 Khilji Road, Dhaka 1207, Bangladesh
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Schwalb A, Cachay R, Curisinche-Rojas M, Gotuzzo E, Ríos J, Ugarte-Gil C. Tuberculosis Scientific Conferences in Peru: Sharing local evidence for local decisions. J Clin Tuberc Other Mycobact Dis 2021; 23:100232. [PMID: 33869808 PMCID: PMC8044673 DOI: 10.1016/j.jctube.2021.100232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction International conferences on tuberculosis (TB) have been held since the 19th century. In Peru, the TB Scientific Conferences have been held annually in Lima since 2013 as a means of developing a national TB research network and setting the stage for researchers and institutions to present and share new findings from studies conducted in Peru. Methods Systematization of information on speakers and presentations from TB Scientific Conferences in Peru. Presentation files and official agendas for the conferences from 2013 to 2019 were obtained from the Tuberculosis Prevention and Control Directorate's website. Results A total of 426 scientific presentations have been delivered by 230 speakers, with a steady annual increase. 37.1% of the talks were given by female speakers. To date, 61.4% of the research presented has been published. Out of all the studies, 10.9% (30/275) were part of international, multicentric research projects. Main research lines were epidemiology (40.1%), drug-resistance (29.6%) and treatment (22.1%). Conclusions TB Scientific Conferences serve as a platform to share region-specific TB evidence between local stakeholders (health officials, academics, and others) who aim to facilitate the implementation of measures with the goal of reducing the national gaps towards the End TB Strategy goals.
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Affiliation(s)
- Alvaro Schwalb
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, 15102 Lima, Peru
| | - Rodrigo Cachay
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, 15102 Lima, Peru
| | - Maricela Curisinche-Rojas
- Dirección de Prevención y Control de Tuberculosis, Ministerio de Salud, Av. Horacio Urteaga 900, Jesús María, 15072 Lima, Peru
| | - Eduardo Gotuzzo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, 15102 Lima, Peru.,School of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, 15102 Lima, Peru
| | - Julia Ríos
- Dirección de Prevención y Control de Tuberculosis, Ministerio de Salud, Av. Horacio Urteaga 900, Jesús María, 15072 Lima, Peru
| | - César Ugarte-Gil
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, 15102 Lima, Peru.,School of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, 15102 Lima, Peru
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Shanley JR, Armistead LP, Musyimi C, Nyamai D, Ishiekwene M, Mutiso V, Ndetei D. Engaging community voices to assess Kenya's strengths and limitations to support a child maltreatment prevention program. Child Abuse Negl 2021; 111:104772. [PMID: 33158583 PMCID: PMC7855883 DOI: 10.1016/j.chiabu.2020.104772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 09/09/2020] [Accepted: 10/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Preventing child maltreatment is a global mission of numerous international organizations, with parent support programs as the critical prevention strategy. In Kenya, 70 % of children are at risk of experiencing abuse and neglect, most often by their parents. Yet, there is a lack of evidence-based parent support programs, and a limited understanding of Kenya's capacity and infrastructures (e.g., policies, funding, service agencies) to support and sustain such programs. OBJECTIVE The purpose of this study was to assess systematically Kenya's strengths and limitations to implement a parent support program using a mixed-methods study design. PARTICIPANTS AND METHODS Twenty-one community stakeholders from Kenya completed the World Health Organization's (WHO) Readiness Assessment for the Prevention of Child Maltreatment to understand Kenya's preparedness to undertake a prevention program. In addition, 91 participants (e.g., parents, community health workers, community leaders) took part in focus group discussions or individual interviews to understand existing support networks around parenting programs. RESULTS Kenya's overall 'readiness' score was comparable to the other countries that completed the WHO survey. The survey results revealed Kenya's strengths and limitations across the ten readiness dimensions. Several themes emerged from the focus groups and interviews, including the diverse sources of support for parents, specific programs available for parents, and gaps in services offered. CONCLUSIONS The results document ways to build upon Kenyan's existing strengths to facilitate implementation of an evidence-based prevention program. These results also highlight the significant need to understand local context when adapting parenting programs for low/middle income countries (LMICs).
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Affiliation(s)
| | - Lisa P Armistead
- Georgia State University, 140 Decatur St., Atlanta, GA 30303, USA.
| | - Christine Musyimi
- Africa Mental Health Research and Training Foundation, PO Box 48423-00100, Nairobi, Kenya.
| | - Darius Nyamai
- Africa Mental Health Research and Training Foundation, PO Box 48423-00100, Nairobi, Kenya.
| | | | - Victoria Mutiso
- Africa Mental Health Research and Training Foundation, PO Box 48423-00100, Nairobi, Kenya.
| | - David Ndetei
- Africa Mental Health Research and Training Foundation, PO Box 48423-00100, Nairobi, Kenya; The University of Nairobi, PO Box 30197-00100, Nairobi, Kenya.
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Dang HM, Lam TT, Dao A, Weiss B. Mental health literacy at the public health level in low and middle income countries: An exploratory mixed methods study in Vietnam. PLoS One 2020; 15:e0244573. [PMID: 33382781 PMCID: PMC7774916 DOI: 10.1371/journal.pone.0244573] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/13/2020] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Mental health literacy (MHL) is key for mental health development, particularly in low-and-middle-income countries (LMIC) where mental health resources are limited. MHL development can be thought of as occurring at two levels: the individual person level (via direct contact, with specifically-targeted individuals), and the public health level (via indirect contact through public media, targeting the general public). Each approach has advantages and disadvantages. METHODS The present mixed methods study assessed the status of and best approaches for development of mental health literacy in the Southeast Asian LMIC Vietnam. Because there has been relatively little discussion of MHL development at the public health level, this assessment focused on the public health level, although not exclusively. Because mental health professionals generally have the most in-depth understanding of their mental health system, study participants were 82 Vietnamese mental health professionals who completed a quantitative survey, with 48 participating in focus groups. RESULTS Most of the professionals viewed MHL in Vietnam as low or very low, and that it was difficult or very difficult for the general public to find effective mental health services. Main barriers underlying these problems and more generally for developing MHL in Vietnam identified in the focus groups were: (a) misinformation in the media regarding mental health and mental illness; (b) lack of licensure for non-medical mental health professionals (e.g., psychologists; social workers); (c) lack of interest in mental health from upper-level leadership. CONCLUSIONS To the best of our knowledge, this is the first study assessing professionals' perceptions regarding mental health literacy at both the public health and individual-person levels. Although sampling was restricted to Vietnamese professionals, results may provide initial preliminary guidance for other LMIC considering mental health literacy development at multiple levels.
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Affiliation(s)
- Hoang-Minh Dang
- Center for Research, Information and Service in Psychology, VNU University of Education, Hanoi, Vietnam
| | | | - Anh Dao
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, TN, United States of America
| | - Bahr Weiss
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, TN, United States of America
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Abstract
Background: As called for by the Sustainable Development Goals, governments, development partners and civil society are working on anti-corruption, transparency and accountability approaches to control corruption and advance Universal Health Coverage. Objectives: The objective of this review is to summarize concepts, frameworks, and approaches used to identify corruption risks and consequences of corruption on health systems and outcomes. We also inventory interventions to fight corruption and increase transparency and accountability. Methods: We performed a critical review based on a systematic search of literature in PubMed and Web of Science and reviewed background papers and presentations from two international technical meetings on the topic of anti-corruption and health. We identified concepts, frameworks and approaches and summarized updated evidence of types and causes corruption in the health sector. Results: Corruption, or the abuse of power for private gain, in health systems includes bribes and kickbacks, embezzlement, fraud, political influence/nepotism and informal payments, among other behaviors. Drivers of corruption include individual and systems level factors such as financial pressures, poorly managed conflicts of interest, and weak regulatory and enforcement systems. We identify six typologies and frameworks that model relationships influencing the scope and seriousness of corruption, and show how anti-corruption strategies such as transparency, accountability, and civic participation can affect corruption risk. Little research exists on the effectiveness of anti-corruption measures; however, interventions such as community monitoring and insurance fraud control programs show promise. Conclusions: Corruption undermines the capacity of health systems to contribute to better health, economic growth and development. Interventions and resources on prevention and control of corruption are essential components of health system strengthening for Universal Health Coverage.
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Affiliation(s)
- Taryn Vian
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
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McCullough M, Msafiri N, Richardson WJ, Harman M, DesJardins JD, Dean D. Diversifying Bioengineering Design Education with an International Partnership. J Biomech Eng 2019; 141:1065453. [PMID: 31596921 DOI: 10.1115/1.4045112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Indexed: 11/08/2022]
Abstract
The field of engineering is increasingly appreciating the value of diversity for innovative design solutions. Successful engineering depends on our ability to explore constrained parameter spaces for finding the best solutions, and more diverse minds and experiences enable us to explore the entire potential solution space more thoroughly, more quickly, and more creatively. With a goal to expand the diversity of experiences and mindsets in our undergraduate bioengineering curricula, Arusha Technical College (ATC) in Arusha, Tanzania and Clemson University (CU) in Clemson, South Carolina, U.S., have partnered together over the past 5 years to provide intercontinental educational opportunities for undergraduate students, graduate assistants, and faculty. In 2018, CU and ATC collaborated on an international design course targeting undergraduate students in biomedical engineering focused on global health solutions for resource poor communities. Undergraduate students from ATC and CU collaborated on design projects through formal videoconferenced group meetings, email, and various social media platforms. The year ended with a joint design symposium in Arusha where the students presented on their work in a public poster forum. This successful ATC-CU Global Health Design Collaboration pilot year provides a solid model upon which to build. Students reported overall positive experiences and plans to continue in their curriculum to graduation, as well as some ATC and CU students changing their career direction to include global health initiatives.
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Affiliation(s)
- Melissa McCullough
- Department of Bioengineering, Clemson University, 301 Rhodes Research Center, Clemson, SC 29634, USA
| | - Nicodemus Msafiri
- Electrical and Biomedical Engineering Department, Arusha Technical College, Nairobi Road, P. O. Box 296, Arusha, Tanzania
| | - William J Richardson
- Department of Bioengineering, Clemson University, 301 Rhodes Research Center, Clemson, SC 29634, USA
| | - Melinda Harman
- Department of Bioengineering, Clemson University, 301 Rhodes Research Center, Clemson, SC 29634, USA
| | - John D DesJardins
- Department of Bioengineering, Clemson University, 301 Rhodes Research Center, Clemson, SC 29634, USA
| | - Delphine Dean
- Department of Bioengineering, Clemson University, 301 Rhodes Research Center, Clemson, SC 29634, USA
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Siagian RC, Ayuningtyas D. Gap analysis for drug development policy-making: An attempt to close the gap between policy and its implementation. PLoS One 2019; 14:e0220605. [PMID: 31386680 DOI: 10.1371/journal.pone.0220605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/21/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction Most drug development policies in developing countries are enacted without achieving the desired results. This study aims to determine the prioritization of drug development in Indonesia through the evidence-based policymaking process in order to close the distance between stated policy goals and the realization of planned goals. Methods A quantitative approach in the form of cross-sectional research using a structured survey was adopted and validated using a set of techniques involved in the calculation of a structural equation model. An independent samples t-test was used to test the significance of the differences between two views: pharmaceutical industries and the government of Indonesia. Findings The study reveals that pharmaceutical industries and governments were highly consistent in their perceived challenges in facing the drug development. It also reveals drivers and weaknesses of drug development, including market opportunities, push-pull-regulatory pull factors and regulation, as priorities for improvement. Conclusions Gap analysis based on a structural model was borne out to address gap challenges between policy and its implementation, with the use of evidence-based policymaking.
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Dang HM, Weiss B, Lam T, Ho H. Mental health literacy and intervention program adaptation in the internationalization of school psychology for Vietnam. Psychol Schs 2018; 55:941-954. [DOI: 10.1002/pits.22156] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | - Ha Ho
- Vietnam National University
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