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Hildreth JEK, Shanker A. The Diaspora Human Genomics Institute Launches the Together for Change Initiative: A Transformative, Historic Partnership to Ensure Health Equity in a Time of Unprecedented Technological Advancements. J Health Care Poor Underserved 2024; 35:ix-xiv. [PMID: 38661853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Human subjects research and drug and device development currently base their findings largely on the genetic data of the non-Hispanic White population, excluding People of Color. This practice puts People of Color at a distinct and potentially deadly disadvantage in being treated for sickness, disability, and disease, as seen during the COVID-19 pandemic. Major disparities exist in all chronic health conditions, including cancer. Data show that less than 2% of genetic information being studied today originates from people of African ancestry. If genomic datasets do not adequately represent People of Color, new drugs and genetic therapies may not work as well as for people of European descent. Addressing the urgent concern that historically marginalized people may again be excluded from the next technological leap affecting human health and the benefits it will bring will requires a paradigm shift. Thus, on behalf of underserved and marginalized people, we developed the Together for CHANGE (T4C) initiative as a unique collaborative public-private partnership to address the concern. The comprehensive programs designed in the T4C initiative, governed by the Diaspora Human Genomics Institute founded by Meharry Medical College, will transform the landscape of education and health care and positively affect global Black communities for decades to come.
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Lian X, Wang W, Zhang J. How to optimize dust pollution control in opencast coal mines: Analysis of a joint social regulation model based on evolutionary game theory. PLoS One 2023; 18:e0289164. [PMID: 37494392 PMCID: PMC10370741 DOI: 10.1371/journal.pone.0289164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023] Open
Abstract
The carbon peaking and carbon neutrality goals drive innovation in pollution governance systems, unleashing the potential of social supervisory forces to achieve coordinated governance by multiple stakeholders. In order to improve dust pollution control in opencast coal mines, this study combines prospect theory with evolutionary game theory, analyzing the evolutionary game process of coordinated governance activities of coal mining enterprises, local regulators, and social camps in the management of dust pollution against the backdrop of national supervisions. The research indicates that the perceived value of dust pollution has a significant impact on the strategic choices of the three agents involved in the game. Coal mining enterprises tend to be risk averse, and by reducing the cost of dust pollution control and increasing the additional benefits of pollution control, it can promote pollution control behavior by coal mining enterprises. Local regulators are also risk averse, but not sensitive to risk benefits. Strengthening pollution subsidy incentives and environmental fines can help promote dust pollution control behavior by coal mining enterprises. However, increasing the strength of the rewards strategy is not conducive to local regulators' own regulatory responsibilities, and environmental fines have limited binding effects. The strategic choices of social camps' supervision have a restrictive effect on the strategic choices of coal mining enterprises and local regulators, promoting the evolution of equilibrium results in the direction of maximizing social benefits. When coal mining enterprises actively governance pollution, local regulators strictly regulated, and social camps do not monitor, the system reaches its optimal equilibrium state. The research results clarify the mechanism and specific effects of social supervision of opencast coal mine dust pollution control, guide the participation of the public in dust pollution control, and regulate the behavior strategies of coal mining enterprises and local regulators, providing the scientific basis for management.
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Affiliation(s)
- Xu Lian
- School of Management, China University of Mining and Technology-Beijing, Beijing, China
| | - Wensheng Wang
- School of Management, China University of Mining and Technology-Beijing, Beijing, China
- Research Institute of Decision-making Science and Big Data, China University of Mining and Technology-Beijing, Beijing, China
| | - Jianmin Zhang
- School of Management, China University of Mining and Technology-Beijing, Beijing, China
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Mitchell CA, Dever JT, Gafner S, Griffiths JC, Marsman DS, Rider C, Welch C, Embry MR. The Botanical Safety Consortium: A public-private partnership to enhance the botanical safety toolkit. Regul Toxicol Pharmacol 2021; 128:105090. [PMID: 34863907 DOI: 10.1016/j.yrtph.2021.105090] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/16/2021] [Accepted: 11/29/2021] [Indexed: 12/31/2022]
Abstract
Botanical dietary supplement use is widespread and growing, therefore, ensuring the safety of botanical products is a public health priority. This commentary describes the mission and objectives of the Botanical Safety Consortium (BSC) - a public-private partnership aimed at enhancing the toolkit for conducting the safety evaluation of botanicals. This partnership is the result of a Memorandum of Understanding between the US FDA, the National Institute of Environmental Health Sciences, and the Health and Environmental Sciences Institute. The BSC serves as a global forum for scientists from government, academia, consumer health groups, industry, and non-profit organizations to work collaboratively on adapting and integrating new approach methodologies (NAMs) into routine botanical safety assessments. The objectives of the BSC are to: 1) engage with a group of global stakeholders to leverage scientific safety approaches; 2) establish appropriate levels of chemical characterization for botanicals as complex mixtures; 3) identify pragmatic, fit-for-purpose NAMs to evaluate botanical safety; 4) evaluate the application of these tools via comparison to the currently available safety information on selected botanicals; 5) and integrate these tools into a framework that can facilitate the evaluation of botanicals. Initially, the BSC is focused on oral exposure from dietary supplements, but this scope could be expanded in future phases of work. This commentary provides an overview of the structure, goals, and strategies of this initiative and insights regarding our first objectives, namely the selection and prioritization of botanicals based on putative toxicological properties.
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Affiliation(s)
| | | | | | | | | | - Cynthia Rider
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Cara Welch
- US Food and Drug Administration, Silver Spring, MD, USA
| | - Michelle R Embry
- Health and Environmental Sciences Institute, Washington, DC, USA
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Liu W, Wang X, Guo Q. Impact of the collaboration mechanism of PPP projects based on consumer participation: A system dynamics model of tripartite evolutionary game. PLoS One 2021; 16:e0256304. [PMID: 34495990 PMCID: PMC8425542 DOI: 10.1371/journal.pone.0256304] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 08/03/2021] [Indexed: 11/18/2022] Open
Abstract
Developing countries need a large number of social infrastructure projects (e.g. schools, medical care, nursing homes). But the government’s finance to invest in these projects is limited. By using the public–private partnership (PPP) mode to attract social capital to invest in PPP projects, it can relieve the financial pressure and improve the operation efficiency. The cooperation between government and consumer can ensure the sustainable development of the project operation. A system dynamics model of tripartite evolutionary game is developed to analyze the interaction of participant’s strategies and simulate the corresponding evolution process. We employ the scenario analysis method to investigate the impact of the key parameters in relation with PPP projects based on realistic scenario assumptions. The results reveal the effect of some policies including reverse effect, blocking effect and over-reliance effect. Specifically, the results show that high penalty can prevent social capital from providing low-quality services, the low cost of government regulation can promote social capital to provide high-quality services, compensation to consumer can increase the enthusiasm of consumer participating in supervision, appropriate difference between price and cost of high-quality service as social capital’s profit can encourage social capital to provide high-quality service. These policy suggestions will contribute to the sustainable development of social infrastructures in PPP mode.
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Affiliation(s)
- Wei Liu
- School of economics and management, Tongji University, Shanghai, China
| | - Xiaoli Wang
- School of economics and management, Tongji University, Shanghai, China
| | - Qian Guo
- Anhui Normal University, Wuhu, Anhui, China
- * E-mail:
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Mattocks KM, Kroll-Desrosiers A, Kinney R, Elwy AR, Cunningham KJ, Mengeling MA. Understanding VA's Use of and Relationships With Community Care Providers Under the MISSION Act. Med Care 2021; 59:S252-S258. [PMID: 33976074 PMCID: PMC8132889 DOI: 10.1097/mlr.0000000000001545] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Congress has enacted 2 major pieces of legislation to improve access to care for Veterans within the Department of Veterans Affairs (VA). As a result, the VA has undergone a major transformation in the way that care is delivered to Veterans with an increased reliance on community-based provider networks. No studies have examined the relationship between VA and contracted community providers. This study examines VA facility directors' perspectives on their successes and challenges building relationships with community providers within the VA Community Care Network (CCN). OBJECTIVES To understand who VA facilities partner with for community care, highlight areas of greatest need for partnerships in various regions, and identify challenges of working with community providers in the new CCN contract. RESEARCH DESIGN We conducted a national survey with VA facility directors to explore needs, challenges, and expectations with the CCN. RESULTS The most common care referred to community providers included physical therapy, chiropractic, orthopedic, ophthalmology, and acupuncture. Open-ended responses focused on 3 topics: (1) Challenges in working with community providers, (2) Strategies to maintain strong relationships with community providers, and (3) Re-engagement with community providers who no longer provide care for Veterans. CONCLUSIONS VA faces challenges engaging with community providers given problems with timely reimbursement of community providers, low (Medicare) reimbursement rates, and confusing VA rules related to prior authorizations and bundled services. It will be critical to identify strategies to successfully initiate and sustain relationships with community providers.
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Affiliation(s)
- Kristin M. Mattocks
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester
- VA Central Western Massachusetts Healthcare System, Leeds
| | - Aimee Kroll-Desrosiers
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester
- VA Central Western Massachusetts Healthcare System, Leeds
| | - Rebecca Kinney
- VA Central Western Massachusetts Healthcare System, Leeds
| | - Anashua R. Elwy
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI
| | | | - Michelle A. Mengeling
- Center for Access & Delivery Research and Evaluation (CADRE) and Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Health Care System
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
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Affiliation(s)
- Radhika Gharpure
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anita Patel
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ruth Link-Gelles
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
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Ho RJY. Warp-Speed Covid-19 Vaccine Development: Beneficiaries of Maturation in Biopharmaceutical Technologies and Public-Private Partnerships. J Pharm Sci 2021; 110:615-618. [PMID: 33212162 PMCID: PMC7671640 DOI: 10.1016/j.xphs.2020.11.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 11/27/2022]
Abstract
It is anticipated that effective vaccines will enable the resumption of social and economic normalcy. Current calls for masking, social distancing and other restrictive measures for the public-good are difficult to enforce and are unstainable. As ~2-4% of the 50 million SARS-CoV2-infected have succumbed to Covid-19, the US department of Health and Human Services has organized a public-private partnership called Operation Warp Speed (OWS) to develop, produce and deliver 300 million doses of safe and effective vaccines with a January 2021 target. While a majority of the 300+ Covid-19 vaccine candidates are in various stages of preclinical and early-stage clinical testing, 6 clinical candidates are supported with over 10 billion USD plus integrated resources under the OWS agenda. This unprecedented approach is investing in the manufacture of product candidates ahead of product approval. It is enabled by new gene and recombinant pharmaceutical platform technologies that are accelerating the clinical study timeline from ~10 to less than 1 year. It is anticipated that one or more of the 6 candidates under the OWS initiative will be safe, effective and provide a sustained immune response to prevent infection and disease progression. This way, social and economic activities could return to normalcy.
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Affiliation(s)
- Rodney J Y Ho
- Department of Pharmaceutics and Bioengineering, University of Washington, Seattle, WA 98206-7610, USA.
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Affiliation(s)
| | - Tony Hickson
- Research & Innovation, Cancer Research UK, London, UK
| | - Iain Foulkes
- Research & Innovation, Cancer Research UK, London, UK
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Barras WP, Duran-Stanton AM. Installation Management Command's COVID-19 Pandemic Efforts Rely on Multiple Collaborative Partnerships. Med J (Ft Sam Houst Tex) 2021:20-21. [PMID: 33666907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The Installation Management Command (IMCOM) delivers quality base support from the strategic support area, enabling readiness for a globally responsive Army. IMCOM has more than 75 installations, covering more than 13 million acres, in 17 time zones, 12 countries and 58 services. In early March 2020, the COVID-19 pandemic required IMCOM to shift focus in ensuring health protection measures were implemented early and quickly, which relied on medical expertise. The IMCOM Surgeon and the Deputy Surgeon serve as the command's key advisors for all matters related to health care and medical readiness. During the COVID-19 pandemic, the IMCOM Surgeon and the Deputy Surgeon were critical in the consolidation of various information from multiple organizations. They promoted the integration of force health protection principles during COVID-19 operations. All of the military members at IMCOM headquarters (HQ) were considered mission essential while other personnel were identified on a phasing structure in the early stages of the pandemic, which meant civilian personnel were instructed to telework.
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Affiliation(s)
| | - Amelia M Duran-Stanton
- Installation Management Command Chief of Ready and Resilient Integration Branch/Deputy Surgeon
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Burki T. Inappropriate behaviour claims at Stop TB prompt review. Lancet 2020; 396:876. [PMID: 32979966 DOI: 10.1016/s0140-6736(20)32003-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Henderson S, Wagner JL, Gosdin MM, Hoeft TJ, Unützer J, Rath L, Hinton L. Complexity in partnerships: A qualitative examination of collaborative depression care in primary care clinics and community-based organisations in California, United States. Health Soc Care Community 2020; 28:1199-1208. [PMID: 32052531 PMCID: PMC7318288 DOI: 10.1111/hsc.12953] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 12/02/2019] [Accepted: 01/14/2020] [Indexed: 05/09/2023]
Abstract
Partnering across health clinics and community organisations, while worthwhile for improving health and well-being, is challenging and time consuming. Even partnerships that have essential elements for success in place face inevitable challenges. To better understand how cross-organisational partnerships work in practice, this paper examines collaborations between six primary care clinics and community-based organisations in the United States that were part of an initiative to address late-life depression using an enhanced collaborative care model (Archstone Foundation Care Partners Project). As part of an evaluation of the Care Partners Project, 54 key informant interviews and 10 focus groups were conducted from 2015 to 2017. Additionally, more than 80 project-related documents were reviewed. Qualitative thematic analysis was used to code the transcripts and identify prominent themes in the data. Examining clinic and community organisation partnerships in practice highlighted their inherent complexity. The partnerships were fluid and constantly evolving, shaped by a multiplicity of perspectives and values, and vulnerable to unpredictability. Care Partners sites negotiated the complexity of their partnerships drawing upon three main strategies: adaptation (allowing for flexibility and rapid change); integration (providing opportunities for multi-level partnerships within and across organisations) and cultivation (fostering a commitment to the partnership and its value). These strategies provided opportunities for Care Partners collaborators to work with the inherent complexity of partnering. Intentionally acknowledging and embracing such complexity rather than trying to reduce or avoid it, may allow clinic and community collaborators to strengthen and sustain their partnerships.
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Affiliation(s)
- Stuart Henderson
- School of MedicineOffice of Research Evaluation UnitUniversity of CaliforniaDavis, SacramentoCAUSA
| | - Jenny L. Wagner
- School of MedicineOffice of Research Evaluation UnitUniversity of CaliforniaDavis, SacramentoCAUSA
| | - Melissa M. Gosdin
- Center for Healthcare Policy and ResearchUniversity of CaliforniaDavis, SacramentoCAUSA
| | - Theresa J. Hoeft
- Department of Psychiatry and Behavioral SciencesUniversity of WashingtonSeattleWAUSA
| | - Jürgen Unützer
- Department of Psychiatry and Behavioral SciencesUniversity of WashingtonSeattleWAUSA
| | | | - Ladson Hinton
- Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaDavis, SacramentoCAUSA
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Azami-Aghdash S, Sadeghi-Bazargani H, Saadati M, Mohseni M, Gharaee H. Experts' perspectives on the application of public-private partnership policy in prevention of road traffic injuries. Chin J Traumatol 2020; 23:152-158. [PMID: 32278612 PMCID: PMC7296355 DOI: 10.1016/j.cjtee.2020.03.001] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 01/17/2020] [Accepted: 02/20/2020] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Successful application experiences on public-private partnership (PPP) in different countries, suggest that PPP could be an option in road traffic injury (RTI) prevention. The present study aims at investigating the applicability of PPP policy in RTI prevention in Iran based on the experts' perspectives. METHODS This is a qualitative study with grounded theory approach which has been conducted in Tabriz University of Medical Sciences, Iran in 2018. The participants were 22 experts in the field of RTIs selected using purposive sampling method. Data were collected by semi-structured interviews and analyzed with content-analysis method. RESULTS The results were classified under 5 main themes (applicability, scopes and services, challenges, advantages, and strategies) for applying PPP policy and 37 sub-themes. Due to the prevalence of RTIs, the present challenges in public sector, existence of qualified private sector, and successful experiences in other areas, there are opportunities for private sector partnership in prevention of RTIs. Private sector could participate in different scopes and services regarding RTI prevention, including road construction and maintenance, maintenance and provision of vehicles safety and public education. The main challenges including legislation issues, ambiguities in collaboration, political and organizational unsustainability, government's financial hardship and lack of experienced experts in the field of RTI. However, there are significant advantages including high efficiency in program implementation, covering the weaknesses of public sector, effective and efficient management on application of PPP in RTI prevention. The strategies include identifying and prioritizing the assignable activities, identifying the qualified private sector, developing PPP policies and legal frameworks, creating a common language between public and private parties, trying to meet the expectations of the private sector by public sector, developing a comprehensive and sound contract, and cultivating public culture to accept private sector in the field of RTI prevention. CONCLUSION This study sought to determine whether PPP could be used as strategy to reduce the burden of RTIs in Iran. But it requires a lot of preliminary studies to provide the context and conditions for applying this policy.
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Affiliation(s)
- Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mohammad Saadati
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Mohseni
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hojatolah Gharaee
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Health Center of Hamadan City, Hamadan University of Medical Science, Hamadan, Iran.
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Berwick DM, Shine K. Enhancing Private Sector Health System Preparedness for 21st-Century Health Threats: Foundational Principles From a National Academies Initiative. JAMA 2020; 323:1133-1134. [PMID: 32207806 DOI: 10.1001/jama.2020.1310] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Donald M Berwick
- Institute for Healthcare Improvement (IHI), Boston, Massachusetts
| | - Kenneth Shine
- Department of Internal Medicine, The University of Texas at Austin
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Hoover P, Der E, Berthier CC, Arazi A, Lederer JA, James JA, Buyon J, Petri M, Belmont HM, Izmirly P, Wofsy D, Hacohen N, Diamond B, Putterman C, Davidson A. Accelerating Medicines Partnership: Organizational Structure and Preliminary Data From the Phase 1 Studies of Lupus Nephritis. Arthritis Care Res (Hoboken) 2020; 72:233-242. [PMID: 31502417 PMCID: PMC6992476 DOI: 10.1002/acr.24066] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/03/2019] [Indexed: 12/20/2022]
Abstract
The Accelerating Medicines Partnership (AMP) Lupus Network was established as a partnership between the National Institutes of Health, pharmaceutical companies, nonprofit stakeholders, and lupus investigators across multiple academic centers to apply high-throughput technologies to the analysis of renal tissue, urine, and blood from patients with lupus nephritis (LN). The AMP network provides publicly accessible data to the community with the goal of generating new scientific hypotheses and improving diagnostic and therapeutic tools so as to improve disease outcomes. We present here a description of the structure of the AMP Lupus Network and a summary of the preliminary results from the phase 1 studies. The successful completion of phase 1 sets the stage for analysis of a large cohort of LN samples in phase 2 and provides a model for establishing similar discovery cohorts.
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Affiliation(s)
- Paul Hoover
- Broad Institute of MIT and Harvard, Cambridge Massachusetts, USA
| | - Evan Der
- Division of Rheumatology and Department of Microbiology and Immunology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Celine C. Berthier
- Internal Medicine, Department of Nephrology, University of Michigan, Ann Arbor, Michigan, USA
| | - Arnon Arazi
- Broad Institute of MIT and Harvard, Cambridge Massachusetts, USA
| | - James A. Lederer
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston Massachusetts, USA
| | - Judith A. James
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Jill Buyon
- Department of Medicine, Division of Rheumatology, New York University School of Medicine, New York, New-York, USA
| | - Michelle Petri
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - H. Michael Belmont
- Department of Medicine, Division of Rheumatology, New York University School of Medicine, New York, New-York, USA
| | - Peter Izmirly
- Department of Medicine, Division of Rheumatology, New York University School of Medicine, New York, New-York, USA
| | - David Wofsy
- Rheumatology Division and Russell/Engleman Rheumatology Research Center, University of California San Francisco, San Francisco, California, USA
| | - Nir Hacohen
- Broad Institute of MIT and Harvard, Cambridge Massachusetts, USA
| | - Betty Diamond
- Center for Autoimmune, Musculoskeletal and Hematologic Diseases, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Chaim Putterman
- Division of Rheumatology and Department of Microbiology and Immunology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Anne Davidson
- Center for Autoimmune, Musculoskeletal and Hematologic Diseases, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York, USA
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Shibu V, Daksha S, Rishabh C, Sunil K, Devesh G, Lal S, Jyoti S, Kiran R, Bhavin V, Amit K, Radha T, Sandeep B, Minnie K, Kaur GR, Vaishnavi J, Sudip M, Sameer K, Achutan NS, Sanjeev K, Puneet D. Tapping private health sector for public health program? Findings of a novel intervention to tackle TB in Mumbai, India. Indian J Tuberc 2020; 67:189-201. [PMID: 32553311 DOI: 10.1016/j.ijtb.2020.01.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 01/09/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND India carries one-fourth of the global tuberculosis (TB) burden. Hence the country has drafted the ambitious National Strategic Plan to eliminate tuberculosis by 2025. To realise this goal, India's Revised National Tuberculosis Control Programme (RNTCP) and partners piloted a novel strategy to engage private-providers for tuberculosis care via a "Private-provider Interface Agency" (PPIA) in Mumbai and other locations. INTERVENTION The program mapped and engaged private-providers, chemists, and laboratories; facilitated TB notification via call centers and field staff; provided free tuberculosis diagnostic tests and anti-TB drugs using novel electronic vouchers; monitored quality of care; and supported patients to ensure anti-TB treatment adherence and completion. This report summarises the descriptive analysis of PPIA implementation data piloted in Mumbai from 2014 to 2017. FINDINGS The program mapped 8789 private doctors, 3438 chemists, and 985 laboratories. Of these, 3836 (44%) doctors, 285 (29%) laboratories, and 353 (10%) chemists were prioritized and engaged in the program. Over three and a half years, the program recorded 60,366 privately-notified tuberculosis patients, of which, 24,146 (40%) were microbiologically-confirmed, 5203 (9%) were rifampicin-resistant, and 4401 (7%) were paediatric TB patients. Mumbai's annual total TB case notification rate increased from a pre-program baseline of 272 per 100,000/year in 2013 to 416 per 100,000/year in 2017. Overall, 42,300 (78%) patients completed the TB treatment, and 4979 (9%) could not be evaluated. INTERPRETATION The PPIA program in Mumbai demonstrated that private-providers can be effectively engaged for TB control in urban India. This program has influenced national policy and has been adapted and funded for a country-wide scale up. The model may also be considered in conditions where private-provider engagement is needed to improve access and quality of care for any area of public health.
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Affiliation(s)
| | - Shah Daksha
- Department of Health, Muncipal Corporation of Greater Mumbai, India
| | | | - Khaparde Sunil
- Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - Gupta Devesh
- Central TB Division, Ministry of Health & Family Welfare, Government of India, New Delhi, India
| | | | | | - Rade Kiran
- World Health Organization, New Delhi, India
| | | | - Karad Amit
- World Health Organization, New Delhi, India
| | | | | | - Khetrapal Minnie
- Department of Health, Muncipal Corporation of Greater Mumbai, India
| | | | | | | | - Kumta Sameer
- Bill & Melinda Gates Foundation, New Delhi, India
| | | | | | - Dewan Puneet
- Independent Public Health Consultant, Seattle, WA, USA
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Tayler E, Gregory R, Bloom G, Salama P, Balkhy H. Universal health coverage: an opportunity to address antimicrobial resistance? Lancet Glob Health 2019; 7:e1480-e1481. [PMID: 31548131 DOI: 10.1016/s2214-109x(19)30362-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 08/05/2019] [Indexed: 11/20/2022]
Affiliation(s)
| | | | - Gerry Bloom
- Institute of Development Studies, Brighton, UK
| | - Peter Salama
- World Health Organization, Geneva 27, Switzerland
| | - Hanan Balkhy
- World Health Organization, Geneva 27, Switzerland
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17
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Abstract
BACKGROUND The World Health Organization (WHO) 2017 Global Conference in Montevideo, Uruguay, was dedicated to promoting successful cases and best practices in fighting and preventing noncommunicable disease (NCDs). The global effort undertaken by WHO aims to reduce road traffic deaths in order to meet goal number 3.4 of the sustainable development goals. OBJECTIVES To describe two Brazilian road safety prevention programs, presented at the WHO 2017 Global Conference: São Paulo Traffic Safety Movement (Movimento Paulista de Segurança no Trânsito) and Safe Life Program of Brasília (Programa Brasília Vida Segura), along with their governance structures, models and results. DESIGN AND SETTING This was a descriptive case study conducted in São Paulo and Brasilia from 2015 to 2018. These programs aimed to reduce the number of deaths caused by road accidents to 8.3 deaths per 100,000 inhabitants in São Paulo by 2020 and in Brasília by 2016; and to reduce harmful use of alcohol by 10% by 2020. METHODS These two initiatives were designed, managed and operated to bring together government and civil society, i.e. industry, academia, non-governmental organizations (NGOs), etc., around the common goal of saving lives. They were collaborative and guided by sharing of best practices, learning and information, thereby making it possible to attain more and better results. Their format enables reproduction in cities across all Brazilian regions. RESULTS The results attest to the efficacy of the programs implemented in these two cities. In Brasília, the initiative helped reduce the number of traffic-related deaths by 35% (2017). In the same year in the state of São Paulo, 7,600 deaths were avoided. CONCLUSION Both programs are innovative public policies that deal with health issues caused by the external agents that ultimately account for the rapid increase in days lost to disability. Prevention of external causes of deaths and injuries, such as traffic violence, strongly correlates with changes in habits and actions, especially excessive consumption of alcohol, and with NCDs in Brazil.
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Affiliation(s)
- Leandro Piquet Carneiro
- MSc, PhD. Economist and Professor, International Relations Institute, Universidade de São Paulo (USP), São Paulo (SP), Brazil.
| | - Linamara Rizzo Battistella
- MD, PhD. Professor, Department of Legal Medicine, Medical Ethics and Social and Labor Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), Brazil.
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18
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Bresee JS, Lafond KE, McCarron M, Azziz-Baumgartner E, Chu SY, Ebama M, Hinman AR, Xeuatvongsa A, Bino S, Richardson D, Porter RM, Moen A, McKinlay M. The partnership for influenza vaccine introduction (PIVI): Supporting influenza vaccine program development in low and middle-income countries through public-private partnerships. Vaccine 2019; 37:5089-5095. [PMID: 31288998 PMCID: PMC6685526 DOI: 10.1016/j.vaccine.2019.06.049] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/22/2019] [Accepted: 06/17/2019] [Indexed: 01/15/2023]
Abstract
Influenza vaccination remains the most effective tool for reducing seasonal influenza disease burden. Few Low and Middle-Income Countries (LMICs) have robust, sustainable annual influenza national vaccination programs. The Partnership for Influenza Vaccine Introduction (PIVI) was developed as a public-private partnership to support LMICs to develop and sustain national vaccination programs through time-limited vaccine donations and technical support. We review the first 5 years of experience with PIVI, including the concept, country progress toward sustainability, and lesson learned. Between 2013 and 2018, PIVI worked with Ministries of Health in 17 countries. Eight countries have received donated vaccines and technical support; of these, two have transitioned to sustained national support of influenza vaccination and six are increasing national support of the vaccine programs towards full transition to local vaccine program support by 2023. Nine additional countries have received technical support for building the evidence base for national policy development and/or program evaluation. PIVI has resulted in increased use of vaccines in partner countries, and early countries have demonstrated progress towards sustainability, suggesting that a model of vaccine and technical support can work in LMICs. PIVI expects to add new country partners as current countries transition to self-reliance.
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Affiliation(s)
- Joseph S Bresee
- Influenza Division, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Center for Vaccine Equity, Task Force for Global Health, Atlanta, GA, USA.
| | - Kathryn E Lafond
- Influenza Division, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Margaret McCarron
- Influenza Division, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eduardo Azziz-Baumgartner
- Influenza Division, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Susan Y Chu
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Malembe Ebama
- Center for Vaccine Equity, Task Force for Global Health, Atlanta, GA, USA
| | - Alan R Hinman
- Center for Vaccine Equity, Task Force for Global Health, Atlanta, GA, USA
| | - Anonh Xeuatvongsa
- Ministry of Health, Lao Peoples Democratic Republic, Vientiane, Laos
| | | | - Dominique Richardson
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rachael M Porter
- Influenza Division, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ann Moen
- Influenza Division, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mark McKinlay
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Coffey S, Latta L, Mueller H, Flanders S. Collaboration, Innovation, and Time: A Shared Journey Through Child Psychiatric Consultation in the School Setting. Psychiatr Serv 2019; 70:631-634. [PMID: 31109265 PMCID: PMC6676897 DOI: 10.1176/appi.ps.201800429] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
About 20% of students in U.S. communities have diagnoses of emotional and behavioral disturbances. Even when mental health services are in place, students and teachers often struggle in the classroom. In this column, the authors describe a partnership with a public school system to provide collaborative, innovative support that also offered a novel training opportunity for child and adolescent psychiatry fellows. Over three years of collaborative work, the child psychiatry team (attending child psychiatrist and two child psychiatry fellows) offered direct clinical care and consultation in a school-based clinic. In later years, the team provided ongoing professional development and consultation to teachers, and the model was implemented districtwide. The authors describe challenges of engaging and working in the school setting, which call on key strengths of an effective partnership: communication, respect, and trust. The multiyear partnership offered a mutually beneficial experience for both educators and psychiatry trainees.
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Affiliation(s)
- Sara Coffey
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa (Coffey); Early Childhood Education Institute (Latta) and Department of Psychiatry, School of Community Medicine (Mueller), University of Oklahoma-Tulsa, Tulsa; Department of Behavioral Health, PeaceHealth Medical Group, Eugene, Oregon (Flanders). Debra A. Pinals, M.D., and Marcia Valenstein, M.D., M.S., are editors of this column
| | - Laura Latta
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa (Coffey); Early Childhood Education Institute (Latta) and Department of Psychiatry, School of Community Medicine (Mueller), University of Oklahoma-Tulsa, Tulsa; Department of Behavioral Health, PeaceHealth Medical Group, Eugene, Oregon (Flanders). Debra A. Pinals, M.D., and Marcia Valenstein, M.D., M.S., are editors of this column
| | - Heath Mueller
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa (Coffey); Early Childhood Education Institute (Latta) and Department of Psychiatry, School of Community Medicine (Mueller), University of Oklahoma-Tulsa, Tulsa; Department of Behavioral Health, PeaceHealth Medical Group, Eugene, Oregon (Flanders). Debra A. Pinals, M.D., and Marcia Valenstein, M.D., M.S., are editors of this column
| | - Sarah Flanders
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa (Coffey); Early Childhood Education Institute (Latta) and Department of Psychiatry, School of Community Medicine (Mueller), University of Oklahoma-Tulsa, Tulsa; Department of Behavioral Health, PeaceHealth Medical Group, Eugene, Oregon (Flanders). Debra A. Pinals, M.D., and Marcia Valenstein, M.D., M.S., are editors of this column
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20
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Sirili N, Frumence G, Kiwara A, Mwangu M, Goicolea I, Hurtig AK. Public private partnership in the training of doctors after the 1990s' health sector reforms: the case of Tanzania. Hum Resour Health 2019; 17:33. [PMID: 31118038 PMCID: PMC6532226 DOI: 10.1186/s12960-019-0372-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 05/09/2019] [Indexed: 06/09/2023]
Abstract
Similar to many other low- and middle-income countries, public private partnership (PPP) in the training of the health workforce has been emphasized since the launch of the 1990s' health sector reforms in Tanzania. PPP in training aims to contribute to addressing the critical shortage of health workforce in these countries. This study aimed to analyse the policy process and experienced outcomes of PPP for the training of doctors in Tanzania two decades after the 1990s' health sector reforms. We reviewed documents and interviewed key informants to collect data from training institutions and umbrella organizations that train and employ doctors in both the public and private sectors. We adopted a hybrid thematic approach to analyse the data while guided by the policy analysis framework by Gagnon and Labonté. PPP in training has contributed significantly to the increasing number of graduating doctors in Tanzania. In tandem, undermining of universities' autonomy and the massive enrolment of medical students unfavourably affect the quality of graduating doctors. Although PPP has proven successful in increasing the number of doctors graduating, unemployment of the graduates and lack of database to inform the training needs and capacity to absorb the graduates have left the country with a health workforce shortage and maldistribution at service delivery points, just as before the introduction of the PPP. This study recommends that Tanzania revisit its PPP approach to ensure the health workforce crisis is addressed in its totality. A comprehensive plan is needed to address issues of training within the framework of PPP by engaging all stakeholders in training and deployment starting from the planning of the number of medical students, and when and how they will be trained while taking into account the quality of the training.
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Affiliation(s)
- Nathanael Sirili
- Department of Epidemiology and Global Health, Umeå University, 90185, Umeå, SE, Sweden.
- Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O.BOX 65454, Dar es Salaam, Tanzania.
| | - Gasto Frumence
- Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O.BOX 65454, Dar es Salaam, Tanzania
| | - Angwara Kiwara
- Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O.BOX 65454, Dar es Salaam, Tanzania
| | - Mughwira Mwangu
- Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O.BOX 65454, Dar es Salaam, Tanzania
| | - Isabel Goicolea
- Department of Epidemiology and Global Health, Umeå University, 90185, Umeå, SE, Sweden
| | - Anna-Karin Hurtig
- Department of Epidemiology and Global Health, Umeå University, 90185, Umeå, SE, Sweden
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21
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Reitsma M, Fox J, Borre PV, Cavanaugh M, Chudnovsky Y, Erlich RL, Gribbin TE, Anhorn R. Effect of a Collaboration Between a Health Plan, Oncology Practice, and Comprehensive Genomic Profiling Company from the Payer Perspective. J Manag Care Spec Pharm 2019; 25:601-611. [PMID: 30632889 PMCID: PMC10398083 DOI: 10.18553/jmcp.2019.18309] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Comprehensive genomic profiling (CGP) is a next-generation sequencing-based methodology that detects 4 classes of genomic alterations, as well as gene signature biomarkers such as microsatellite instability and tumor mutational burden. In the context of precision oncology, CGP can help to direct treatment to genomically matched therapies. OBJECTIVE To describe the results of a 3-year observational analysis of patients undergoing testing with CGP assays (either FoundationOne or FoundationOne Heme) at a community oncology practice after a regional health plan implemented a medical policy that enabled coverage of CGP. METHODS A retrospective analysis of medical records was completed at the oncology practice from November 2013 to January 2017; this date range was chosen to coincide with the regional health plan's medical policy implementation of CGP. The medical policy provided coverage of CGP for patients with advanced solid and hematologic cancers. A medical record review assessed all previous and current molecular test results, matched therapy or clinical trial enrollment, and clinical outcomes (clinical benefit or disease progression). The potential cost diversion, from payer to study sponsor, for patients who enrolled in clinical trials was explored. RESULTS There were 96 patients in the community oncology practice who received CGP over the 3-year period, 86 of whom had clinically relevant genomic alterations. Of the 86, 15 patients were treated with genomically matched therapy, and 6 patients enrolled in clinical trials based on CGP results. In a subset of 32 patients who previously underwent conventional testing, most (84%) had clinically relevant genomic alterations detected by CGP that conventional testing did not identify, and a portion of these patients subsequently received treatment based on the CGP results. In the separate cost diversion analysis of 20 patients who enrolled in phase 1 clinical trials, an estimated $25,000 per-patient cost-benefit may have been accrued to the payer. CONCLUSIONS This observational analysis characterized the use of CGP in a large community oncology practice among a group of patients insured by a regional health plan. Clinical trial enrollment was facilitated by CGP use in the community setting and may have contributed to cost diversion from the payer to study sponsors. DISCLOSURES No separate study-related funding was provided by or to Priority Health, Foundation Medicine, and Cancer and Hematology Centers of West Michigan. Data analysis by Reitsma was conducted as part of an internship funded by Priority Health. Reitsma and Fox are employed by Priority Health. Anhorn, Vanden Borre, Cavanaugh, Chudnovsky, and Erlich are employed by Foundation Medicine.
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Affiliation(s)
- Mitchell Reitsma
- Priority Health, Grand Rapids, Michigan, and Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - John Fox
- Priority Health, Grand Rapids, Michigan
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Polk S, DeCamp LR, Guerrero Vázquez M, Kline K, Andrade A, Cook B, Cheng T, Page KR. Centro SOL: A Community-Academic Partnership to Care for Undocumented Immigrants in an Emerging Latino Area. Acad Med 2019; 94:538-543. [PMID: 30379663 PMCID: PMC6435395 DOI: 10.1097/acm.0000000000002508] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PROBLEM From 2000 to 2014, the Latino population in Baltimore city, an emerging Latino settlement area, experienced rapid growth. Many of these individuals are undocumented and not eligible for coverage. Academic medical centers often lead the way in addressing the health needs of undocumented immigrants; however, examples from emerging immigrant areas are limited. APPROACH In October 2013, Johns Hopkins Medicine clinicians established the Center for Salud/Health and Opportunities for Latinos (Centro SOL) to better address the health needs of Baltimore's growing Latino community. Centro SOL's mission focuses on four core activities: clinical services; advocacy and community engagement efforts; pipeline/education opportunities; and research consultations. Progress is measured through a scorecard reviewed annually by Centro SOL leadership. OUTCOMES Centro SOL's program has expanded health care access for undocumented immigrants, patient safety and quality of service/care programs for patients with limited English proficiency, and pipeline opportunities for Latino youth. In 2017, 2,763 uninsured patients received primary or specialty care and 290 people received group therapy to address stress-related conditions. In addition, 49 Latino students (ranging from high school to postgraduate students) received mentorship at Centro SOL. NEXT STEPS In the next five years, Centro SOL plans to expand the pipeline for Latinos interested in health professions fields and to further improve access to health services for Latino families through both advocacy efforts and enhanced clinical services.
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Affiliation(s)
- Sarah Polk
- S. Polk is assistant professor of pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland. L.R. DeCamp is assistant professor of pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland. M.G. Vázquez is Bloomberg American Health Initiative Fellow, Bloomberg Johns Hopkins University School of Public Health, Baltimore, Maryland. K. Kline is instructor, Johns Hopkins University School of Medicine, Baltimore, Maryland. A. Andrade is currently acting chief, HIV Research Branch, Division of AIDS, National Institutes of Health, Rockville, Maryland. At the time of writing (March 2018), she was associate professor of medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. B. Cook is clinical associate, Johns Hopkins University School of Medicine, Baltimore, Maryland. T. Cheng is professor and chief, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland. K.R. Page is associate professor of medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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23
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Oliver N, Holt RIG. The James Lind Alliance research priorities for diabetes. Diabet Med 2019; 36:267-268. [PMID: 30770611 DOI: 10.1111/dme.13917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- N Oliver
- Diabetic Medicine, London, UK
- Division of Diabetes and Endocrinology, Imperial College, London, UK
| | - R I G Holt
- Diabetic Medicine, University of Southampton, Southampton, UK
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
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Palaco I, Park MJ, Kim SK, Rho JJ. Public-private partnerships for e-government in developing countries: An early stage assessment framework. Eval Program Plann 2019; 72:205-218. [PMID: 30415092 DOI: 10.1016/j.evalprogplan.2018.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 09/20/2018] [Accepted: 10/16/2018] [Indexed: 05/07/2023]
Abstract
Although public-private partnerships (PPP) and electronic government (e-government) have proven to be fruitful mechanisms for economic development and emerging economies seem to recognize their importance, consistent methods for analyzing the early planning stages of e-government portfolios are lacking. The present work utilized a comprehensive literature review to understand the evaluation criteria for PPP projects throughout the early-stage planning process. A qualitative meta-synthesis was employed to identify critical factors for PPP and e-government, with a particular focus on developing countries, PPP, and e-government criteria. Our research presents a framework named "PPP4e-Gov" (public-private partnerships for e-government). The framework compares risk and value factors of e-government PPP projects and adopts a weighted scoring model that estimates the risks that should be considered in a project and how much value a given e-government initiative may generate if the PPP option is chosen. As an illustration of how the framework may be used, the paper interviewed ten practitioners in Costa Rica who tried out PPP4e-Gov and showcased how to plan their e-government initiatives.
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Affiliation(s)
- Ileana Palaco
- Global IT Technology Program (ITTP), Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon, Republic of Korea.
| | - Min Jae Park
- Department of Business Administration, Seoul School of Integrated Sciences and Technologies (aSSIST), 46 Ewhayeodae 2-gil, Seodaemun-gu, Seoul, Republic of Korea.
| | - Suk Kyoung Kim
- School of Business and Technology Management, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon, Republic of Korea.
| | - Jae Jeung Rho
- School of Business and Technology Management, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon, Republic of Korea.
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Chowkwanyun M. Rethinking Private-Public Partnership in the Health Care Sector: The Case of Municipal Hospital affiliation. Bull Hist Med 2019; 93:483-517. [PMID: 31885014 DOI: 10.1353/bhm.2019.0070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
By the late 1950s, New York City's public hospital system-more extensive than any in the nation-was falling apart, with dilapidated buildings and personnel shortages. In response, Mayor Robert Wagner authorized an affiliation plan whereby the city paid private academic medical centers to oversee training programs, administrative tasks, and resource procurement. Affiliation sparked vigorous protest from critics, who saw it as both an incursion on the autonomy of community-oriented public hospitals and the steamrolling of private interests over public ones. In the wake of the New York City fiscal crisis of 1975, however, the viability of a purely public hospital system withered, given the new economic climate facing the city. In its place was a new institutional form: affiliation and the public-private provision of public health care.
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Knai C, Petticrew M, Douglas N, Durand MA, Eastmure E, Nolte E, Mays N. The Public Health Responsibility Deal: Using a Systems-Level Analysis to Understand the Lack of Impact on Alcohol, Food, Physical Activity, and Workplace Health Sub-Systems. Int J Environ Res Public Health 2018; 15:ijerph15122895. [PMID: 30562999 PMCID: PMC6313377 DOI: 10.3390/ijerph15122895] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 11/16/2022]
Abstract
The extent to which government should partner with business interests such as the alcohol, food, and other industries in order to improve public health is a subject of ongoing debate. A common approach involves developing voluntary agreements with industry or allowing them to self-regulate. In England, the most recent example of this was the Public Health Responsibility Deal (RD), a public⁻private partnership launched in 2011 under the then Conservative-led coalition government. The RD was organised around a series of voluntary agreements that aim to bring together government, academic experts, and commercial, public sector and voluntary organisations to commit to pledges to undertake actions of public health benefit. This paper brings together the main findings and implications of the evaluation of the RD using a systems approach. We analysed the functioning of the RD exploring the causal pathways involved and how they helped or hindered the RD; the structures and processes; feedback loops and how they might have constrained or potentiated the effects of the RD; and how resilient the wider systems were to change (i.e., the alcohol, food, and other systems interacted with). Both the production and uptake of pledges by RD partners were largely driven by the interests of partners themselves, enabling these wider systems to resist change. This analysis demonstrates how and why the RD did not meet its objectives. The findings have lessons for the development of effective alcohol, food and other policies, for defining the role of unhealthy commodity industries, and for understanding the limits of industry self-regulation as a public health measure.
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Affiliation(s)
- Cécile Knai
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15⁻17 Tavistock Place, London WC1H 9SH, UK.
| | - Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15⁻17 Tavistock Place, London WC1H 9SH, UK.
| | - Nick Douglas
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15⁻17 Tavistock Place, London WC1H 9SH, UK.
| | - Mary Alison Durand
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15⁻17 Tavistock Place, London WC1H 9SH, UK.
| | - Elizabeth Eastmure
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15⁻17 Tavistock Place, London WC1H 9SH, UK.
| | - Ellen Nolte
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15⁻17 Tavistock Place, London WC1H 9SH, UK.
| | - Nicholas Mays
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15⁻17 Tavistock Place, London WC1H 9SH, UK.
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El Bcheraoui C, Kamath AM, Dansereau E, Palmisano EB, Schaefer A, Hernandez B, Mokdad AH. Results-based aid with lasting effects: sustainability in the Salud Mesoamérica Initiative. Global Health 2018; 14:97. [PMID: 30326928 PMCID: PMC6192274 DOI: 10.1186/s12992-018-0418-x] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 10/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Salud Mesoamérica Initiative is a public-private partnership aimed at reducing maternal and child morbidity and mortality for the poorest populations in Central America and the southernmost state of Mexico. Currently at the midpoint of implementation and with external funding expected to phase out by 2020, SMI's sustainability warrants evaluation. In this study, we examine if the major SMI components fit into the Dynamic Sustainability Framework to predict whether SMI benefits could be sustainable beyond the external funding and to identify threats to sustainability. METHODS Through the 2016 Salud Mesoamérica Initiative Process Evaluation, we applied qualitative methods including document review, key informant interviews, focus group discussions, and a social network analysis to address our objective. RESULTS SMI's design continuously evolves and aligns with national needs and objectives. Partnerships, the regional approach, and the results-based aid model create a culture that prioritizes health care. SMI's sector-wide approach and knowledge-sharing framework strengthen health systems. Evidence-based practice promotes policy dialogue and scale-up of interventions. CONCLUSION Most SMI elements fit within the Dynamic Sustainability Framework, suggesting a likelihood of sustainability after external funding ceases, and subsequent application of lessons learned by the global community. This includes a flexible design, partnerships and a culture of prioritizing healthcare, health systems strengthening mechanisms, policy changes, and scale-ups of interventions. However, threats to sustainability, including possible transient culture of prioritizing health care, dissipation of reputational risk and financial partnerships, and personnel turnover, need to be addressed.
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Affiliation(s)
- Charbel El Bcheraoui
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600, Seattle, WA 98121 USA
| | - Aruna M Kamath
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600, Seattle, WA 98121 USA
- Department of Anesthesiology, University of Washington, Seattle Children’s Hospital, Seattle, WA USA
| | - Emily Dansereau
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600, Seattle, WA 98121 USA
| | - Erin B Palmisano
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600, Seattle, WA 98121 USA
| | - Alexandra Schaefer
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600, Seattle, WA 98121 USA
| | - Bernardo Hernandez
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600, Seattle, WA 98121 USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600, Seattle, WA 98121 USA
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Suchman L, Hart E, Montagu D. Public-private partnerships in practice: collaborating to improve health finance policy in Ghana and Kenya. Health Policy Plan 2018; 33:777-785. [PMID: 29905855 PMCID: PMC6097457 DOI: 10.1093/heapol/czy053] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2018] [Indexed: 01/11/2023] Open
Abstract
Social health insurance (SHI), one mechanism for achieving universal health coverage, has become increasingly important in low- and middle-income countries (LMICs) as they work to achieve this goal. Although small private providers supply a significant proportion of healthcare in LMICs, integrating these providers into SHI systems is often challenging. Public-private partnerships in health are one way to address these challenges, but we know little about how these collaborations work, how effectively, and why. Drawing on semi-structured interviews conducted with National Health Insurance (NHI) officials in Kenya and Ghana, as well as with staff from several international NGOs (INGOs) representing social franchise networks that are partnering to increase private provider accreditation into the NHIs, this article examines one example of public-private collaboration in practice. We found that interviewees initially had incomplete knowledge about the potential for cross-sector synergy, but both sides were motivated to work together around shared goals and the potential for mutual benefit. The public-private relationship then evolved over time through regular face-to-face interactions, reciprocal feedback, and iterative workplan development. This process led to a collegial relationship that also has given small private providers more voice in the health system. In order to sustain this relationship, we recommend that both public and private sector representatives develop formalized protocols for working together, as well as less formal open channels for communication. Models for aggregating small private providers and delivering them to government programmes as a package have potential to facilitate public-private partnerships as well, but there is little evidence on how these models work in LMICs thus far.
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Affiliation(s)
- Lauren Suchman
- Institute for Global Health Sciences, University of California San Francisco, 550 16th Street, 3rd Floor Box 1224, San Francisco, USA
| | - Elizabeth Hart
- Department of Sociology University of California Davis, 1 Shields Avenue, Davis, USA
| | - Dominic Montagu
- Institute for Global Health Sciences, University of California San Francisco, 550 16th Street, 3rd Floor Box 1224, San Francisco, USA
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Abstract
Education needs for workforce development may seem to be in conflict with available resources and plans. Taking a new approach to partnership for educational affiliations can breathe new life into partnerships by focusing on shared values, proven evidence about learner needs and commitment to innovation, and cooperating in new ways. J Contin Educ Nurs. 2018;49(6):248-250.
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Allen L, Bloomfield A. Engaging the private sector to strengthen NCD prevention and control. Lancet Glob Health 2018; 4:e897-e898. [PMID: 27855861 DOI: 10.1016/s2214-109x(16)30216-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 08/12/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Luke Allen
- Consultant to the WHO Global Coordination Mechanism on NCDs, WHO, Geneva, Switzerland.
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Blackstone EA, Hakim S, Meehan B. A regional, market oriented governance for disaster management: A new planning approach. Eval Program Plann 2017; 64:57-68. [PMID: 28535428 DOI: 10.1016/j.evalprogplan.2017.05.014] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/05/2017] [Accepted: 05/10/2017] [Indexed: 06/07/2023]
Abstract
This paper proposes a regional competitive governance and management of response and recovery from disasters. It presents problems experienced in major disasters, analyzes the failures, and suggests how a competitive system that relies on private and volunteer regional leaders, personnel, and capital can improve preparation, response and recovery efforts over the existing government system. A Public Choice approach is adopted to explain why government often fails, and how regional governance may be socially more efficient than the existing federal- state-local funded and managed disaster system. The paper suggests that the federal role might change from both funding and supplying aid in disasters to merely funding disaster recovery efforts. When a disaster occurs, available businesses and government resources in the region can be utilized under a competitive system. These resources could replace existing federal and state inventories and emergency personnel. An independent regionally controlled and managed council, which also develops its own financial resources, and local volunteer leaders are key for success. The paper suggests a new planning method that utilizes the statistical Factor Analysis methodology to derive an efficient organizational and functional model to confront disasters.
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Affiliation(s)
- Erwin A Blackstone
- College of Liberal Arts, and members of the Center for Competitive Government of the Fox School, Temple University, Philadelphia, PA, USA
| | - Simon Hakim
- College of Liberal Arts, and members of the Center for Competitive Government of the Fox School, Temple University, Philadelphia, PA, USA.
| | - Brian Meehan
- Campbell School of Business, Berry College, Mt. Berry, Georgia.
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Menon DK, Kishore MT, Sivakumar T, Maulik PK, Kumar D, Lakhan R, Banerjee R. The National Trust: A viable model of care for adults with intellectual disabilities in India. J Intellect Disabil 2017; 21:259-269. [PMID: 28812964 DOI: 10.1177/1744629517709832] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The longevity of people with intellectual disabilities is increasing in developing nations. However, developing nations lack a proper system of care for aging persons with intellectual disabilities. Until now the care has been provided by parents and relatives in the home environment in developing countries, but this scenario is also changing; therefore, there is a strong need to explore a plan of care for this population which is also feasible and replicable. The National Trust is an autonomous body of the Government of India which has developed a comprehensive plan of care for adults with intellectual disabilities. In this article, the National Trust is discussed using a socioecological model. The replicability and suitability of this model for other developing countries are discussed.
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Affiliation(s)
| | | | - T Sivakumar
- National Institute of Mental Health and Neuroscience, India
| | - Pallab K Maulik
- The George Institute for Global Health, India; Oxford University, UK
| | - Devvarta Kumar
- National Institute of Mental Health and Neuroscience, India
| | | | - Ruma Banerjee
- State Nodal Agency Centre-Karnataka Chapter, Bangalore
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Kostyak L, Shaw DM, Elger B, Annaheim B. A means of improving public health in low- and middle-income countries? Benefits and challenges of international public-private partnerships. Public Health 2017; 149:120-129. [PMID: 28595064 DOI: 10.1016/j.puhe.2017.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 02/08/2017] [Accepted: 03/09/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE In the last two decades international public-private partnerships have become increasingly important to improving public health in low- and middle-income countries. Governments realize that involving the private sector in projects for financing, innovation, development, and distribution can make a valuable contribution to overcoming major health challenges. Private-public partnerships for health can generate numerous benefits but may also raise some concerns. To guide best practice for public-private partnerships for health to maximize benefits and minimize risks, the first step is to identify potential benefits, challenges, and motives. We define motives as the reasons why private partners enter partnerships with a public partner. STUDY DESIGN We conducted a systematic review of the literature using the PRISMA guidelines. METHOD We reviewed the literature on the benefits and challenges of public-private partnerships for health in low- and middle-income countries provided by international pharmaceutical companies and other health-related companies. We provide a description of these benefits, challenges, as well as of motives of private partners to join partnerships. An approach of systematic categorization was used to conduct this research. RESULT We identified six potential benefits, seven challenges, and three motives. Our main finding was a significant gap in the available academic literature on this subject. Further empirical research using both qualitative and quantitative approaches is required. From the limited information that is readily available, we conclude that public-private partnerships for health imply several benefits but with some noticeable and crucial limitations. CONCLUSION In this article, we provide a description of these benefits and challenges, discuss key themes, and conclude that empirical research is required to determine the full extent of the challenges addressed in the literature.
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Affiliation(s)
- L Kostyak
- Institute for Biomedical Ethics, University of Basel, Spalenring 73, CH-4055, Basel, Switzerland.
| | - D M Shaw
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, CH-4056, Basel, Switzerland.
| | - B Elger
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, CH-4056, Basel, Switzerland.
| | - B Annaheim
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, CH-4056, Basel, Switzerland.
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Wadge H, Roy R, Sripathy A, Fontana G, Marti J, Darzi A. How to harness the private sector for universal health coverage. Lancet 2017; 390:e19-e20. [PMID: 28651883 DOI: 10.1016/s0140-6736(17)31718-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 06/19/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Hester Wadge
- Institute of Global Health Innovation, Imperial College London, St Mary's Hospital, London W2 1NY, UK
| | - Rhia Roy
- Institute of Global Health Innovation, Imperial College London, St Mary's Hospital, London W2 1NY, UK
| | - Arthika Sripathy
- Institute of Global Health Innovation, Imperial College London, St Mary's Hospital, London W2 1NY, UK
| | - Gianluca Fontana
- Institute of Global Health Innovation, Imperial College London, St Mary's Hospital, London W2 1NY, UK
| | - Joachim Marti
- Institute of Global Health Innovation, Imperial College London, St Mary's Hospital, London W2 1NY, UK
| | - Ara Darzi
- Institute of Global Health Innovation, Imperial College London, St Mary's Hospital, London W2 1NY, UK.
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Young ME, Wallace SP, Bonilla A, Pourat N, Rodriguez M. Partnership Strategies of Community Health Centers: Building Capacity in Good Times and Bad. Policy Brief UCLA Cent Health Policy Res 2017:1-8. [PMID: 28806038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Federally Qualified Health Centers--commonly referred to as Community Health Centers (CHCs)--serve as critical safety net providers for those who are uninsured or who may become uninsured. This policy brief reports the findings from the Remaining Uninsured Access to Community Health Centers (REACH) research project, which sought to identify the impact of the Affordable Care Act (ACA) on the ability of CHCs to serve the remaining uninsured. We examined strategies undertaken by CHCs in four states to reinforce the local safety net through partnerships, improvements to the local health system, and advocacy. With the uncertainties about whether Medicaid expansion will be continued or will be handed over to the states with limited oversight, partnerships both among CHCs and between CHCs and others in the health care system and beyond may become even more important.
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Balakrishnan VS. Ending neglected tropical diseases. Lancet Infect Dis 2017; 17:584-585. [PMID: 28555584 DOI: 10.1016/s1473-3099(17)30253-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Affiliation(s)
- Diana J Mason
- Diana J. Mason, PhD, RN, Professor Emerita and Co-Director, Center for Health, Media & Policy at Hunter College, City University of New York; and Senior Policy Service Professor, George Washington University School of Nursing. She is the immediate past president of the American Academy of Nursing
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Hockley J, Harrison JK, Watson J, Randall M, Murray S. Fixing the broken image of care homes, could a 'care home innovation centre' be the answer? Age Ageing 2017; 46:175-178. [PMID: 27609210 DOI: 10.1093/ageing/afw154] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 08/01/2016] [Indexed: 11/13/2022] Open
Abstract
The UK has many excellent care homes that provide high-quality care for their residents; however, across the care home sector, there is a significant need for improvement. Even though the majority of care homes receive a rating of 'good' from regulators, still significant numbers are identified as requiring 'improvement' or are 'inadequate'. Such findings resonate with the public perceptions of long-term care as a negative choice, to be avoided wherever possible-as well as impacting on the career choices of health and social care students. Projections of current demographics highlight that, within 10 years, the part of our population that will be growing the fastest will be those people older than 80 years old with the suggestion that spending on long-term care provision needs to rise from 0.6% of our Gross Domestic Product in 2002 to 0.96% by 2031. Teaching/research-based care homes have been developed in the USA, Canada, Norway, the Netherlands and Australia in response to scandals about care, and the shortage of trained geriatric healthcare staff. There is increasing evidence that such facilities help to reduce inappropriate hospital admissions, increase staff competency and bring increased enthusiasm about working in care homes and improve the quality of care. Is this something that the UK should think of developing? This commentary details the core goals of a Care Home Innovation Centre for training and research as a radical vision to change the culture and image of care homes, and help address this huge public health issue we face.
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Affiliation(s)
- Jo Hockley
- Usher Institute of Population Health Sciences and Informatics, Primary Palliative Care Research Group, Medical School, Edinburgh EH8 9AG, UK
| | - Jennifer Kirsty Harrison
- Alzheimer Scotland Dementia Research Centre & Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | | | | | - Scott Murray
- Usher Institute of Population Health Sciences and Informatics, Primary Palliative Care Research Group, Medical School, Edinburgh EH8 9AG, UK
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Jdidi J, Mejdoub Y, Yaich S, Ben Ayed H, Kassis M, Fki H, Ayadi I, Damak J. Private public partnership: a solution for the development of health system in Tunisia. Tunis Med 2017; 95:160-167. [PMID: 29446808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In a context of economic difficulties, the Tunisian government is required to find solutions to meet the expectations of the population. Health sector is one of the critical areas requiring radical reform. The objective of this paper is to find the place of public private partnership project in the harmonious development of both public and private sectors in Tunisia. Indeed, the Tunisian health system consists of two main sectors: the public sector, and the private sector, booming since the 90s. Tunisian infrastructure and staff resources distribution is characterised by a very significant regional disparity, to the detriment of the interior regions, which is more pronounced in the private sector. This area, considered innovative and responsive, captures the local wealthy clientele, and the foreign highly specialized care seekers. It wins over the best healthcare providers, inspite of some reported claims against pricing abuses leading to user's lack of confidence. As for the public sector under funded, handicapped by red tape and some forms of lack of transparency and lobbying, it can not cope with the influx of customers of poor and middle classes. The relationship between the two sectors misses often. The current challenge in the Tunisian health sector is how can public and private sectors combine and harmonize their efforts to achieve common interest objectives. The public-private partnership, is a process helping the state to involve private investors in the realization of public interest projects and develop long term contracts. So, the two sectors will share resources and technical expertise and will access to further advantages. However, it is essential to establish clear and effective legal and institutional frameworks governing private participation in the public sector.
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Abstract
The vaginal route is increasingly being considered for both local and systemic delivery of drugs, especially those unsuitable for oral administration. One of the opportunities offered by this route but yet to be fully utilised is the administration of microbicides. Microbicides have an unprecedented potential for mitigating the global burden from HIV infection as heterosexual contact accounts for most of the new infections occurring in sub-Saharan Africa, the region with the highest prevalent rates. Decades of efforts and massive investment of resources into developing an ideal microbicide have resulted in disappointing outcomes, as attested by several clinical trials assessing the suitability of those formulated so far. The highly complex and multi-level biochemical interactions that must occur among the virus, host cells and the drug for transmission to be halted means that a less sophisticated approach to formulating a microbicide e.g. conventional gels, etc may have to give way for a different formulation approach. Nanotechnology has been identified to offer prospects for fabricating structures with high capability of disrupting HIV transmission. In this review, predominant challenges seen in microbicide development have been highlighted and possible ways of surmounting them suggested. Furthermore, formulations utilising some of these highly promising nanostructures such as liposomes, nanofibres and nanoparticles have been discussed. A perspective on how a tripartite collaboration among governments and their agencies, the pharmaceutical industry and academic scientists to facilitate the development of an ideal microbicide in a timely manner has also been briefly deliberated.
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Affiliation(s)
- Francis Brako
- Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK. University College London, School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK
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Balamurugan A, Adolph S, Faramawi M, George M, Zohoori N, Delongchamp R. Community Team-Based Care for Hypertension Management: A Public-Private Partnership in Rural Arkansas. J Ark Med Soc 2017; 113:150-154. [PMID: 30085459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Hypertension is a major public health problem in Arkansas. Team-based care (TBC), delivered by health care professionals such as a nurse, dietician, social worker, or community health worker rather than a physician alone, has been shown to improve blood pressure control.
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Paradis G, Hamelin AM, Malowany M, Levy J, Rossignol M, Bergeron P, Kishchuk N. The University-Public Health Partnership for Public Health Research Training in Quebec, Canada. Am J Public Health 2017; 107:100-104. [PMID: 27854518 PMCID: PMC5308173 DOI: 10.2105/ajph.2016.303529] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2016] [Indexed: 11/04/2022]
Abstract
Enhancing effective preventive interventions to address contemporary public health problems requires improved capacity for applied public health research. A particular need has been recognized for capacity development in population health intervention research to address the complex multidisciplinary challenges of developing, implementing, and evaluating public health practices, intervention programs, and policies. Research training programs need to adapt to these new realities. We have presented an example of a 2003 to 2015 training program in transdisciplinary research on public health interventions that embedded doctoral and postdoctoral trainees in public health organizations in Quebec, Canada. This university-public health partnership for research training is an example of how to link science and practice to meet emerging needs in public health.
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Affiliation(s)
- Gilles Paradis
- Gilles Paradis, Anne-Marie Hamelin, and Michel Rossignol are with the Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. Gilles Paradis and Pierre Bergeron are with the Institut national de santé publique du Québec, Montreal Quebec. Maureen Malowany is with the Braun School of Public Health & Community Medicine, Hebrew University of Jerusalem-Hadassah, Jerusalem, Israel. Joseph Levy is with the Département de sexologie, Université du Québec, Montreal. Natalie Kishchuk is with Program Evaluation and Beyond Inc., Montreal
| | - Anne-Marie Hamelin
- Gilles Paradis, Anne-Marie Hamelin, and Michel Rossignol are with the Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. Gilles Paradis and Pierre Bergeron are with the Institut national de santé publique du Québec, Montreal Quebec. Maureen Malowany is with the Braun School of Public Health & Community Medicine, Hebrew University of Jerusalem-Hadassah, Jerusalem, Israel. Joseph Levy is with the Département de sexologie, Université du Québec, Montreal. Natalie Kishchuk is with Program Evaluation and Beyond Inc., Montreal
| | - Maureen Malowany
- Gilles Paradis, Anne-Marie Hamelin, and Michel Rossignol are with the Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. Gilles Paradis and Pierre Bergeron are with the Institut national de santé publique du Québec, Montreal Quebec. Maureen Malowany is with the Braun School of Public Health & Community Medicine, Hebrew University of Jerusalem-Hadassah, Jerusalem, Israel. Joseph Levy is with the Département de sexologie, Université du Québec, Montreal. Natalie Kishchuk is with Program Evaluation and Beyond Inc., Montreal
| | - Joseph Levy
- Gilles Paradis, Anne-Marie Hamelin, and Michel Rossignol are with the Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. Gilles Paradis and Pierre Bergeron are with the Institut national de santé publique du Québec, Montreal Quebec. Maureen Malowany is with the Braun School of Public Health & Community Medicine, Hebrew University of Jerusalem-Hadassah, Jerusalem, Israel. Joseph Levy is with the Département de sexologie, Université du Québec, Montreal. Natalie Kishchuk is with Program Evaluation and Beyond Inc., Montreal
| | - Michel Rossignol
- Gilles Paradis, Anne-Marie Hamelin, and Michel Rossignol are with the Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. Gilles Paradis and Pierre Bergeron are with the Institut national de santé publique du Québec, Montreal Quebec. Maureen Malowany is with the Braun School of Public Health & Community Medicine, Hebrew University of Jerusalem-Hadassah, Jerusalem, Israel. Joseph Levy is with the Département de sexologie, Université du Québec, Montreal. Natalie Kishchuk is with Program Evaluation and Beyond Inc., Montreal
| | - Pierre Bergeron
- Gilles Paradis, Anne-Marie Hamelin, and Michel Rossignol are with the Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. Gilles Paradis and Pierre Bergeron are with the Institut national de santé publique du Québec, Montreal Quebec. Maureen Malowany is with the Braun School of Public Health & Community Medicine, Hebrew University of Jerusalem-Hadassah, Jerusalem, Israel. Joseph Levy is with the Département de sexologie, Université du Québec, Montreal. Natalie Kishchuk is with Program Evaluation and Beyond Inc., Montreal
| | - Natalie Kishchuk
- Gilles Paradis, Anne-Marie Hamelin, and Michel Rossignol are with the Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. Gilles Paradis and Pierre Bergeron are with the Institut national de santé publique du Québec, Montreal Quebec. Maureen Malowany is with the Braun School of Public Health & Community Medicine, Hebrew University of Jerusalem-Hadassah, Jerusalem, Israel. Joseph Levy is with the Département de sexologie, Université du Québec, Montreal. Natalie Kishchuk is with Program Evaluation and Beyond Inc., Montreal
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Narayana MR. India's Proposed Universal Health Coverage Policy: Evidence for Age Structure Transition Effect and Fiscal Sustainability. Appl Health Econ Health Policy 2016; 14:673-690. [PMID: 27541279 DOI: 10.1007/s40258-016-0270-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND India's High Level Expert Group on Universal Health Coverage in 2011 recommended a universal, public-funded and national health coverage policy. As a plausible forward-looking macroeconomic reform in the health sector, this policy proposal on universal health coverage (UHC) needs to be evaluated for age structure transition effect and fiscal sustainability to strengthen its current design and future implementation. OBJECTIVE Macroeconomic analyses of the long-term implications of age structure transition and fiscal sustainability on India's proposed UHC policy. METHODS A new measure of age-specific UHC is developed by combining the age profile of public and private health consumption expenditure by using the National Transfer Accounts methodology. Different projections of age-specific public health expenditure are calculated over the period 2005-2100 to account for the age structure transition effect. The projections include changes in: (1) levels of the expenditure as gross domestic product grows, (2) levels and shape of the expenditure as gross domestic product grows and expenditure converges to that of developed countries (or convergence scenario) based on the Lee-Carter model of forecasting mortality rates, and (3) levels of the expenditure as India moves toward a UHC policy. Fiscal sustainability under each health expenditure projection is determined by using the measures of generational imbalance and sustainability gap in the Generational Accounting methodology. RESULTS Public health expenditure is marked by age specificities and the elderly population is costlier to support for their healthcare needs in the future. Given the discount and productivity growth rates, the proposed UHC is not fiscally sustainable under India's current fiscal policies except for the convergence scenario. However, if the income elasticity of public expenditure on social welfare and health expenditure is less than one, fiscal sustainability of the UHC policy is attainable in all scenarios of projected public health expenditures. These new results strengthen the proposed UHC policy by accounting for age structure transition effect and justifying its sustainability within the framework of India's current fiscal policies. CONCLUSION The age structure transition effect is important to incorporate the age-specific cost and benefit of the proposed UHC policy, especially as India moves toward an ageing society. Fiscal sustainability is essential to ensure that the proposed UHC is implementable on a long-term basis and within the framework of current fiscal policies.
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Affiliation(s)
- Muttur Ranganathan Narayana
- Centre for Economic Studies and Policy, Institute for Social and Economic Change, Nagarabhavi P.O., Bengaluru, 560072, Karnataka, India.
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Bazzoli GJ, Casey E, Alexander JA, Conrad DA, Shortell SM, Sofaer S, Hasnain-Wynia R, Zukoski AP. Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships. Med Care Res Rev 2016; 60:63S-94S. [PMID: 14687430 DOI: 10.1177/1077558703259082] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Amajor challenge facing a community partnership is the implementation of its collaborative initiatives. This article examines the progress Community Care Networks (CCNs) made in implementing their initiatives and factors that helped or hindered their progress. Study findings suggest that partnership progress is affected by external market and regulatory factors beyond the control of the partnership, the availability of local community resources to support efforts, the scope and intensity of tasks associated with an initiative, expansion of the partnership to include new members, and the balance of work between partners and paid partnership staff. Implications of study findings for community partnerships include (1) recognizing and anticipating dependency on others, (2) acknowledging that the tasks that lie ahead will be more complicated than imagined, (3) maintaining focus on priorities, and (4) learning to be adaptive and creative, given a constantly changing environment.
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Stanhope SJ, Wilken JM, Pruziner AL, Dearth CL, Wyatt M, Ziemke GW, Strickland R, Milbourne SA, Kaufman KR. The Bridging Advanced Developments for Exceptional Rehabilitation (BADER) Consortium: Reaching in Partnership for Optimal Orthopaedic Rehabilitation Outcomes. Mil Med 2016; 181:13-19. [PMID: 27849456 PMCID: PMC5580819 DOI: 10.7205/milmed-d-15-00501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The Bridging Advanced Developments for Exceptional Rehabilitation (BADER) Consortium began in September 2011 as a cooperative agreement with the Department of Defense (DoD) Congressionally Directed Medical Research Programs Peer Reviewed Orthopaedic Research Program. A partnership was formed with DoD Military Treatment Facilities (MTFs), U.S. Department of Veterans Affairs (VA) Centers, the National Institutes of Health (NIH), academia, and industry to rapidly conduct innovative, high-impact, and sustainable clinically relevant research. The BADER Consortium has a unique research capacity-building focus that creates infrastructures and strategically connects and supports research teams to conduct multiteam research initiatives primarily led by MTF and VA investigators.BADER relies on strong partnerships with these agencies to strengthen and support orthopaedic rehabilitation research. Its focus is on the rapid forming and execution of projects focused on obtaining optimal functional outcomes for patients with limb loss and limb injuries. The Consortium is based on an NIH research capacity-building model that comprises essential research support components that are anchored by a set of BADER-funded and initiative-launching studies. Through a partnership with the DoD/VA Extremity Trauma and Amputation Center of Excellence, the BADER Consortium's research initiative-launching program has directly supported the identification and establishment of eight BADER-funded clinical studies. BADER's Clinical Research Core (CRC) staff, who are embedded within each of the MTFs, have supported an additional 37 non-BADER Consortium-funded projects. Additional key research support infrastructures that expedite the process for conducting multisite clinical trials include an omnibus Cooperative Research and Development Agreement and the NIH Clinical Trials Database. A 2015 Defense Health Board report highlighted the Consortium's vital role, stating the research capabilities of the DoD Advanced Rehabilitation Centers are significantly enhanced and facilitated by the BADER Consortium.
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Affiliation(s)
| | - Jason M Wilken
- Center for the Intrepid, Department of Rehabilitation Medicine, Brooke Army Medical Center, 3551 Roger Brooke Drive, Joint Base San Antonio, Fort Sam Houston, TX 78234
| | - Alison L Pruziner
- Extremity Trauma and Amputation Center of Excellence, 2748 Worth Road, Suite 29 Fort Sam Houston, TX 78234
| | - Christopher L Dearth
- Extremity Trauma and Amputation Center of Excellence, 2748 Worth Road, Suite 29 Fort Sam Houston, TX 78234
| | - Marilynn Wyatt
- Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134
| | - Gregg W Ziemke
- Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23708
| | | | - Suzanne A Milbourne
- Center for Disabilities Studies, University of Delaware, 540 Wyoming Road, Newark, DE 19716
| | - Kenton R Kaufman
- Biomedical Engineering, Mayo Clinic, 200 First St. SW, Rochester, MN 55905
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Affiliation(s)
- Mark B McClellan
- Duke-Robert J. Margolis Center for Health Policy, Duke University, Durham, North Carolina
| | - Mike O Leavitt
- Former United States Secretary of Health and Human Services, Washington, DC3Leavitt Partners, Salt Lake City, Utah
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Affiliation(s)
- Steven E Hyman
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Story C Landis
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland (retired)
| | - Alan I Leshner
- American Association for the Advancement of Science, Potomac, Maryland (retired)
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Storeng KT, Béhague DP. "Lives in the balance": The politics of integration in the Partnership for Maternal, Newborn and Child Health. Health Policy Plan 2016; 31:992-1000. [PMID: 27106911 PMCID: PMC5013778 DOI: 10.1093/heapol/czw023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2016] [Indexed: 01/07/2023] Open
Abstract
A decade ago, the Partnership for Maternal, Newborn and Child Health (PMNCH) was established to combat the growing fragmentation of global health action into uncoordinated, issue-specific efforts. Inspired by dominant global public-private partnerships for health, the PMNCH brought together previously competing advocacy coalitions for safe motherhood and child survival and attracted support from major donors, foundations and professional bodies. Today, its founders highlight its achievements in generating priority for 'MNCH', encouraging integrated health systems thinking and demonstrating the value of collaboration in global health endeavours. Against this dominant discourse on the success of the PMNCH, this article shows that rhetoric in support of partnership and integration often masks continued structural drivers and political dynamics that bias the global health field towards vertical goals. Drawing on ethnographic research, this article examines the Safe Motherhood Initiative's evolution into the PMNCH as a response to the competitive forces shaping the current global health field. Despite many successes, the PMNCH has struggled to resolve historically entrenched programmatic and ideological divisions between the maternal and child health advocacy coalitions. For the Safe Motherhood Initiative, the cost of operating within an extremely competitive policy arena has involved a partial renouncement of ambitions to broader social transformations in favour of narrower, but feasible and 'sellable' interventions. A widespread perception that maternal health remains subordinated to child health even within the Partnership has elicited self-protective responses from the safe motherhood contingent. Ironically, however, such responses may accentuate the kind of fragmentation to global health governance, financing and policy solutions that the Partnership was intended to challenge. The article contributes to the emerging critical ethnographic literature on global health initiatives by highlighting how integration may only be possible with a more radical conceptualization of global health governance.
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Affiliation(s)
- Katerini T Storeng
- Centre for Development and the Environment, University of Oslo, Oslo, Norway London School of Hygiene & Tropical Medicine, London, UK
| | - Dominique P Béhague
- The Center for Medicine, Health and Society, Vanderbilt University, USA Department of Social Science, Health and Medicine, Kings College London, London, UK London School of Hygiene & Tropical Medicine, London, UK
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Abstract
BACKGROUND The advent of global health initiatives (GHIs) has changed the landscape and architecture of health financing in low and middle income countries, particularly in Africa. Over the last decade, the African Region has realised improvements in health outcomes as a result of interventions implemented by both governments and development partners. However, alignment and harmonisation of partnerships and GHIs are still difficult in the African countries with inadequate capacity for their effective coordination. METHOD Both published and grey literature was reviewed to understand the governance, priorities, harmonisation and alignment of GHIs in the African Region; to synthesise the knowledge and highlight the persistent challenges; and to identify gaps for future research. RESULTS GHI governance structures are often separate from those of the countries in which they operate. Their divergent funding channels and modalities may have contributed to the failure of governments to track their resources. There is also evidence that basically, earmarking and donor conditions drive funding allocations regardless of countries' priorities. Although studies cite the lack of harmonisation of GHI priorities with national strategies, evidence shows improvements in that area over time. GHIs have used several strategies and mechanisms to involve the private sector. These have widened the pool of health service policy-makers and providers to include groups such as civil society organisations (CSOs), with both positive and negative implications. GHI strategies such as co-financing by countries as a condition for support have been positive in achieving sustainability of interventions. CONCLUSIONS GHI approaches have not changed substantially over the years but there has been evolution in terms of donor funding and conditions. GHIs still largely operate in a vertical manner, bypassing country systems; they compete for the limited human resources; they influence country policies; and they are not always harmonised with other donors. To maximise returns on GHI support, there is need to ensure that their approaches are more comprehensive as opposed to being selective; to improve GHI country level governance and alignment with countries' changing epidemiologic profiles; and to strengthen their involvement of CSOs.
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Affiliation(s)
- Aziza Mwisongo
- Health Systems and Services Cluster, World Health Organization Regional Office for Africa, B.P. 06, Brazzaville, Congo
| | - Juliet Nabyonga-Orem
- Health Systems and Services Cluster, World Health Organization Regional Office for Africa, B.P. 06, Brazzaville, Congo
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