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Sample records for africa public health

  1. Training opportunities for public health in South Africa.

    PubMed

    Shisana, O

    1994-03-01

    South Africa has 4 public health training institutions: the Transvaal School of Public Health, the Public Health Programme of the University of the Western Cape, the Natal Institute of Community Health Education, and the Eastern Cape School of Public Health. They are interinstitutional (universities, polytechnic schools, health service providers, statutory research councils, and nongovernmental organizations). A steering committee heads up each institution. One person leads the committee, managing all activities and making sure that all activities fulfill the requirements of the steering committee. The Epidemiological Society of Southern Africa also contributes to public health training through its annual forum for public health researchers and meetings of public health personnel, where they talk about public health training needs. Interest in public health training reemerged in the late 1980s, mainly due to the dismantling of apartheid, which called for a restructuring of the public health service. Primary health care is the focus of all South Africa's public health institutions. Courses convey community-oriented approaches in the design of health programs and research. They use a multidisciplinary approach to education. They examine socioeconomic conditions affecting health as well as the biomedical aspects of public health. The Transvaal School of Public Health targets post-basic and post-graduate health staff at the middle or senior level positions. On the other hand, the Eastern Cape School of Public Health targets field workers, primary health care workers, and public health professionals. Currently, the programs only provide a Master of Public Health. As South Africa makes its way to democracy and with adequate funding, public health training in South Africa will result in positive efforts helping all of Africa.

  2. Generating public awareness in Africa. Advocacy for reproductive health: Africa.

    PubMed

    Nyong'o, D

    1996-01-01

    In 1995 the IPPF Africa Region undertook advocacy missions to six countries in the region to sensitize national leaders about family planning (FP). This mission was governed by the six challenges laid down in the IPPF's strategic plan, Vision 2000, and the program of action of the International Conference on Population and Development (ICPD) held in Cairo in 1994. In Ethiopia, Kenya, and Tanzania the concerns were adolescent sexuality, family life education, and services to youth. In Uganda unsafe abortion; while in the Central African Republic and Guinea sexual and reproductive health, unsafe abortion, the sexuality of youth, and the empowerment of women were the main issues. Documentation packages prepared for the mission included annual reports, periodicals, conference reports, booklets, and position papers. The target audiences were political leaders, national, regional, and international organizations, religious, educational, and media leaders, and the public. Press conferences were organized and lobbying was conducted with national family planning associations to strengthen networking and coalition building. In Ethiopia the IPPF president's visit pertained to the sexuality of young people. In Kenya the mission coincided with the controversy of introducing family life education in primary schools. A seminar in Nairobi brought together 100 influential people who came to an agreement on the necessity of such education. In Tanzania the advocacy team crusaded for reproductive health services for young people. The country's president fully supported FP activities even allowing the use of hospitals and health centers for the distribution of contraceptives. There was a visit to a teenage mothers' center providing vocational training and reproductive health counseling in Dar es Salaam. In Uganda UNFPA, USAID, and national family planning association representatives met to forge closer working relations and examine the issue of tax exemption for imported contraceptives

  3. The health and health system of South Africa: historical roots of current public health challenges.

    PubMed

    Coovadia, Hoosen; Jewkes, Rachel; Barron, Peter; Sanders, David; McIntyre, Diane

    2009-09-05

    The roots of a dysfunctional health system and the collision of the epidemics of communicable and non-communicable diseases in South Africa can be found in policies from periods of the country's history, from colonial subjugation, apartheid dispossession, to the post-apartheid period. Racial and gender discrimination, the migrant labour system, the destruction of family life, vast income inequalities, and extreme violence have all formed part of South Africa's troubled past, and all have inexorably affected health and health services. In 1994, when apartheid ended, the health system faced massive challenges, many of which still persist. Macroeconomic policies, fostering growth rather than redistribution, contributed to the persistence of economic disparities between races despite a large expansion in social grants. The public health system has been transformed into an integrated, comprehensive national service, but failures in leadership and stewardship and weak management have led to inadequate implementation of what are often good policies. Pivotal facets of primary health care are not in place and there is a substantial human resources crisis facing the health sector. The HIV epidemic has contributed to and accelerated these challenges. All of these factors need to be addressed by the new government if health is to be improved and the Millennium Development Goals achieved in South Africa.

  4. Sexual minorities, human rights and public health strategies in Africa.

    PubMed

    Epprecht, Marc

    2012-01-01

    Remarkable progress has been made towards the recognition of sexual minority rights in Africa. At the same time, a marked increase in attacks, rhetorical abuse, and restrictive legislation against sexual minorities or ‘homosexuality’ makes activism for sexual rights a risky endeavour in many African countries. Campaigns for sexual rights and ‘coming out’ are frequently perceived as a form of Western cultural imperialism, leading to an exportation of Western gay identities and provoking a patriotic defensiveness. Cultures of quiet acceptance of same-sex relationships or secretive bisexuality are meanwhile also problematic given the high rate of HIV prevalence on much of the continent. This article examines specific initiatives that are using subtle, somewhat covert means to negotiate a path between rights activism and secretive bisexuality. It argues that strategies primarily focused on health concerns that simultaneously yet discreetly promote sexual rights are having some success in challenging prevalent homophobic or ‘silencing’ cultures and discourses.

  5. Public health systems strengthening in Africa: the role of South Africa Field Epidemiology and Laboratory Training Programme.

    PubMed

    Kuonza, Lazarus; Tint, Khin San; Harris, Bernice; Nabukenya, Immaculate

    2011-01-01

    The South Africa Field Epidemiology and Laboratory Training Programme (SAFELTP) was created in 2006 after recognizing the need to build and sustain the country's human resource capacity in field (applied) epidemiology and public health practice. The programme was formed as a collaboration between the South Africa Department of Health (DoH), the National Institute for Communicable Diseases (NICD), the National Health Laboratory Services (NHLS), the US Centers for Disease Control and Prevention (CDC) and the University of Pretoria. The primary goal of the programme was to produce field-trained epidemiologists equipped with knowledge and practical skills to effectively and efficiently address the public health priorities of South Africa. SAFELTP is a 2-year full-time training, consisting of a combination of classroom-based instruction (30%) and mentored field work (70%). The training places emphasis on public health surveillance, investigation of disease epidemics, public health laboratory practice and communication of epidemiologic information, among other aspects of epidemiology research. At completion, residents are awarded a Master of Public Health (MPH) degree from the University of Pretoria. Since its inception in 2006, 48 residents have enrolled onto the programme and 30 (62%) of them have completed the training. Over the past 5 years, the residents have conducted more than 92 outbreak investigations, 47 surveillance evaluations, 19 planned studies, analyzed 37 large databases and presented more than 56 papers at local and international conferences. In recognition of the high-quality work, at least five SAFELTP residents have received awards at various international scientific conferences during the 5 years. In conclusion, the South Africa FELTP is now fully established and making valuable contributions to the country's public health system, albeit with innumerable challenges.

  6. The Implications of the Developmental Origins of Health and Disease on Public Health Policy and Health Promotion in South Africa

    PubMed Central

    Reddy, Sasiragha Priscilla; Mbewu, Anthony David

    2016-01-01

    The developmental origins of health and disease (DOHaD) hypothesis states that environmental influences in utero and in early life can determine health and disease in later life through the programming of genes and/or altered gene expression. The DOHaD is likely to have had an effect in South Africa during the fifty years of apartheid; and during the twenty years since the dawn of democracy in 1994. This has profound implications for public health and health promotion policies in South Africa, a country experiencing increased prevalence of noncommunicable diseases (NCDs) and risk factors and behaviours for NCDs due to rapid social and economic transition, and because of the DOHaD. Public health policy and health promotion interventions, such as those introduced by the South African Government over the past 20 years, were designed to improve the health of pregnant women (and their unborn children). They could in addition, through the DOHaD mechanism, reduce NCDs and their risk factors in their offspring in later life. The quality of public health data over the past 40 years in South Africa precludes the possibility of proving the DOHaD hypothesis in that context. Nevertheless, public health and health promotion policies need to be strengthened, if South Africa and other low and middle income countries (LMICs) are to avoid the very high prevalence of NCDs seen in Europe and North America in the 50 years following the Second World War, as a result of socio economic transition and the DOHaD. PMID:27834861

  7. The application of geographical information systems to important public health problems in Africa.

    PubMed

    Tanser, Frank C; Le Sueur, David

    2002-12-09

    Africa is generally held to be in crisis, and the quality of life for the majority of the continent's inhabitants has been declining in both relative and absolute terms. In addition, the majority of the world's disease burden is realised in Africa. Geographical information systems (GIS) technology, therefore, is a tool of great inherent potential for health research and management in Africa. The spatial modelling capacity offered by GIS is directly applicable to understanding the spatial variation of disease, and its relationship to environmental factors and the health care system. Whilst there have been numerous critiques of the application of GIS technology to developed world health problems it has been less clear whether the technology is both applicable and sustainable in an African setting. If the potential for GIS to contribute to health research and planning in Africa is to be properly evaluated then the technology must be applicable to the most pressing health problems in the continent. We briefly outline the work undertaken in HIV, malaria and tuberculosis (diseases of significant public health impact and contrasting modes of transmission), outline GIS trends relevant to Africa and describe some of the obstacles to the sustainable implementation of GIS. We discuss types of viable GIS applications and conclude with a discussion of the types of African health problems of particular relevance to the application of GIS.

  8. The implementation of public health interventions in Africa: a neglected strategic theme.

    PubMed

    Ridde, V; Olivier de Sardan, J-P

    2016-12-12

    Organizing effective public health interventions is required to improve population health and reduce social inequalities in health. However, measuring their effectiveness is not enough; we must also understand how these interventions are implemented and what role is played by the context and the social actors. Today, it seems that the importance of studying intervention implementation by public health actors (stakeholders, policy makers, donors, and researchers) has not yet been sufficiently considered. In this Tribune, we wish to draw the attention of the public health community, including that interested in interventions in Africa, to the need to analyze their implementation in depth. We must produce empirical and theoretical knowledge about implementation but also train students and young researchers more effectively in this scientific approach, which, although indispensable, has been ignored too long.

  9. Poor quality vital anti-malarials in Africa - an urgent neglected public health priority

    PubMed Central

    2011-01-01

    Background Plasmodium falciparum malaria remains a major public health problem. A vital component of malaria control rests on the availability of good quality artemisinin-derivative based combination therapy (ACT) at the correct dose. However, there are increasing reports of poor quality anti-malarials in Africa. Methods Seven collections of artemisinin derivative monotherapies, ACT and halofantrine anti-malarials of suspicious quality were collected in 2002/10 in eleven African countries and in Asia en route to Africa. Packaging, chemical composition (high performance liquid chromatography, direct ionization mass spectrometry, X-ray diffractometry, stable isotope analysis) and botanical investigations were performed. Results Counterfeit artesunate containing chloroquine, counterfeit dihydroartemisinin (DHA) containing paracetamol (acetaminophen), counterfeit DHA-piperaquine containing sildenafil, counterfeit artemether-lumefantrine containing pyrimethamine, counterfeit halofantrine containing artemisinin, and substandard/counterfeit or degraded artesunate and artesunate+amodiaquine in eight countries are described. Pollen analysis was consistent with manufacture of counterfeits in eastern Asia. These data do not allow estimation of the frequency of poor quality anti-malarials in Africa. Conclusions Criminals are producing diverse harmful anti-malarial counterfeits with important public health consequences. The presence of artesunate monotherapy, substandard and/or degraded and counterfeit medicines containing sub-therapeutic amounts of unexpected anti-malarials will engender drug resistance. With the threatening spread of artemisinin resistance to Africa, much greater investment is required to ensure the quality of ACTs and removal of artemisinin monotherapies. The International Health Regulations may need to be invoked to counter these serious public health problems. PMID:22152094

  10. Public-private interactions on health in South Africa: opportunities for scaling up.

    PubMed

    Kula, Nothemba; Fryatt, Robert J

    2014-08-01

    South Africa has long recognized partnerships between the public and private sectors as a policy objective in health, but experience is still limited and poorly documented. The objectives of this article are to understand the factors that increase the likelihood of success of public-private interactions in South Africa, and identify and discuss opportunities for them to be scaled up. There is a strong legislative framework and a number of guidelines and tools that have been developed by the Treasury for managing partnerships. The review of literature confirmed the need for the state to have effective regulations in order to oversee quality and standards and to provide stewardship and oversight. The public sector requires sufficient capacity not only to manage relationships with the private sector but also to enable innovation and experimentation. Evaluation is an integral part of all interactions not only to learn from successes but also to identify any perverse incentives that may lead to unintended consequences. Four case studies show that the private for-profit sector is already engaged in a number of projects that are closely aligned to current health system reform priorities. Factors that increase the likelihood of interactions being successful include: increasing the government's capacity to manage public-private relationships; choosing public-private interactions that are strategically important to national goals; building a knowledge base on what works, where and why; moving from pilots to large scale initiatives; harnessing the contracting expertise in private providers; and encouraging innovation and learning.

  11. Strengthening public health education in population and reproductive health through an innovative academic partnership in Africa: the Gates partners experience.

    PubMed

    Oni, Gbolahan; Fatusi, Adesegun; Tsui, Amy; Enquselassie, Fikre; Ojengbede, Oladosu; Agbenyega, Tsiri; Ojofeitimi, Ebenezer; Taulo, Frank; Quakyi, Isabella

    2011-01-01

    Poor reproductive health constitutes one of the leading public health problems in the world, particularly in sub-Saharan Africa (SSA). We report here an academic partnership that commenced in 2003 between a US institution and six universities in SSA. The partnership addresses the human resources development challenge in Africa by strengthening public health education and research capacity to improve population and reproductive health (PRH) outcomes in low-resource settings. The partnership's core activities focused on increasing access to quality education, strengthening health research capacity and translating scholarship and science into policy and practices. Partnership programmes focused on the educational dimension of the human resources equation provide students with improved learning facilities and enhanced work environments and also provide faculty with opportunities for professional development and an enhanced capacity for curriculum delivery. By 2007, 48 faculty members from the six universities in SSA attended PRH courses at Johns Hopkins University, 93 PRH courses were offered across the six universities, 625 of their master's students elected PRH concentrations and 158 had graduated. With the graduation of these and future student cohorts, the universities in SSA will systematically be expanding the number of public health practitioners and strengthening programme effectiveness to resolve reproductive health needs. Some challenges facing the partnership are described in this article.

  12. Public health professionals’ perceptions of mental health services in Equatorial Guinea, Central-West Africa

    PubMed Central

    Reuter, Peter Robert; McGinnis, Shannon Marcail; Reuter, Kim Eleanor

    2016-01-01

    Introduction Mental health disorders constitute 13% of global disease burden, the impacts of which are disproportionality felt in sub-Saharan Africa. Equatorial Guinea, located in Central-West Africa, has the highest per-capita investment in healthcare on the African continent, but only two studies have discussed mental health issues in the country and none of have examined the perspective of professionals working in the field. The purpose of this study was to gain a preliminary understanding of Equatoguinean health care professionals' perspectives on the mental health care system. Methods Nine adult participants (directors or program managers) were interviewed in July 2013 in Malabo, Equatorial Guinea from government agencies, aid organizations, hospitals, and pharmacies. Interviews were designed to collect broad information about the mental healthcare system in Equatorial Guinea including the professionals' perspectives and access to resources. This research was reviewed and approved by an ethical oversight committee. Results All individuals interviewed indicated that the mental health system does not currently meet the needs of the community. Professionals cited infrastructural capacity, stigmatization, and a lack of other resources (training programs, knowledgeable staff, medications, data) as key factors that limit the effectiveness of mental healthcare. Conclusion This study provides a preliminary understanding of the existing mental health care needs in the country, highlighting opportunities for enhanced healthcare services. PMID:28293352

  13. Public policies and health systems in Sahelian Africa: theoretical context and empirical specificity

    PubMed Central

    2015-01-01

    This research on user fee removal in three African countries is located at the interface of public policy analysis and health systems research. Public policy analysis has gradually become a vast and multifaceted area of research consisting of a number of perspectives. But the context of public policies in Sahelian Africa has some specific characteristics. They are largely shaped by international institutions and development agencies, on the basis of very common 'one-size-fits-all' models; the practical norms that govern the actual behaviour of employees are far removed from official norms; public goods and services are co-delivered by a string of different actors and institutions, with little coordination between them; the State is widely regarded by the majority of citizens as untrustworthy. In such a context, setting up and implementing health user fee exemptions in Burkina Faso, Mali and Niger was beset by major problems, lack of coherence and bottlenecks that affect public policy-making and implementation in these countries. Health systems research for its part started to gain momentum less than twenty years ago and is becoming a discipline in its own right. But French-speaking African countries scarcely feature in it, and social sciences are not yet fully integrated. This special issue wants to fill the gap. In the Sahel, the bad health indicators reflect a combination of converging factors: lack of health centres, skilled staff, and resources; bad quality of care delivery, corruption, mismanagement; absence of any social security or meaningful commitment to the worst-off; growing competition from drug peddlers on one side, from private clinics on the other. Most reforms of the health system have various 'blind spots'. They do not take in account the daily reality of its functioning, its actual governance, the implicit rationales of the actors involved, and the quality of healthcare provision. In order to document the numerous neglected problems of the health

  14. Public policies and health systems in Sahelian Africa: theoretical context and empirical specificity.

    PubMed

    Olivier de Sardan, Jean-Pierre; Ridde, Valéry

    2015-01-01

    This research on user fee removal in three African countries is located at the interface of public policy analysis and health systems research. Public policy analysis has gradually become a vast and multifaceted area of research consisting of a number of perspectives. But the context of public policies in Sahelian Africa has some specific characteristics. They are largely shaped by international institutions and development agencies, on the basis of very common 'one-size-fits-all' models; the practical norms that govern the actual behaviour of employees are far removed from official norms; public goods and services are co-delivered by a string of different actors and institutions, with little coordination between them; the State is widely regarded by the majority of citizens as untrustworthy. In such a context, setting up and implementing health user fee exemptions in Burkina Faso, Mali and Niger was beset by major problems, lack of coherence and bottlenecks that affect public policy-making and implementation in these countries.

  15. Urban effluent discharges as causes of public and environmental health concerns in South Africa's aquatic milieu.

    PubMed

    Sibanda, Timothy; Selvarajan, Ramganesh; Tekere, Memory

    2015-12-01

    The water quality in South Africa's river systems is rapidly deteriorating as a consequence of increased discharge of wastewater effluents. The natural ability of rivers and reservoirs to trap toxic chemicals and nutrients in their sediments enables these systems to accumulate contaminants, altering the natural balance in environmental water quality, thereby raising a plethora of public and environmental health concerns. Impaired water quality has been linked to an array of problems in South Africa including massive fish mortalities, altered habitat template leading to the thinning of riverine macroinvertebrate diversity, shifts in microbial community structures with drastic ecological consequences and evolvement of antibiotic resistance genes that, under natural conditions, can be transferred to waterborne pathogens. Urban wastewater discharge has also been implicated in increased bioaccumulation of metals in edible plant parts, elevated concentrations of endocrine-disrupting compounds (EDCs), which are blamed for reduced fertility and increased cancer risk, excessive growth of toxic cyanobacteria and an increase in concentrations of pathogenic microorganisms which constitute a potential health threat to humans. However, despite the ecotoxicological hazards posed by wastewater effluents, ecotoxicological studies are currently underutilised in South African aquatic ecosystem assessments, and where they have been done, the observation is that ecotoxicological studies are mostly experimental and restricted to small study areas. More research is still needed to fully assess especially the ecotoxicological consequences of surface water pollution by urban wastewater effluents in South Africa. A review of the effects of urban effluent discharges that include domestic effluent mixed with industrial effluent and/or urban stormwater run-off is hereby presented.

  16. Mobile Phone-Based mHealth Approaches for Public Health Surveillance in Sub-Saharan Africa: A Systematic Review

    PubMed Central

    Brinkel, Johanna; Krämer, Alexander; Krumkamp, Ralf; May, Jürgen; Fobil, Julius

    2014-01-01

    Whereas mobile phone-based surveillance has the potential to provide real-time validated data for disease clustering and prompt respond and investigation, little evidence is available on current practice in sub-Sahara Africa. The objective of this review was to examine mobile phone-based mHealth interventions for Public Health surveillance in the region. We conducted electronic search in MEDLINE, EMBASE, IEE Xplore, African Index Medicus (AIM), BioMed Central, PubMed Central (PMC), the Public Library of Science (PLoS) and IRIS for publications used in the review. In all, a total of nine studies were included which focused on infectious disease surveillance of malaria (n = 3), tuberculosis (n = 1) and influenza-like illnesses (n = 1) as well as on non-infectious disease surveillance of child malnutrition (n = 2), maternal health (n = 1) and routine surveillance of various diseases and symptoms (n = 1). Our review revealed that mobile phone-based surveillance projects in the sub-Saharan African countries are on small scale, fragmented and not well documented. We conclude by advocating for a strong drive for more research in the applied field as well as a better reporting of lessons learned in order to create an epistemic community to help build a more evidence-based field of practice in mHealth surveillance in the region. PMID:25396767

  17. Modern Environmental Health Hazards: A Public Health Issue of Increasing Significance in Africa

    PubMed Central

    Nweke, Onyemaechi C.; Sanders III, William H.

    2009-01-01

    Objectives Traditional hazards such as poor sanitation currently account for most of Africa’s environmentally related disease burden. However, with rapid development absent appropriate safeguards for environment and health, modern environmental health hazards (MEHHs) may emerge as critical contributors to the continent’s disease burden. We review recent evidence of human exposure to and health effects from MEHHs, and their occurrence in environmental media and consumer products. Our purpose is to highlight the growing significance of these hazards as African countries experience urbanization, industrial growth, and development. Data sources We reviewed published epidemiologic, exposure, and environmental studies of chemical agents such as heavy metals and pesticides. Data synthesis The body of evidence demonstrates ongoing environmental releases of MEHHs and human exposures sometimes at toxicologically relevant levels. Several sources of MEHHs in environmental media have been identified, including natural resource mining and processing and automobile exhaust. Biomonitoring studies provided direct evidence of human exposure to metals such as mercury and lead and pesticides such as p,p′-dichlorodiphenyltrichloroethane (DDT) and organophosphates. Land and water resource pollution and industrial air toxics are areas of significant data gaps, notwithstanding the presence of several emitting sources. Conclusion Unmitigated MEHH releases and human exposure have implications for Africa’s disease burden. For Africans encumbered by conditions such as malnutrition that impair resilience to toxicologic challenges, the burden may be higher. A shift in public health policy toward accommodating the emerging diversity in Africa’s environmental health issues is necessary to successfully alleviate the burden of avoidable ill health and premature death for all its communities now and in the future. PMID:19590675

  18. Organochlorine pesticide contamination of foods in Africa: incidence and public health significance.

    PubMed

    Thompson, Lesa A; Darwish, Wageh Sobhy; Ikenaka, Yoshinori; Nakayama, Shouta M M; Mizukawa, Hazuki; Ishizuka, Mayumi

    2017-03-16

    Organochlorine pesticides (OCPs) have been used worldwide, particularly in Africa for several decades. Although many are banned, several African countries still use OCPs especially for the prevention and control of malaria. OCPs are characterized by their bio-accumulation in the environment, especially in the food chain, where they find their way into the human body. Despite no clear epidemiological studies confirming hazardous effects of these chemicals on human health, many studies have reported positive associations between the use of OCPs and neurological and reproductive disorders, and cancer risk. There is a clear gap in published reports on OCPs in Africa and their potential health hazards. Thus, the aim of this review is to summarize the incidence of OCP contamination in various foods in Africa, to demonstrate the potential transmission of these chemicals to people, and to discuss their possible health hazards.

  19. Paediatric liver transplantation for children treated at public health facilities in South Africa: time for change.

    PubMed

    Lala, S G; Britz, R; Botha, J; Loveland, J

    2014-11-01

    Paediatric liver transplantation (PLT) is the only therapeutic option for many children with end-stage chronic liver disease or irreversible fulminant hepatic failure, and is routinely considered as a therapy by paediatric gastroenterologists and surgeons working in developed countries. In South Africa (SA), a PLT programme has been available at Red Cross War Memorial Children's Hospital in Cape Town since November 1991, and another has rapidly developed at the Wits Donald Gordon Medical Centre in Johannesburg over the past decade. However, for most children with progressive chronic liver disease who are reliant on the services provided at state facilities in SA, PLT is not an option because of a lack of resources in a mismanaged public health system. This article briefly outlines the services offered at Chris Hani Baragwanath Academic Hospital--which is typical of state facilities in SA--and proposes that resources be allocated to establish an innovative, nationally funded centre that would enable greater numbers of children access to a PLT programme.

  20. [Public financing of health care in Africa, budgetary constraints and direct payment by users: an overview of the essential questions].

    PubMed

    Mathonnat, Jacky

    2008-12-01

    The improvement of health in Africa is confronted with many challenges. The financial resources devoted to health are insufficient, but to increase them is not enough. It is essential to reinforce the systems of health care and to improve efficiency of the public and private expenditure in health. In the majority of the countries, the budgetary constraints are strong, but there is room for maneuver to increase the public health expenditure, by domestic financing or by foreign assistance. It is advisable, however, to be particularly vigilant as to the negative effects which could possibly result from this on the various elements which might play a significant role in the improvement of health. States must exploit relevantly all possibilities of increasing the health expenditure which become available. A majority of them are not able to afford to neglect direct payments, even although they have to be integrated into a coherent strategy of financing, carefully analyzed and implemented.

  1. HIV infection and tuberculosis in South Africa: an urgent need to escalate the public health response.

    PubMed

    Abdool Karim, Salim S; Churchyard, Gavin J; Karim, Quarraisha Abdool; Lawn, Stephen D

    2009-09-12

    One of the greatest challenges facing post-apartheid South Africa is the control of the concomitant HIV and tuberculosis epidemics. HIV continues to spread relentlessly, and tuberculosis has been declared a national emergency. In 2007, South Africa, with 0.7% of the world's population, had 17% of the global burden of HIV infection, and one of the world's worst tuberculosis epidemics, compounded by rising drug resistance and HIV co-infection. Until recently, the South African Government's response to these diseases has been marked by denial, lack of political will, and poor implementation of policies and programmes. Nonetheless, there have been notable achievements in disease management, including substantial improvements in access to condoms, expansion of tuberculosis control efforts, and scale-up of free antiretroviral therapy (ART). Care for acutely ill AIDS patients and long-term provision of ART are two issues that dominate medical practice and the health-care system. Decisive action is needed to implement evidence-based priorities for the control of the HIV and tuberculosis epidemics. By use of the framework of the Strategic Plans for South Africa for tuberculosis and HIV/AIDS, we provide prioritised four-step approaches for tuberculosis control, HIV prevention, and HIV treatment. Strong leadership, political will, social mobilisation, adequate human and financial resources, and sustainable development of health-care services are needed for successful implementation of these approaches.

  2. HIV infection and tuberculosis in South Africa: an urgent need to escalate the public health response

    PubMed Central

    Abdool Karim, Salim S.; Churchyard, Gavin J.; Abdool Karim, Quarraisha; Lawn, Stephen D.

    2009-01-01

    One of the greatest challenges facing post-apartheid South Africa is the control of the concomitant HIV and tuberculosis epidemics. HIV continues to spread relentlessly, and tuberculosis has been declared a national emergency. In 2007, South Africa, with 0·7% of the world’s population, had 17% of the global burden of HIV infection, and one of the world’s worst tuberculosis epidemics, compounded by rising drug resistance and HIV co-infection. Until recently, the South African Government’s response to these diseases has been marked by denial, lack of political will, and poor implementation of policies and programmes. Nonetheless, there have been notable achievements in disease management, including substantial improvements in access to condoms, expansion of tuberculosis control efforts, and scale-up of free antiretroviral therapy (ART). Care for acutely ill AIDS patients and long-term provision of ART are two issues that dominate medical practice and the health-care system. Decisive action is needed to implement evidence-based priorities for the control of the HIV and tuberculosis epidemics. By use of the framework of the Strategic Plans for South Africa for tuberculosis and HIV/AIDS, we provide prioritised four-step approaches for tuberculosis control, HIV prevention, and HIV treatment. Strong leadership, political will, social mobilisation, adequate human and financial resources, and sustainable development of health-care services are needed for successful implementation of these approaches. PMID:19709731

  3. Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa?

    PubMed Central

    Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Tekwu, Emmanuel N.; Olalubi, Oluwasogo A.; Midzi, Nicolas; Bengyella, Louis; Adedeji, Ahmed A.; Ngogang, Jeanne Y.

    2016-01-01

    Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems.  As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs. PMID:27508058

  4. Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa?

    PubMed

    Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Tekwu, Emmanuel N; Olalubi, Oluwasogo A; Midzi, Nicolas; Bengyella, Louis; Adedeji, Ahmed A; Ngogang, Jeanne Y

    2016-01-01

    Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems.  As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs.

  5. Application of Ethical Principles to Research using Public Health Data in The Global South: Perspectives from Africa.

    PubMed

    Anane-Sarpong, Evelyn; Wangmo, Tenzin; Sankoh, Osman; Tanner, Marcel; Elger, Bernice Simone

    2016-12-22

    Existing ethics guidelines, influential literature and policies on ethical research generally focus on real-time data collection from humans. They enforce individual rights and liberties, thereby lowering need for aggregate protections. Although dependable, emerging public health research paradigms like research using public health data (RUPD) raise new challenges to their application. Unlike traditional research, RUPD is population-based, aligned to public health activities, and often reliant on pre-collected longitudinal data. These characteristics, when considered in relation to the generally lower protective ethico-legal frameworks of the Global South, including Africa, highlight ethical gaps. Health and demographic surveillance systems are examples of public health programs that accommodate RUPD in these contexts. We set out to explore the perspectives of professionals with a working knowledge of these systems to determine practical ways of appropriating the foundational principles of health research to advance the ever growing opportunities in RUPD. We present their perspectives and in relation to the literature and our ethical analysis, make context relevant recommendations. We further argue for the development of a framework founded on the discussions and recommendations as a minimum base for achieving optimal ethics for optimal RUPD in the Global South.

  6. Public spending on health care in Africa: do the poor benefit?

    PubMed Central

    Castro-Leal, F.; Dayton, J.; Demery, L.; Mehra, K.

    2000-01-01

    Health care is a basic service essential in any effort to combat poverty, and is often subsidized with public funds to help achieve that aim. This paper examines public spending on curative health care in several African countries and finds that this spending favours mostly the better-off rather than the poor. It concludes that this targeting problem cannot be solved simply by adjusting the subsidy allocations. The constraints that prevent the poor from taking advantage of these services must also be addressed if the public subsidies are to be effective in reaching the poor. PMID:10686734

  7. U.S. Public Health Service Response to the 2014-2015 Ebola Epidemic in West Africa: A Nursing Perspective.

    PubMed

    Mosquera, Alexis; Braun, Michelle; Hulett, Melissa; Ryszka, Lauren

    2015-01-01

    The 2014-2015 Ebola epidemic in West Africa has been the deadliest Ebola epidemic to date. In response to this deadly epidemic, the U.S. government declared this a top national security priority and members of the Commissioned Corps of the United States Public Health Service were tasked to provide direct patient care to Ebola virus disease patients. Commissioned Corps nurses provided the highest level of care under the most austere conditions. This article discusses the training, ethical dilemmas, and constant risk for potential exposure while working in an Ebola Treatment Unit.

  8. The challenges of offering public second trimester abortion services in South Africa: health care providers' perspectives.

    PubMed

    Harries, J; Lince, N; Constant, D; Hargey, A; Grossman, D

    2012-03-01

    Around 25% of abortions in South Africa are performed in the second trimester. This study aimed to better understand what doctors, nurses and hospital managers involved in second trimester abortion care thought about these services and how they could be improved. Nineteen in-depth interviews with abortion-related service providers and managers in the Western Cape Province, South Africa, were undertaken. Data were analysed using a thematic analysis approach. Participants expressed resistance to the dilation and evacuation (D&E) procedure, as this required more active provider involvement. Medical abortion was preferred as it required less provider involvement in the abortion process. A shortage of providers willing to perform D&E resulted in most public sector services being outsourced to private sector doctors. Respondents noted an increased demand for services and a concomitant lack of infrastructure, physical space and personnel to respond to these demands, sometimes resulting in fragmented or poor quality care. At medical induction sites, most thought introducing the combined mifepristone-misoprostol regimen would improve service capacity, although they were concerned about cost. Improving contraceptive services was also seen as a much-needed intervention to improve care and prevent abortion. Ongoing training, including values clarification, as well as emotional support and team-building for providers are needed to ensure sustainable, high-quality second trimester abortion services.

  9. Using exercises to improve public health preparedness in Asia, the Middle East and Africa

    PubMed Central

    2014-01-01

    Background Exercises are increasingly common tools used by the health sector and other sectors to evaluate their preparedness to respond to public health threats. Exercises provide an opportunity for multiple sectors to practice, test and evaluate their response to all types of public health emergencies. The information from these exercises can be used to refine and improve preparedness plans. There is a growing body of literature about the use of exercises among local, state and federal public health agencies in the United States. There is much less information about the use of exercises among public health agencies in other countries and the use of exercises that involve multiple countries. Results We developed and conducted 12 exercises (four sub-national, five national, three sub-regional) from August 2006 through December 2008. These 12 exercises included 558 participants (average 47) and 137 observers (average 11) from 14 countries. Participants consistently rated the overall quality of the exercises as very good or excellent. They rated the exercises lowest on their ability to identifying key gaps in performance. The vast majority of participants noted that they would use the information they gained at the exercise to improve their organization’s preparedness to respond to an influenza pandemic. Participants felt the exercises were particularly good at raising awareness and understanding about public health threats, assisting in evaluating plans and identifying priorities for improvement, and building relationships that strengthen preparedness and response across sectors and across countries. Participants left the exercises with specific ideas about the most important actions that they should engage in after the exercise such as improved planning coordination across sectors and countries and better training of health workers and response personnel. Conclusions These experiences suggest that exercises can be a valuable, low-burden tool to improve emergency

  10. Information technology systems in public sector health facilities in developing countries: the case of South Africa

    PubMed Central

    2013-01-01

    Background The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa. Methods Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces) to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information. Results Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace. Conclusion The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation. PMID:23347433

  11. Developing Ethical Practices for Public Health Research Data Sharing in South Africa

    PubMed Central

    Denny, Spencer G.; Silaigwana, Blessing; Bull, Susan; Parker, Michael

    2015-01-01

    The abundance of South African clinical and public health research data has the potential to unlock important and valuable future advances in biomedical science. Amid increasing calls for more effective sharing of individual-level data, commitment to promote access to research data is evident within South Africa’s public research sector, but national guidance and regulation are absent. This qualitative study examined the perceptions, experiences and concerns of 32 research stakeholders about data-sharing practices. There was consensus about the utility of data sharing in publicly funded health research. However, disparate views emerged about the possible harms and benefits of sharing data and how these should be weighed. The relative dearth of policies governing data-sharing practices needs to be addressed and a framework of support developed that incentivizes data-sharing practices for researchers that are both ethical and effective. PMID:26297750

  12. Models of public-private engagement for health services delivery and financing in Southern Africa: a systematic review.

    PubMed

    Whyle, Eleanor Beth; Olivier, Jill

    2016-12-01

    In low- and middle-income countries (LMICs), the private sector-including international donors, non-governmental organizations, for-profit providers and traditional healers-plays a significant role in health financing and delivery. The use of the private sector in furthering public health goals is increasingly common. By working with the private sector through public -: private engagement (PPE), states can harness private sector resources to further public health goals. PPE initiatives can take a variety of forms and understanding of these models is limited. This paper presents the results of a Campbell systematic literature review conducted to establish the types and the prevalence of PPE projects for health service delivery and financing in Southern Africa. PPE initiatives identified through the review were categorized according to a PPE typology. The review reveals that the full range of PPE models, eight distinct models, are utilized in the Southern African context. The distribution of the available evidence-including significant gaps in the literature-is discussed, and key considerations for researchers, implementers, and current and potential PPE partners are presented. It was found that the literature is disproportionately representative of PPE initiatives located in South Africa, and of those that involve for-profit partners and international donors. A significant gap in the literature identified through the study is the scarcity of information regarding the relationship between international donors and national governments. This information is key to strengthening these partnerships, improving partnership outcomes and capacitating recipient countries. The need for research that disaggregates PPE models and investigates PPE functioning in context is demonstrated.

  13. A public health approach to the impact of climate change on health in southern Africa - identifying priority modifiable risks.

    PubMed

    Myers, J; Young, T; Galloway, M; Manyike, P; Tucker, T

    2011-11-01

    Anthropogenic climate change and anticipated adverse impacts on human health as outlined by the Intergovernmental Panel on Climate Change (IPCC) are taken as given. A conceptual model for thinking about the spectrum of climate-related health risks ranging from distal and infrastructural to proximal and behavioural and their relation to the burden of disease pattern typical of sub-Saharan Africa is provided. The model provides a tool for identifying modifiable risk factors with a view to future research, specifically into the performance of interventions to reduce the impact of climate change.

  14. Public health significance of zoonotic bacterial pathogens from bushmeat sold in urban markets of Gabon, Central Africa.

    PubMed

    Bachand, Nicholas; Ravel, André; Onanga, Richard; Arsenault, Julie; Gonzalez, Jean-Paul

    2012-07-01

    Wild animal meat represents an important source of protein for many people in central Africa. Also known as bushmeat, this meat commodity is derived from wild animals hunted under uncontrolled conditions, transported to distant markets under rudimentary or no hygienic methods, and often eviscerated >24 hr after death. Considering the plausible role of wildlife as a reservoir for bacterial zoonotic pathogens, bushmeat may be an important public health risk in Central Africa. This cross-sectional survey served to evaluate the presence of Campylobacter, Salmonella, and Shigella in the muscle tissue of 128 wild animal carcasses from several hunted wildlife species (guenons [Cercopithecus spp.], collared mangabeys [Cercocebus torquatus], gray-cheeked mangabeys [Lophocebus albigena], African crested porcupines [Atherurus africanus], duikers [Cephalophus spp.], and red river hogs [Potamocherus porcus]) sold in two markets of Port-Gentil, Gabon, in July and August 2010. Salmonella was detected from one carcass; no Campylobacter or Shigella was detected. If Campylobacter and Shigella were present, the maximum expected prevalence was estimated at 6% and 1%, respectively. In light of such very low apparent muscle contamination levels, bushmeat likely does not represent a health risk per se with respect to Campylobacter, Salmonella, or Shigella. However, because carcass evisceration and skinning can take place within households prior to consumption, consumers should follow strict hygiene and food safety practices to avoid potential health hazards associated with the handling, preparation, or consumption of bushmeat.

  15. Human trafficking, labor brokering, and mining in southern Africa: responding to a decentralized and hidden public health disaster.

    PubMed

    Steele, Sarah

    2013-01-01

    Many southern African economies are dependent on the extractive industries. These industries rely on low-cost labor, often supplied by migrants, typically acquired through labor brokers. Very little attention has so far been paid to trafficking of men into extractive industries or its connection with trafficked women in the region's mining hubs. Recent reports suggest that labor-brokering practices foster human trafficking, both by exposing migrant men to lack of pay and exploitative conditions and by creating male migratory patterns that generate demand for sex workers and associated trafficking of women and girls. While trafficking in persons violates human rights, and thus remains a priority issue globally, there is little or no evidence of an effective political response to mine-related trafficking in southern Africa. This article concludes with recommendations for legal and policy interventions, as well as an enhanced public health response, which if implemented would help reduce human trafficking toward mining sites.

  16. Bibliographic analysis of scientific research on selected topics in public health nutrition in West Africa: Review of articles published from 1998 to 2008.

    PubMed

    Aaron, Grant J; Wilson, Shelby E; Brown, Kenneth H

    2010-01-01

    Few countries in West Africa have the capacity for carrying out advanced training in nutrition and public health. To provide additional information on current regional applied nutrition research capacity and productivity, we analysed peer-reviewed articles on key public health nutrition topics that were published from 1998 to 2008. Using MEDLINE/PubMed, the following terms were searched: 'breast feeding', 'infant nutrition physiology' (comprising complementary feeding and weaning), 'protein energy malnutrition', 'nutrition and infection', 'vitamin A', 'iodine', 'zinc' and 'overweight', each linked with the term 'Western Africa'. In total, 412 unique articles (37±6 articles per year) were identified. Most research focused on infant and young child feeding practices, selected micronutrient deficiencies, and the emerging problem of overweight and obesity. The primary author of nearly half (46%) the publications was located in an institution outside of West Africa. Most articles were published in English (90%), and nearly half of all articles (41%) were cross-sectional studies. Our findings indicate that few peer-reviewed research studies are being published on key public health topics in the West African region, considering the magnitude of nutrition problems in this region. New approaches are needed to encourage and support research capacity and output in West Africa.

  17. The emergence of Taenia solium cysticercosis in Eastern and Southern Africa as a serious agricultural problem and public health risk.

    PubMed

    Phiri, Isaac K; Ngowi, Helena; Afonso, Sonia; Matenga, Elizabeth; Boa, Mathias; Mukaratirwa, Samson; Githigia, Samuel; Saimo, Margaret; Sikasunge, Chummy; Maingi, Ndichu; Lubega, George W; Kassuku, Ayub; Michael, Lynne; Siziya, Seter; Krecek, Rosina C; Noormahomed, Emilia; Vilhena, Manuela; Dorny, Pierre; Willingham, A Lee

    2003-06-01

    pigs positive. In Zimbabwe, a retrospective study in official abattoirs around the country from 1994 to 2001 reported a mean prevalence of 0.34% which is in contrast to a post-mortem survey in 1999, which showed that the prevalence of porcine cysticercosis in rural west Zimbabwe where smallholder pig keeping is popular was 28.6%. In Zambia, abattoir records reported porcine cysticercosis in six of the nine provinces. Routine meat inspection of 1316 pigs at a slaughter slab in Lusaka showed that 20.6% of the pigs had cysticercosis whereas serological testing of 874 pigs at the same abattoir indicated that 56.6% were found to have circulating antigens of Taenia solium. Field surveys based on lingual palpation in Southern and Eastern Provinces of Zambia revealed prevalences of 8.2-28.4 and 5.2%, respectively. South Africa has the largest number of pigs in Southern Africa and cysticercosis has been recognised as a problem in the country for many decades. There is strong evidence supporting the high prevalence of neurocysticercosis infecting humans from resource-poor areas of the country where pigs are being raised under smallholder conditions. In spite of this community-based surveys on porcine cysticercosis have never been conducted in South Africa and the last slaughterhouse survey was conducted nearly 40 years ago. The prevalences of porcine cysticercosis found in these ESA countries rank among the highest in the world and the disease is emerging as an important constraint for the nutritional and economic well being of resource-poor smallholder farming communities. The current findings suggest the widespread presence of human tapeworm carriers and thus a high risk of human cysticercosis in both rural areas and urban centres in the ESA region. More research is required in the region to assess the extent and public health and economic impact of T. solium infection in order to determine whether and what prevention and control efforts are needed.

  18. Social Mobilization and Community Engagement Central to the Ebola Response in West Africa: Lessons for Future Public Health Emergencies

    PubMed Central

    Gillespie, Amaya M; Obregon, Rafael; El Asawi, Rania; Richey, Catherine; Manoncourt, Erma; Joshi, Kshiitij; Naqvi, Savita; Pouye, Ade; Safi, Naqibullah; Chitnis, Ketan; Quereshi, Sabeeha

    2016-01-01

    ABSTRACT Following the World Health Organization (WHO) declaration of a Public Health Emergency of International Concern regarding the Ebola outbreak in West Africa in July 2014, UNICEF was asked to co-lead, in coordination with WHO and the ministries of health of affected countries, the communication and social mobilization component—which UNICEF refers to as communication for development (C4D)—of the Ebola response. For the first time in an emergency setting, C4D was formally incorporated into each country's national response, alongside more typical components such as supplies and logistics, surveillance, and clinical care. This article describes the lessons learned about social mobilization and community engagement in the emergency response to the Ebola outbreak, with a particular focus on UNICEF's C4D work in Guinea, Liberia, and Sierra Leone. The lessons emerged through an assessment conducted by UNICEF using 4 methods: a literature review of key documents, meeting reports, and other articles; structured discussions conducted in June 2015 and October 2015 with UNICEF and civil society experts; an electronic survey, launched in October and November 2015, with staff from government, the UN, or any partner organization who worked on Ebola (N = 53); and key informant interviews (N = 5). After triangulating the findings from all data sources, we distilled lessons under 7 major domains: (1) strategy and decentralization: develop a comprehensive C4D strategy with communities at the center and decentralized programming to facilitate flexibility and adaptation to the local context; (2) coordination: establish C4D leadership with the necessary authority to coordinate between partners and enforce use of standard operating procedures as a central coordination and quality assurance tool; (3) entering and engaging communities: invest in key communication channels (such as radio) and trusted local community members; (4) messaging: adapt messages and strategies

  19. An Assessment of Private General Practitioners Contracting for Public Health Services Delivery in O.R. Tambo District, South Africa

    PubMed Central

    Hongoro, Charles; Funani, I Itumeleng N.; Chitha, Wezile; Godlimpi, Lizo

    2015-01-01

    Low- and middle-income countries are striving towards universal health coverage in a variety of ways. Achieving this goal requires the participation of both public and the private sector providers. The study sought to assess existing capacity for independent general practitioner contracting in primary care, the reasons for the low uptake of government national contract and the expectations of general practitioners of such contractual arrangements. This was a case study conducted in a rural district of South Africa. The study employed both quantitative and qualitative data collection methods. Data were collected using a general practitioner and practice profiling tool, and a structured questionnaire. A total of 42 general practitioners were interviewed and their practices profiled. Contrary to observed low uptake of the national general practitioner contract, 90% of private doctors who had not yet subscribed to it were actually interested in it. Substantial evidence indicated that private doctors had the capacity to deliver quality care to public patients. However, low uptake of national contarct related mostly to lack of effective communication and consultation between them and national government which created mistrust and apprehension amongst local private doctors. Paradoxically, these general practitioners expressed satisfaction with other existing state contracts. An analysis of the national contract showed that there were likely to benefit more from it given the relatively higher payment rates and the guaranteed nature of this income. Proposed key requisites to enhanced uptake of the national contract related to the type of the contract, payment arrangements and flexibility of the work regime, and prospects for continuous training and clinical improvements. Low uptake of the national General Practitioner contract was due to variety of factors related to lack of understanding of contract details. Such misunderstandings between potential contracting parties

  20. Health Data Publications No. 18. Ghana.

    DTIC Science & Technology

    PUBLIC HEALTH, *GHANA, SUBSAHARAN AFRICA, ECONOMICS, NATURAL RESOURCES, DEMOGRAPHY, DISEASES, MAPS , ANIMALS, INFECTIOUS DISEASES, MEDICAL SERVICES, NUTRITION, GEOGRAPHY, EPIDEMIOLOGY, SANITARY ENGINEERING, DISEASE VECTORS.

  1. Current State of Resistance to Antibiotics of Last-Resort in South Africa: A Review from a Public Health Perspective

    PubMed Central

    Osei Sekyere, John

    2016-01-01

    A review of the literature was undertaken to delineate the current level and mechanisms of resistance to carbapenems, colistin, and tigecycline in South Africa. Thirty-two English publications and 32 National Institute of Communicable Diseases communiqués identified between early January 2000 and 20 May, 2016 showed substantial reports of NDM (n = 860), OXA-48 (n = 584), VIM (n = 131), and IMP (n = 45) carbapenemases within this period, mainly in Klebsiella pneumoniae (n = 1138), Acinetobacter baumannii (n = 332), Enterobacter cloacae (n = 201), and Serratia marcescens (n = 108). Colistin and tigecycline resistance was prevalent among K. pneumoniae, A. baumannii, S. marcescens, and E. cloacae. The first mcr-1 colistin resistance gene to be detected in South Africa was reported in Escherichia coli from livestock as well as from hospitalized and outpatients. There are increasing reports of NDM and OXA-48 carbapenemases among Enterobacteriaceae and A. baumannii in South Africa. Mcr-1 is now present in South African patients and livestock. Resistance to carbapenems, colistin, and tigecycline restricts infection management options for clinicians. PMID:27747206

  2. Current State of Resistance to Antibiotics of Last-Resort in South Africa: A Review from a Public Health Perspective.

    PubMed

    Osei Sekyere, John

    2016-01-01

    A review of the literature was undertaken to delineate the current level and mechanisms of resistance to carbapenems, colistin, and tigecycline in South Africa. Thirty-two English publications and 32 National Institute of Communicable Diseases communiqués identified between early January 2000 and 20 May, 2016 showed substantial reports of NDM (n = 860), OXA-48 (n = 584), VIM (n = 131), and IMP (n = 45) carbapenemases within this period, mainly in Klebsiella pneumoniae (n = 1138), Acinetobacter baumannii (n = 332), Enterobacter cloacae (n = 201), and Serratia marcescens (n = 108). Colistin and tigecycline resistance was prevalent among K. pneumoniae, A. baumannii, S. marcescens, and E. cloacae. The first mcr-1 colistin resistance gene to be detected in South Africa was reported in Escherichia coli from livestock as well as from hospitalized and outpatients. There are increasing reports of NDM and OXA-48 carbapenemases among Enterobacteriaceae and A. baumannii in South Africa. Mcr-1 is now present in South African patients and livestock. Resistance to carbapenems, colistin, and tigecycline restricts infection management options for clinicians.

  3. Developing Ethical Practices for Public Health Research Data Sharing in South Africa: The Views and Experiences From a Diverse Sample of Research Stakeholders.

    PubMed

    Denny, Spencer G; Silaigwana, Blessing; Wassenaar, Douglas; Bull, Susan; Parker, Michael

    2015-07-01

    The abundance of South African clinical and public health research data has the potential to unlock important and valuable future advances in biomedical science. Amid increasing calls for more effective sharing of individual-level data, commitment to promote access to research data is evident within South Africa's public research sector, but national guidance and regulation are absent. This qualitative study examined the perceptions, experiences and concerns of 32 research stakeholders about data-sharing practices. There was consensus about the utility of data sharing in publicly funded health research. However, disparate views emerged about the possible harms and benefits of sharing data and how these should be weighed. The relative dearth of policies governing data-sharing practices needs to be addressed and a framework of support developed that incentivizes data-sharing practices for researchers that are both ethical and effective.

  4. Urban groundwater quality in sub-Saharan Africa: current status and implications for water security and public health

    NASA Astrophysics Data System (ADS)

    Lapworth, D. J.; Nkhuwa, D. C. W.; Okotto-Okotto, J.; Pedley, S.; Stuart, M. E.; Tijani, M. N.; Wright, J.

    2017-01-01

    Groundwater resources are important sources of drinking water in Africa, and they are hugely important in sustaining urban livelihoods and supporting a diverse range of commercial and agricultural activities. Groundwater has an important role in improving health in sub-Saharan Africa (SSA). An estimated 250 million people (40% of the total) live in urban centres across SSA. SSA has experienced a rapid expansion in urban populations since the 1950s, with increased population densities as well as expanding geographical coverage. Estimates suggest that the urban population in SSA will double between 2000 and 2030. The quality status of shallow urban groundwater resources is often very poor due to inadequate waste management and source protection, and poses a significant health risk to users, while deeper borehole sources often provide an important source of good quality drinking water. Given the growth in future demand from this finite resource, as well as potential changes in future climate in this region, a detailed understanding of both water quantity and quality is required to use this resource sustainably. This paper provides a comprehensive assessment of the water quality status, both microbial and chemical, of urban groundwater in SSA across a range of hydrogeological terrains and different groundwater point types. Lower storage basement terrains, which underlie a significant proportion of urban centres in SSA, are particularly vulnerable to contamination. The relationship between mean nitrate concentration and intrinsic aquifer pollution risk is assessed for urban centres across SSA. Current knowledge gaps are identified and future research needs highlighted.

  5. An exploratory study of the need for curriculum review of Master of Public Health Degree at a Rural-based University in South Africa

    PubMed Central

    2016-01-01

    Background Master of Public Health (MPH) training programmes were developed worldwide in response to the crisis in human resources for health. Aim To determine whether the MPH programme at the selected rural-based university in South Africa enabled students to achieve the MPH core competencies relevant for Lower Middle Income Countries. Setting The study was carried out at a rural-based University in South Africa. The target population was the 2011 first-year cohort of MPH students who by the beginning of 2014 had just completed their coursework. Methodology A quantitative cross-sectional descriptive research design was adapted. Eighty-five students were randomly selected to participate in the study. A structured questionnaire comprising seven competency clusters was developed. The selected students completed a self-administered questionnaire. Only those students who signed consent forms participated in this study. The questionnaire was tested for construct validity and reliability using 10 students with similar characteristics to those sampled for the study. Microsoft Excel software was used to analyse the data descriptively in terms of frequency and percentages. Results The students were confident of their competencies regarding public health science skills. Amongst these were analytical assessment, communication, community and inter-sectorial competencies as well as ethics. However, the students lacked confidence in context-sensitive issues, planning and management, research and development, and leadership competencies. Yet the latter is the backbone of public health practice. Conclusion and recommendation There is a need for revamping public health curricula. In this respect, a follow-up study that builds a deeper understanding of the subject is needed. PMID:27380845

  6. Critical role of ethics in clinical management and public health response to the West Africa Ebola epidemic

    PubMed Central

    Folayan, Morenike O; Haire, Bridget G; Brown, Brandon

    2016-01-01

    The devastation caused by the Ebola virus disease (EVD) outbreak in West Africa has brought to the fore a number of important ethical debates about how best to respond to a health crisis. These debates include issues related to prevention and containment, management of the health care workforce, clinical care, and research design, all of which are situated within the overarching moral problem of severe transnational disadvantage, which has very real and specific impacts upon the ability of citizens of EVD-affected countries to respond to a disease outbreak. Ethical issues related to prevention and containment include the appropriateness and scope of quarantine and isolation within and outside affected countries. The possibility of infection in health care workers impelled consideration of whether there is an obligation to provide health services where personal protection equipment is inadequate, alongside the issue of whether the health care workforce should have special access to experimental treatment and care interventions under development. In clinical care, ethical issues include the standards of care owed to people who comply with quarantine and isolation restrictions. Ethical issues in research include appropriate study design related to experimental vaccines and treatment interventions, and the sharing of data and biospecimens between research groups. The compassionate use of experimental drugs intersects both with research ethics and clinical care. The role of developed countries also came under scrutiny, and we concluded that developed countries have an obligation to contribute to the containment of EVD infection by contributing to the strengthening of local health care systems and infrastructure in an effort to provide fair benefits to communities engaged in research, ensuring that affected countries have ready and affordable access to any therapeutic or preventative interventions developed, and supporting affected countries on their way to recovery from

  7. Institutionalising of public health.

    PubMed

    Karkee, R

    2014-01-01

    Though public health situation in Nepal is under-developed, the public health education and workforce has not been prioritised. Nepal should institutionalise public health education by means of accrediting public health courses, registration of public health graduates in a data bank and increasing job opportunities for public health graduates in various institutions at government sector.

  8. Health care in Africa.

    PubMed

    Brown, M S

    1984-07-01

    This is the third and last article reporting professional exchange tours between American nurses and nurses of other countries. In this article, the health care system of Kenya is discussed and comparisons made between this system and our own. Out of this comparison come several insights into our own way of doing things and possibilities for improving them. "Health Care in the Soviet Union" appeared in the April 1984 issue of The Nurse Practitioner. "Health Care in China" appeared in the May 1984 issue of the journal.

  9. Public Health

    EPA Science Inventory

    Earth observations can be used to address human health concerns in many ways: projecting occurrence of disease or disease outbreaks; rapid detection and tracking of events; construction of risk maps; targeting interventions; and enhancing knowledge of human health-environment int...

  10. Private sector, human resources and health franchising in Africa.

    PubMed

    Prata, Ndola; Montagu, Dominic; Jefferys, Emma

    2005-04-01

    In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. Using data from The World Bank's Health Nutrition and Population Poverty Thematic Reports on 22 countries in Africa, an assessment was made of the use of public and private health services, by asset quintile groups, for treatment of diarrhoea and acute respiratory infections, proxies for publicly subsidized services. The evidence and theory on using franchise networks to supplement government programmes in the delivery of public health services was assessed. Examples from health franchises in Africa and Asia are provided to illustrate the potential for franchise systems to leverage private providers and so increase delivery-point availability for public-benefit services. We argue that based on the established demand for private medical services in Africa, these providers should be included in future planning on human resources for public health. Having explored the range of systems that have been tested for working with private providers, from contracting to vouchers to behavioural change and provider education, we conclude that franchising has the greatest potential for integration into large-scale programmes in Africa to address critical illnesses of public health importance.

  11. Private sector, human resources and health franchising in Africa.

    PubMed Central

    Prata, Ndola; Montagu, Dominic; Jefferys, Emma

    2005-01-01

    In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. Using data from The World Bank's Health Nutrition and Population Poverty Thematic Reports on 22 countries in Africa, an assessment was made of the use of public and private health services, by asset quintile groups, for treatment of diarrhoea and acute respiratory infections, proxies for publicly subsidized services. The evidence and theory on using franchise networks to supplement government programmes in the delivery of public health services was assessed. Examples from health franchises in Africa and Asia are provided to illustrate the potential for franchise systems to leverage private providers and so increase delivery-point availability for public-benefit services. We argue that based on the established demand for private medical services in Africa, these providers should be included in future planning on human resources for public health. Having explored the range of systems that have been tested for working with private providers, from contracting to vouchers to behavioural change and provider education, we conclude that franchising has the greatest potential for integration into large-scale programmes in Africa to address critical illnesses of public health importance. PMID:15868018

  12. American Public Health Association

    MedlinePlus

    ... is Public Health? Creating Healthy Communities Topics & Issues Climate Change Gun Violence Environmental Health Health Equity Health Reform ... to AJPH Public Health Newswire April 14 news: Climate change, mumps outbreak in Texas, type 2 diabetes in ...

  13. First record of Stegomyia albopicta (= Aedes albopictus) in Morocco: a major threat to public health in North Africa?

    PubMed

    Bennouna, A; Balenghien, T; El Rhaffouli, H; Schaffner, F; Garros, C; Gardès, L; Lhor, Y; Hammoumi, S; Chlyeh, G; Fassi Fihri, O

    2017-03-01

    The Asian tiger mosquito Stegomyia albopicta (= Aedes albopictus) (Diptera: Culicidae), native to Asian forests, is a nuisance mosquito and is responsible for the transmission of arboviruses of public health importance, such as dengue, chikungunya and Zika viruses. It has colonized parts of all continents, except Antarctica, over the past 30-40 years. However, to date, the only records of S. albopicta in North Africa refer to occasional collections in 2010 and 2014 in Algeria. In early September 2015, S. albopicta larvae and adults were collected in a district of Rabat, Morocco. Morphological identification was confirmed by molecular analysis. This is the first record of this invasive mosquito in Morocco. A national surveillance programme will be implemented in 2016 to establish its geographical distribution in Morocco and to instigate control measures to prevent the establishment of new populations and the transmission of arboviruses.

  14. Ebola and Marburg haemorrhagic fever viruses: major scientific advances, but a relatively minor public health threat for Africa.

    PubMed

    Leroy, E M; Gonzalez, J-P; Baize, S

    2011-07-01

    Ebola and Marburg viruses are the only members of the Filoviridae family (order Mononegavirales), a group of viruses characterized by a linear, non-segmented, single-strand negative RNA genome. They are among the most virulent pathogens for humans and great apes, causing acute haemorrhagic fever and death within a matter of days. Since their discovery 50 years ago, filoviruses have caused only a few outbreaks, with 2317 clinical cases and 1671 confirmed deaths, which is negligible compared with the devastation caused by malnutrition and other infectious diseases prevalent in Africa (malaria, cholera, AIDS, dengue, tuberculosis …). Yet considerable human and financial resourses have been devoted to research on these viruses during the past two decades, partly because of their potential use as bioweapons. As a result, our understanding of the ecology, host interactions, and control of these viruses has improved considerably.

  15. Health Promoting Schools: Initiatives in Africa

    ERIC Educational Resources Information Center

    Macnab, Andrew J.; Stewart, Donald; Gagnon, Faith A.

    2014-01-01

    Purpose: The purpose of this paper is to describe the rationale for and potential of World Health Organization (WHO) health promoting schools (HPS) in Africa. Design/Methodology/Approach: Overview of the related literature and presentations at the 2011 Stellenbosch international colloquium on HPS relating to sub-Saharan Africa. Findings: Schools…

  16. Training Public Health Advisors.

    PubMed

    Meyer, Pamela A; Brusuelas, Kristin M; Baden, Daniel J; Duncan, Heather L

    2015-01-01

    Federal public health advisors provide guidance and assistance to health departments to improve public health program work. The Centers for Disease Control and Prevention (CDC) prepares them with specialized training in administering public health programs. This article describes the evolving training and is based on internal CDC documents and interviews. The first federal public health advisors worked in health departments to assist with controlling syphilis after World War II. Over time, more CDC prevention programs hired them. To meet emerging needs, 3 major changes occurred: the Public Health Prevention Service, a fellowship program, in 1999; the Public Health Associate Program in 2007; and integration of those programs. Key components of the updated training are competency-based training, field experience, supervision, recruitment and retention, and stakeholder support. The enduring strength of the training has been the experience in a public health agency developing practical skills for program implementation and management.

  17. A Multi-Disciplinary Collaborative Project Developing Public Health Higher Education in Four Higher Education Institutes in Africa and Europe

    ERIC Educational Resources Information Center

    Haaranen, Ari; Saarti, Jarmo; Miettola, Juhani; Erkkilä, Arja T.

    2016-01-01

    The HEI-ICI project involves cooperation between the University of Eastern Finland (UEF) and three African partners. The main aim of the project, now in its fourth year, has been to develop education in health sciences and to improve the quality of teaching. The target has been to develop the skills of selected junior faculty from the Public…

  18. Environment and health in South Africa: gains, losses, and opportunities.

    PubMed

    Mathee, Angela

    2011-01-01

    South Africans face a range of preventable environmental hazards to their health, many of which are rooted in the country's colonial and apartheid past, and ongoing poverty and inequality. Since the advent of democracy in the country, government has made considerable progress in improving living conditions and in developing the legal framework to prevent and manage environmental contamination. Considerable, under-exploited potential also exists in South Africa to prevent disease, including infectious and chronic diseases, and to promote health through a more holistic and public health approach. This article summarizes the main environmental health concerns and reflects on mechanisms and opportunities to improve public environmental health.

  19. Modernizing public health law.

    PubMed

    Griffith, Richard; Tengnah, Cassam

    2011-07-01

    The rapid spread of a mutant strain of Escherichia coli throughout Europe highlights the need for modern and flexible public health laws to identify, control and treat infections and contamination that give significant concern for the health of the population. In this article, Richard Griffith and Cassam Tengnah outline the amendments to the Public Health (Control of Disease) Act 1984 that adopt an all-hazards approach to threats to public health.

  20. Public health workforce enumeration.

    PubMed

    Gebbie, Kristine M; Raziano, Amanda; Elliott, Sterling

    2009-05-01

    Comprehensive data on the public health workforce are fundamental to workforce development throughout the public health system. Such information is also a critical data element in public health systems research, a growing area of study that can inform the practice of public health at all levels. However, methodologic and institutional issues challenge the development of comparable indicators for the federal, state, and local public health workforce. A 2006-2007 Association of State and Territorial Health Officials workforce enumeration pilot project demonstrated the issues involved in collecting workforce data. This project illustrated key elements of an institutionalized national system of workforce enumeration, which would be needed for a robust, recurring count that provides a national picture of the public health workforce.

  1. Transportation and public health.

    PubMed

    Litman, Todd

    2013-01-01

    This article investigates various ways that transportation policy and planning decisions affect public health and better ways to incorporate public health objectives into transport planning. Conventional planning tends to consider some public health impacts, such as crash risk and pollution emissions measured per vehicle-kilometer, but generally ignores health problems resulting from less active transport (reduced walking and cycling activity) and the additional crashes and pollution caused by increased vehicle mileage. As a result, transport agencies tend to undervalue strategies that increase transport system diversity and reduce vehicle travel. This article identifies various win-win strategies that can help improve public health and other planning objectives.

  2. Public health law reform.

    PubMed

    Gostin, L O

    2001-09-01

    Public health law reform is necessary because existing statutes are outdated, contain multiple layers of regulation, and are inconsistent. A model law would define the mission and functions of public health agen cies, provide a full range of flexible powers, specify clear criteria and procedures for activities, and provide protections for privacy and against discrimination. The law reform process provides an opportunity for public health agencies to draw attention to their resource needs and achievements and to form ties with constituency groups and enduring relations with the legislative branch of government. Ultimately, the law should become a catalyst, rather than an impediment, to reinvigorating the public health system.

  3. Public Health Law Reform

    PubMed Central

    Gostin, Lawrence O.

    2001-01-01

    Public health law reform is necessary because existing statutes are outdated, contain multiple layers of regulation, and are inconsistent. A model law would define the mission and functions of public health agencies, provide a full range of flexible powers, specify clear criteria and procedures for activities, and provide protections for privacy and against discrimination. The law reform process provides an opportunity for public health agencies to draw attention to their resource needs and achievements and to form ties with constituency groups and enduring relations with the legislative branch of government. Ultimately, the law should become a catalyst, rather than an impediment, to reinvigorating the public health system. PMID:11527757

  4. Defining and Negotiating the Social Value of Research in Public Health Facilities: Perceptions of Stakeholders in a Research-Active Province of South Africa.

    PubMed

    Lutge, Elizabeth; Slack, Catherine; Wassenaar, Douglas

    2017-02-01

    This article reports on qualitative research conducted in KwaZulu-Natal, South Africa, among researchers and gate-keepers of health facilities in the province. Results suggest disparate but not irreconcilable perceptions of the social value of research in provincial health facilities. This study found that researchers tended to emphasize the contribution of research to the generation of knowledge and to the health of future patients while gate-keepers of health facilities tended to emphasize its contribution to the healthcare system and to current patients. Furthermore, relations between research stakeholders were perceived to be somewhat fragile, making it difficult for stakeholders to achieve consensus about the social value of research, as well as on ways to maximize value. Interventions to negotiate a shared perspective on the social value of research would appear to be warranted, and the findings of this study suggest some focus areas for such intervention.

  5. ENVIRONMENTAL PUBLIC HEALTH INDICATORS

    EPA Science Inventory

    Environmental Public Health Indicators (EPHIs), quantitative measures of health factors and environmental influences tracked over time, can be used to identify specific areas and populations for intervention and prevention efforts and to evaluate the outcomes of implemented polic...

  6. What Ails Public Health?

    ERIC Educational Resources Information Center

    Alcabes, Philip

    2007-01-01

    Public health, once the gem of American social programs, has turned to dross. During the 20th century, the public-health sector wiped smallpox and polio off the U.S. map; virtually eliminated rickets, rubella, and goiter; stopped epidemic typhoid and yellow fever; and brought tuberculosis--once the leading cause of death in U.S. cities--under…

  7. Public health workforce taxonomy.

    PubMed

    Boulton, Matthew L; Beck, Angela J; Coronado, Fátima; Merrill, Jacqueline A; Friedman, Charles P; Stamas, George D; Tyus, Nadra; Sellers, Katie; Moore, Jean; Tilson, Hugh H; Leep, Carolyn J

    2014-11-01

    Thoroughly characterizing and continuously monitoring the public health workforce is necessary for ensuring capacity to deliver public health services. A prerequisite for this is to develop a standardized methodology for classifying public health workers, permitting valid comparisons across agencies and over time, which does not exist for the public health workforce. An expert working group, all of whom are authors on this paper, was convened during 2012-2014 to develop a public health workforce taxonomy. The purpose of the taxonomy is to facilitate the systematic characterization of all public health workers while delineating a set of minimum data elements to be used in workforce surveys. The taxonomy will improve the comparability across surveys, assist with estimating duplicate counting of workers, provide a framework for describing the size and composition of the workforce, and address other challenges to workforce enumeration. The taxonomy consists of 12 axes, with each axis describing a key characteristic of public health workers. Within each axis are multiple categories, and sometimes subcategories, that further define that worker characteristic. The workforce taxonomy axes are occupation, workplace setting, employer, education, licensure, certification, job tasks, program area, public health specialization area, funding source, condition of employment, and demographics. The taxonomy is not intended to serve as a replacement for occupational classifications but rather is a tool for systematically categorizing worker characteristics. The taxonomy will continue to evolve as organizations implement it and recommend ways to improve this tool for more accurate workforce data collection.

  8. Prevalence of post-traumatic stress symptoms and associated factors in tuberculosis (TB), TB retreatment and/or TB-HIV co-infected primary public health-care patients in three districts in South Africa.

    PubMed

    Peltzer, Karl; Naidoo, Pamela; Matseke, Gladys; Louw, Julia; McHunu, Gugu; Tutshana, Bomkazi

    2013-01-01

    High rates of tuberculosis (TB) and TB/HIV co-infection is often linked with mental health issues such as post-traumatic stress disorder (PTSD) symptoms, which is further associated with poor health outcomes. In a country such as South Africa where rates of these infectious diseases are high, it is concerning that there is limited/no data on prevalence rates of mental disorders such as PTSD and its associated factors. Therefore, the aim of this study was to establish the prevalence of PTSD symptoms and associated factors in TB, TB retreatment and/or TB-HIV co-infected primary public health-care patients in three districts in South Africa. Brief screening self-report tools were used to measure: PTSD symptoms, psychological distress (anxiety and depression) and alcohol misuse. Other relevant measures, such as adherence to medication, stressful life events and sexual risk-taking behaviours, were obtained through structured questions. A total of 4900 public primary care adult patients from clinics in high TB burden districts from three provinces in South Africa participated. All the patients screened positive for TB (either new or retreatment cases). The prevalence of PTSD symptoms was 29.6%. Patients who screened positive for PTSD symptoms and psychological distress were more likely to be on antidepressant medication. Factors that predicted PTSD symptoms were poverty, residing in an urban area, psychological distress, suicide attempt, alcohol and/or drug use before sex, unprotected sex, TB-HIV co-infected and the number of other chronic conditions. Health-care systems should be strengthened to improve delivery of mental health care, by focusing on existing programmes and activities, such as those which address the prevention and treatment of TB and HIV.

  9. Public health and peace.

    PubMed

    Laaser, Ulrich; Donev, Donco; Bjegović, Vesna; Sarolli, Ylli

    2002-04-01

    The modern concept of public health, the New Public Health, carries a great potential for healthy and therefore less aggressive societies. Its core disciplines are health promotion, environmental health, and health care management based on advanced epidemiological methodologies. The main principles of living together in healthy societies can be summarized as four ethical concepts of the New Public Health essential to violence reduction equity, participation, subsidiarity, and sustainability. The following issues are discussed as violence determinants: the process of urbanization; type of neighborhood and accommodation, and consequent stigmatization; level of education; employment status; socialization of the family; women's status; alcohol and drug consumption; availability of the firearms; religious, ethnic, and racial prejudices; and poverty. Development of the health systems has to contribute to peace, since aggression, violence, and warfare are among the greatest risks for health and the economic welfare. This contribution can be described as follows: 1) full and indiscriminate access to all necessary services, 2) monitoring of their quality, 3) providing special support to vulnerable groups, and 4) constant scientific and public accountability of the evaluation of the epidemiological outcome. Violence can also destroy solidarity and social cohesion of groups, such as family, team, neighborhood, or any other social organization. Durkheim coined the term anomie for a state in which social disruption of the community results in health risks for individuals. Health professionals can make a threefold contribution to peace by 1) analyzing the causal interrelationships of violence phenomena, 2) curbing the determinants of violence according to the professional standards, and 3) training professionals for this increasingly important task. Because tolerance is an essential part of an amended definition of health, monitoring of the early signs of public intolerance is

  10. Challenges and issues in health professions education in Africa.

    PubMed

    Burdick, William

    2007-11-01

    The challenges facing health professions education in Africa focus on physical infrastructure, accreditation systems, student selection and faculty recruitment, retention, and development. Higher education in the health professions must be closely aligned with community health needs, and with the training and support of community health workers. A key ingredient in changing institutions in this way is implementation of effective strategies for strengthening the faculty. In addition, information systems, and their prerequisite stable electric power supply, must be supported by internal public resources combined with external aid. These infrastructure investments will facilitate better quality education, improved diffusion of information among schools, and more useful data for self study by institutions.

  11. Children's Health Publications

    EPA Pesticide Factsheets

    Each title has a brief description and link for downloading the full text. Includes the publications catalog, the Child Health Champion resource guide, student curriculum materials, reports, fact sheets, and booklets/brochures of advice and tools.

  12. Population Health Science: A Core Element of Health Science Education in Sub-Saharan Africa.

    PubMed

    Hiatt, Robert A; Engmann, Natalie J; Ahmed, Mushtaq; Amarsi, Yasmin; Macharia, William M; Macfarlane, Sarah B; Ngugi, Anthony K; Rabbani, Fauziah; Walraven, Gijs; Armstrong, Robert W

    2017-04-01

    Sub-Saharan Africa suffers an inordinate burden of disease and does not have the numbers of suitably trained health care workers to address this challenge. New concepts in health sciences education are needed to offer alternatives to current training approaches.A perspective of integrated training in population health for undergraduate medical and nursing education is advanced, rather than continuing to take separate approaches for clinical and public health education. Population health science educates students in the social and environmental origins of disease, thus complementing disease-specific training and providing opportunities for learners to take the perspective of the community as a critical part of their education.Many of the recent initiatives in health science education in sub-Saharan Africa are reviewed, and two case studies of innovative change in undergraduate medical education are presented that begin to incorporate such population health thinking. The focus is on East Africa, one of the most rapidly growing economies in sub-Saharan Africa where opportunities for change in health science education are opening. The authors conclude that a focus on population health is a timely and effective way for enhancing training of health care professionals to reduce the burden of disease in sub-Saharan Africa.

  13. Theory Meets Theatre Practice: Making a Difference to Public Health Programmes in Southern Africa. Professor Lynn Dalrymple--South African Scholar, Activist, Educator

    ERIC Educational Resources Information Center

    Durden, Emma; Tomaselli, Keyan

    2012-01-01

    Lynn Dalrymple is a pioneer in the field of communication about HIV and AIDS in South Africa. Her work has influenced practitioners, researchers and thinkers in South Africa and beyond. This review explores Dalrymple's background as a teacher in the rural areas of Zululand in South Africa, and how she came to apply theatre theory for one of the…

  14. Systematic review of public health branding.

    PubMed

    Evans, W Douglas; Blitstein, Jonathan; Hersey, James C; Renaud, Jeanette; Yaroch, Amy L

    2008-12-01

    Brands build relationships between consumers and products, services, or lifestyles by providing beneficial exchanges and adding value to their objects. Brands can be measured through associations that consumers hold for products and services. Public health brands are the associations that individuals hold for health behaviors, or lifestyles that embody multiple health behaviors. We systematically reviewed the literature on public health brands; developed a methodology for describing branded health messages and campaigns; and examined specific branding strategies across a range of topic areas, campaigns, and global settings. We searched the literature for published studies on public health branding available through all relevant, major online publication databases. Public health branding was operationalized as any manuscripts in the health, social science, and business literature on branding or brands in health promotion marketing. We developed formalized decision rules and applied them in identifying articles for review. We initially identified 154 articles and reviewed a final set of 37, 10 from Africa, Australia, and Europe. Branded health campaigns spanned most of the major domains of public health and numerous communication strategies and evaluation methodologies. Most studies provided clear information on planning, development, and evaluation of the branding effort, while some provided minimal information. Branded health messages typically are theory based, and there is a body of evidence on their behavior change effectiveness, especially in nutrition, tobacco control, and HIV/AIDS. More rigorous research is needed, however, on how branded health messages impact specific populations and behaviors.

  15. Insights in Public Health

    PubMed Central

    Nelson-Hurwitz, Denise C; Arakaki, Lee-Ann; Uemoto, Maya

    2017-01-01

    The University of Hawai‘i at Manoa (UHM) has long provided public health graduate education. The University's Office of Public Health Studies (OPHS) has recently started to offer a Bachelor of Arts in Public Health (BA PH) degree in response to the growing need for professionals in the health field. The purpose of this paper is to describe how UHM operates the BA PH and how the program complements OPHS's mission and goals. First, we describe the overall scope of the BA PH within OPHS and within UHM. Then we provide examples of how the BA PH program and past undergraduate student projects align with OPHS's four main goals: (1) education, (2) research, (3) service, and (4) program development. PMID:28352496

  16. Structural adjustment and health policy in Africa.

    PubMed

    Loewenson, R

    1993-01-01

    World Bank/International Monetary Fund Structural Adjustment Programs (SAPs) have been introduced in over 40 countries of Africa. This article outlines their economic policy measures and the experience of the countries that have introduced them, in terms of nutrition, health status, and health services. The evidence indicates that SAPs have been associated with increasing food insecurity and undernutrition, rising ill-health, and decreasing access to health care in the two-thirds or more of the population of African countries that already lives below poverty levels. SAPs have also affected health policy, with loss of a proactive health policy framework, a widening gap between the affected communities and policy makers, and the replacement of the underlying principle of equity in and social responsibility for health care by a policy in which health is marketed commodity and access to health care becomes an individual responsibility. The author argues that there is a deep contradiction between SAPs and policies aimed at building the health of the population. Those in the health sector need to contribute to the development and advocacy of economic policies in which growth is based on human resource development, and to the development of a civic environment in Africa that can ensure the implementation of such policies.

  17. Insights in Public Health

    PubMed Central

    Pitt, Ruth

    2016-01-01

    Hawai‘i had high insurance coverage rates even before the Affordable Health Care Act and continues to have a high percentage of the population with health insurance today. However, high insurance rates can disguise wide variation in what is covered and what it costs. In this essay, an Australian Masters in Public Health student from the University of Hawai‘i considers the strengths and weaknesses of insurance coverage in the US health-care system when her friend “Peter” becomes seriously ill. PMID:27688955

  18. Insights in Public Health

    PubMed Central

    Canyon, Deon V

    2013-01-01

    The strengthening of health systems is fundamental to improving health outcomes, crisis preparedness, and our capacity to meet global challenges, such as accelerating progress towards the Millennium Development Goals, reducing maternal and child mortality, combating HIV, malaria and other diseases, limiting the effects of a new influenza pandemic, and responding appropriately to climate change. To meet these complex needs, the Association of Schools and Programs in Public Health, the World Health Organization, and the Institute of Medicine promote systems thinking as the only sensible means to respond to issues that greatly exceed the normal capacity of health and medical services. This paper agrees with the application of systems thinking but argues that health organizations have misunderstood and misapplied systems thinking to the extent that the term has become meaningless. This paper presents the basic constructs of systems thinking, explains why systems thinking has been misapplied, examines some misapplications of systems thinking in health, and suggests how the concept can be applied correctly to medicine and public health to achieve the reason it was adopted in the first place. PMID:24377080

  19. Urbanisation and women's health in South Africa.

    PubMed

    Pick, W; Cooper, D

    1997-03-01

    For many decades the migrant labor system and the influx control legislation in South Africa exacerbated male-dominant patterns of migration typical of Africa. In recent years, however, and especially following the easing of influx control legislation in 1986, migration in South Africa has increasingly involved women. This paper reports on a study conducted in Khayelitsha, Cape Town, which explored the relationship between urbanisation and the health of women. The objectives were to relate age, migration, length of stay in urban areas, employment status, and occupation to the health, including reproductive health, of women living in Khayelitsha. Interviews with 659 women (61 households had no senior woman) revealed that women enjoyed considerable social support through their neighbours, church organisations, and women's organisations. Women who lived in the most deprived section of Khayelitsha enjoyed more support from their neighbours but reported less satisfaction with the area in which they lived. Child-care support was poor and a considerable proportion of the women were disempowered by their male partners. More than 90 percent of the women had access to antenatal care. Recent immigrants had more pregnancies, were less aware of screening for cervical cancer, less likely to have had a Pap smear, less knowledgeable about where to have a Pap smear done, and less likely to have heard AIDS. More women were aware of AIDS (86%) than Pap smears (45%). More than half of those of childbearing age used contraception, mainly intramuscular hormones (76%). A significant proportion (53%) of the women reported that they had had their first pregnancy as teenagers and younger, less educated women were more likely to have had adolescent pregnancies. Policy makers are confronted by a compelling need to redress well-known urban-rural inequalities in health care in South Africa. Policy attention must also be given to the increasing urbanisation of women and the growing health care

  20. Transforming Public Health?

    PubMed Central

    ALDOUS, Chris

    2008-01-01

    Historical assessments of the Occupation’s efforts to tackle enteric diseases (cholera, typhoid, paratyphoid and dysentery) have generally reflected a celebratory narrative of US-inspired public health reforms, strongly associated with the head of the Public Health and Welfare Section, Crawford F. Sams. Close inspection of the documentary record, however, reveals much greater continuity with pre-war Japanese public health practices than has hitherto been acknowledged. Indeed, there are strong grounds for disputing American claims of novelty and innovation in such areas as immunisation, particularly in relation to typhoid vaccine, and environmental sanitation, where disparaging comments about the careless use of night soil and a reluctance to control flies and other disease vectors reveal more about the politics of public health reform than the reality of pre-war practices. Likewise, the representation of American-inspired sanitary teams as clearly distinct from and far superior to traditional sanitary associations (eisei kumiai) was closer to propaganda than an accurate rendering of past and present developments. PMID:19048809

  1. Public Health Pest Control.

    ERIC Educational Resources Information Center

    Arizona Univ., Tucson. Cooperative Extension Service.

    This manual supplies information helpful to individuals wishing to become certified in public health pest control. It is designed as a technical reference for vector control workers and as preparatory material for structural applicators of restricted use pesticides to meet the General Standards of Competency required of commercial applicators. The…

  2. Neuroenhancing public health.

    PubMed

    Shaw, David

    2014-06-01

    One of the most fascinating issues in the emerging field of neuroethics is pharmaceutical cognitive enhancement (CE). The three main ethical concerns around CE were identified in a Nature commentary in 2008 as safety, coercion and fairness; debate has largely focused on the potential to help those who are cognitively disabled, and on the issue of 'cosmetic neurology', where people enhance not because of a medical need, but because they want to (as many as 25% of US students already use nootropic cognitive enhancers such as ritalin). However, the potential for CE to improve public health has been neglected. This paper examines the prospect of improving health outcomes through CE among sections of the population where health inequalities are particularly pronounced. I term this enhancement of the public's health through CE 'neuroenhancing health'. It holds great promise, but raises several ethical issues. This paper provides an outline of these issues and related philosophical problems. These include the potential effectiveness of CE in reducing health inequalities; issues concerning autonomy and free will; whether moral enhancement might be more effective than CE in reducing health inequalities; and the problem of how to provide such CE, including the issue of whether to provide targeted or universal coverage.

  3. Globalisation and public health.

    PubMed

    Bettcher, D; Lee, K

    2002-01-01

    At the dawn of the 21st century, globalisation is a word that has become a part of everyday communication in all corners of the world. It is a concept that for some holds the promise of a new and brighter future, while for others it represents a threat that needs to be confronted and counteracted. In the area of public health, a wide range of claims have been made about the various impacts, both positive and negative, that can be attributed to globalisation. In the ever expanding literature on globalisation and health, it has become apparent that considerable confusion is emerging in both the ways that terminology is applied and concepts are defined. The determinants of health are increasingly multisectoral, and in tackling these challenges it is necessary to take a multidisciplinary approach that includes policy analyses in such areas as trade, environment, defence/security, foreign policy, and international law. In assembling the terms for this glossary, we have attempted to demonstrate the richness of the globalisation and public health debate, and in so doing have selected some of the core terms that require definition. We hope that this glossary will help to clarify this interesting and challenging area, and will also serve as a useful entry point to this new debate in public health.

  4. Harnessing the power of the grassroots to conduct public health research in sub-Saharan Africa: a case study from western Kenya in the adaptation of community-based participatory research (CBPR) approaches

    PubMed Central

    2013-01-01

    Background Community-based participatory research (CBPR) is a collaborative approach to research that involves the equitable participation of those affected by an issue. As the field of global public health grows, the potential of CBPR to build capacity and to engage communities in identification of problems and development and implementation of solutions in sub-Saharan Africa has yet to be fully tapped. The Orphaned and Separated Children’s Assessments Related to their Health and Well-Being (OSCAR) project is a longitudinal cohort of orphaned and non-orphaned children in Kenya. This paper will describe how CBPR approaches and principles can be incorporated and adapted into the study design and methods of a longitudinal epidemiological study in sub-Saharan Africa using this project as an example. Methods The CBPR framework we used involves problem identification, feasibility and planning; implementation; and evaluation and dissemination. This case study will describe how we have engaged the community and adapted CBPR methods to OSCAR’s Health and Well-being Project’s corresponding to this framework in four phases: 1) community engagement, 2) sampling and recruitment, 3) retention, validation, and follow-up, and 4) analysis, interpretation and dissemination. Results To date the study has enrolled 3130 orphaned and separated children, including children living in institutional environments, those living in extended family or other households in the community, and street-involved children and youth. Community engagement and participation was integral in refining the study design and identifying research questions that were impacting the community. Through the participation of village Chiefs and elders we were able to successfully identify eligible households and randomize the selection of participants. The on-going contribution of the community in the research process has been vital to participant retention and data validation while ensuring cultural and

  5. Nanotechnology and public health.

    PubMed

    Matsudai, Masami; Hunt, Geoffrey

    2005-11-01

    Nanotechnology is developing very quickly, and Japan is in many respects leading the world in this convergence of nanoscale engineering techniques. The public health community in Japan must start to think about the public health impacts of nanotechnology over the next 20 years. The responsibility for the benefits and the harms of nanotechnology lies with government, with corporations and the business community, with scientists and specialists in all related fields, and with NPOs and the public. There are very many questions of public health which are not yet being asked about nanotechnology. If nanoparticles are to be used in cosmetics, food production and packaging, how will they react or interact with the human skin and organs? What chemical-toxic effects on life might there be from the nanoparticles in car tires and vehicle plastic mouldings when they are disposed of by incineration? Will they pass into the soil and groundwater and enter into the food-chain? It is now an urgent ethical demand, based on the precautionary principle, that Japan join the governments of the world to take an intergovernmental initiative to intervene in the further development, production and marketing of nanotechnological products with precautionary research and regulation.

  6. Health care financing: recent experience in Africa.

    PubMed

    Dunlop, D W

    1983-01-01

    The economic realities of health sector development in Africa has been analyzed in this paper. Both the global and national macroeconomic context has been defined. Given the available data, it is clear that most African countries face increasingly serious economic realities, such as slow or even declining economic growth (per capita), a depressed food production situation, severe balance of payments crises, and increasing dependence on external financial assistance. Given the limited but increasingly available 1981 and 1982 data, the economic situation in many countries is more constrained than those indicated by the data contained in this paper. In this context, the potential competitive situation facing governmental health care systems was reviewed. In addition, the diversity in the sources of health expenditures between countries in Africa was highlighted. These data provide clear evidence that governments clearly do not finance the entire health care system and that individual payment for service in many countries represent an important source of revenue for many care providers in various health care systems operating in any given country. The potential for governments to finance either an expansion of or improvements to the government component of their health care systems is then reviewed. The highlights of this analysis include the following points. First, the tax structure in many African countries is highly dependent on export and import duties, which in turn creates dependency on sustained foreign demand for exports.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Public health law research: exploring law in public health systems.

    PubMed

    Ibrahim, Jennifer K; Burris, Scott; Hays, Scott

    2012-11-01

    The importance of law in the organization and operation of public health systems has long been a matter of interest to public health lawyers and practitioners, but empirical research on law as a factor in health system performance has been limited in quantity and sophistication. The emergence of Public Health Law Research and Public Health Systems and Services Research within a coordinated effort to strengthen public health research and practice has dramatically changed matters. This article introduces Public Health Law Research as an integral part of Public Health Systems and Services Research, discusses the challenges of integrating the 2 fields, and highlights 2 examples of current research that demonstrate the benefits of an integrated approach to improve the use of law in public health practice.

  8. Consumers' Perspectives on National Health Insurance in South Africa: Using a Mobile Health Approach

    PubMed Central

    Stuttaford, Maria C

    2014-01-01

    Background Building an equitable health system is a cornerstone of the World Health Organization (WHO) health system building block framework. Public participation in any such reform process facilitates successful implementation. South Africa has embarked on a major reform in health policy that aims at redressing inequity and enabling all citizens to have equal access to efficient and quality health services. Objective This research is based on a survey using Mxit as a mobile phone–based social media network. It was intended to encourage comments on the proposed National Health Insurance (NHI) and to raise awareness among South Africans about their rights to free and quality health care. Methods Data were gathered by means of a public e-consultation, and following a qualitative approach, were then examined and grouped in a theme analysis. The WHO building blocks were used as the conceptual framework in analysis and discussion of the identified themes. Results Major themes are the improvement of service delivery and patient-centered health care, enhanced accessibility of health care providers, and better health service surveillance. Furthermore, health care users demand stronger outcome-based rather than rule-based indicators of the health system’s governance. Intersectoral solidarity and collaboration between private and public health care providers are suggested. Respondents also propose a code of ethical values for health care professionals to address corruption in the health care system. It is noteworthy that measures for dealing with corruption or implementing ethical values are neither described in the WHO building blocks nor in the NHI. Conclusions The policy makers of the new health system for South Africa should address the lack of trust in the health care system that this study has exposed. Furthermore, the study reveals discrepancies between the everyday lived reality of public health care consumers and the intended health policy reform. PMID:25351980

  9. Insights in Public Health

    PubMed Central

    Chock, Linda R; Hayes, Donald K; Tomiyasu, Danette Wong

    2014-01-01

    The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a proven, cost-effective investment in strengthening families. As part of the United States Department of Agriculture's (USDA) 15 federal nutrition assistance programs for the past 40 years, WIC has grown to be the nation's leading public health nutrition program. WIC serves as an important first access point to health care and social service systems for many limited resource families, serving approximately half the births in the nation as well as locally. By providing nutrition education, breastfeeding promotion and foods in addition to referrals, WIC plays a crucial role in promoting lifetime health for women, infants and children. WIC helps achieve national public health goals such as reducing premature births and infant mortality, increasing breastfeeding, and reducing maternal and childhood overweight. Though individuals and families can self-refer into WIC, physicians and allied health professionals have the opportunity and are encouraged to promote awareness of WIC and refer families in their care. PMID:25285258

  10. Health and social policies in the new South Africa.

    PubMed

    Pillay, Y G; Bond, P

    1995-01-01

    South Africa's first democratic government is today confronted with the challenge of recasting apartheid social and health policies, transforming a moribund bureaucracy's mode of governance, and restructuring a variety of public and private institutions, including the national Department of Health. In the attempt to redress racial, gender, and class inequities, enormous barriers confront health policy analysts and planners, progressive politicians, and activists within civil society who work in the field of health. This article sets the broad social policy context for the emerging strategies, documents some of the continuing inequities in the health sector, and recounts some recent experiences in one of the nine provinces (KwaZulu-Natal). to illustrate the difficulties and potentials that change of this magnitude presents under the prevailing conditions of neoliberal politics and economics.

  11. Insights in Public Health

    PubMed Central

    Whelen, A Christian; Kitagawa, Kent; Maddock, Jay; Hayes, Donald; St John, Tonya Lowery; Rajan, Ranjani

    2013-01-01

    Chronically understaffed public health laboratories depend on a decreasing number of employees who must assume broader responsibilities in order to sustain essential functions for the many clients the laboratories support. Prospective scientists considering a career in public health are often not aware of the requirements associated with working in a laboratory regulated by the Clinical Laboratory Improvement Amendments (CLIA). The purpose of this pilot internship was two-fold; introduce students to operations in a regulated laboratory early enough in their academics so that they could make good career decisions, and evaluate internship methodology as one possible solution to workforce shortages. Four interns were recruited from three different local universities, and were paired with an experienced State Laboratories Division (SLD) staff mentor. Students performed tasks that demonstrated the importance of CLIA regulations for 10–15 hours per week over a 14 week period. Students also attended several directed group sessions on regulatory lab practice and quality systems. Both interns and mentors were surveyed periodically during the semester. Surveys of mentors and interns indicated overall positive experiences. One-on-one pairing of experienced public health professionals and students seems to be a mutually beneficial arrangement. Interns reported that they would participate if the internship was lower paid, unpaid, or for credit only. The internship appeared to be an effective tool to expose students to employment in CLIA-regulated laboratories, and potentially help address public health laboratory staffing shortfalls. Longer term follow up with multiple classes of interns may provide a more informed assessment. PMID:23386992

  12. Insights in Public Health

    PubMed Central

    Hayes, Donald K; Calhoun, Candice R; Joseph, Lin; Farnsworth, JoAnn Y; Arakaki, Kimberly B

    2016-01-01

    The Hawai‘i Maternal and Infant Health Collaborative, founded in 2013, is a public-private partnership committed to improving birth outcomes and reducing infant mortality. The Collaborative was developed in partnership with the Executive Office on Early Learning Action Strategy with help from the Department of Health and National Governor's Association. The Action Strategy provides Hawai‘i with a roadmap for an integrated and comprehensive early childhood system, spanning preconception to third grade. The Collaborative helps advance goals within the Action Strategy by focusing on ensuring that children have the best start in life by being healthy and welcomed. The Collaborative has completed a strategic plan and accompanying Logic Model, The First 1,000 Days, aimed at achieving the outcomes of 8% reduction in preterm births and 4% reduction in infant mortality. To date over 120 people across Hawai‘i have been involved in the Collaborative. These members include physicians and clinicians, public health planners and providers, insurance providers and health care administrators. The work is divided into three primary areas and coordinated by a cross sector leadership team. Work is specific, outcome driven, informed by data and primarily accomplished in small work groups. PMID:27738566

  13. Canada: public health genomics.

    PubMed

    Little, J; Potter, B; Allanson, J; Caulfield, T; Carroll, J C; Wilson, B

    2009-01-01

    Canada has a diverse population of 32 million people and a universal, publicly funded health care system provided through provincial and territorial health insurance plans. Public health activities are resourced at provincial/territorial level with strategic coordination from national bodies. Canada has one of the longest-standing genetics professional specialty organizations and is one of the few countries offering master's level training designed specifically for genetic counselors. Prenatal screening is offered as part of routine clinical prenatal services with variable uptake. Surveillance of the effect of prenatal screening and diagnosis on the birth prevalence of congenital anomalies is limited by gaps and variations in surveillance systems. Newborn screening programs vary between provinces and territories in terms of organization and conditions screened for. The last decade has witnessed a four-fold increase in requests for genetic testing, especially for late onset diseases. Tests are performed in provincial laboratories or outside Canada. There is wide variation in participation in laboratory quality assurance schemes, and there are few regulatory frameworks in Canada that are directly relevant to genetics testing services or population genetics. Health technology assessment in Canada is conducted by a diverse range of organizations, several of which have produced reports related to genetics. Several large-scale population cohort studies are underway or planned, with initiatives to harmonize their conduct and the management of ethical issues, both within Canada and with similar projects in other countries.

  14. Africa.

    ERIC Educational Resources Information Center

    Martz, Carlton

    2001-01-01

    This publication explores issues related to Africa. It examines the U.S. response to the Barbary pirate states (Morocco, Algiers, Tunis, Tripoli) in the early 19th century; the current AIDS crisis in Africa; and 14th century Mali and other Islamic lands through the eyes of Ibn Battuta, who traveled throughout the Muslim world. Each article…

  15. Public health, public trust and lobbying.

    PubMed

    Wynia, Matthew K

    2007-06-01

    Each year, infection with Human Papillomavirus (HPV) leads to millions of abnormal Pap smears and thousands of cases of cervical cancer in the US. Throughout the developing world, where Pap smears are less common, HPV is a leading cause of cancer death among women. So when the international pharmaceutical giant Merck developed a vaccine that could prevent infection with several key strains of HPV, the public health community was anxious to celebrate a major advance. But then marketing and lobbying got in the way. Merck chose to pursue an aggressive lobbying campaign, trying to make its new vaccine mandatory for young girls. The campaign stoked public mistrust about how vaccines come to be mandated, and now it's not just Merck's public image that has taken a hit. The public health community has also been affected. What is the lesson to be learned from this story? Public health communication relies on public trust.

  16. [Phonoaudiology in public health].

    PubMed

    Freire, R M

    1992-06-01

    An undestanding of the activities and functions of a speech therapist within the specific context of the Basic Health Units (Unidades Básicas de Saúde) is sought. Difficulties relating to the introduction of a new service on the basis of one of the health professions that has not hitherto belonged to the group of categories which are traditionally incorporated in these same Basic Units. When the statistical data on the demand for speech therapy services by the population who attend health centres were considered, it was discovered that 32% were of schooling age and had been referred by schools, allegedly due to "learning problems". Closer contact with these children, through speech therapy, has brought a different aspect to light i.e. that one cannot consider as disturbance/deviation/problem/pathology written signs which constitute indications of the shock between the process of literacy and that of learning how to read and write. To understand the problem from the point of view of public health, a programme of teacher counselling is proposed, with the purpose of helping the school to clarify its role as co-constructor of the child's literacy process and of returning to the teacher the responsibility for the success and/or failure of teaching how to read and write. A similar programme is proposed for creches where coincidently, a greater proportion (44%) of the younger children (2 to 5 years of age) are seen to have difficulties in oral language development.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Health in South Africa: changes and challenges since 2009.

    PubMed

    Mayosi, Bongani M; Lawn, Joy E; van Niekerk, Ashley; Bradshaw, Debbie; Abdool Karim, Salim S; Coovadia, Hoosen M

    2012-12-08

    increase the health research budget to 2·0% of national health spending. However, large racial differentials exist in social determinants of health, especially housing and sanitation for the poor and inequity between the sexes, although progress has been made in access to basic education, electricity, piped water, and social protection. Integration of the private and public sectors and of services for HIV, tuberculosis, and non-communicable diseases needs to improve, as do surveillance and information systems. Additionally, successful interventions need to be delivered widely. Transformation of the health system into a national institution that is based on equity and merit and is built on an effective human-resources system could still place South Africa on track to achieve Millennium Development Goals 4, 5, and 6 and would enhance the lives of its citizens.

  18. Feminism and public health ethics.

    PubMed

    Rogers, W A

    2006-06-01

    This paper sketches an account of public health ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in public health ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of public health, from policy making through to programme delivery. The complexity of public health demands investigation using multiple perspectives and an attention to detail that is capable of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of public health ethics embraces rather than avoids the inescapable political dimensions of public health.

  19. Insights in Public Health

    PubMed Central

    Oshiro, Peter

    2015-01-01

    Reducing the occurrence of and influencing the rapid correction of food illness risk factors is a common goal for all governmental food regulatory programs nationwide. Foodborne illness in the United States is a major cause of personal distress, preventable illness, and death. To improve public health outcomes, additional workforce was required due to long standing staffing shortages and was obtained partially through consolidation of the Hawai‘i Department of Health's (HDOH) two food safety programs, the Sanitation Branch, and the Food & Drug Branch in July 2012, and through legislation that amended existing statutes governing the use of food establishment permit fees. Additionally, a more transparent food establishment grading system was developed after extensive work with industry partners based on three possible placards issued after routine inspections: green, yellow, and red. From late July 2014 to May 2015, there were 6,559 food establishments inspected statewide using the placard system with 79% receiving a green, 21% receiving a yellow, and no red placards issued. Sufficient workforce to allow timely inspections, continued governmental transparency, and use of new technologies are important to improve food safety for the public. PMID:26279966

  20. Emtonjeni-A Structural Intervention to Integrate Sexual and Reproductive Health into Public Sector HIV Care in Cape Town, South Africa: Results of a Phase II Study.

    PubMed

    Mantell, J E; Cooper, D; Exner, T M; Moodley, J; Hoffman, S; Myer, L; Leu, C-S; Bai, D; Kelvin, E A; Jennings, K; Stein, Z A; Constant, D; Zweigenthal, V; Cishe, N; Nywagi, N

    2017-03-01

    Integration of sexual and reproductive health within HIV care services is a promising strategy for increasing access to family planning and STI services and reducing unwanted pregnancies, perinatal HIV transmission and maternal and infant mortality among people living with HIV and their partners. We conducted a Phase II randomized futility trial of a multi-level intervention to increase adherence to safer sex guidelines among those wishing to avoid pregnancy and adherence to safer conception guidelines among those seeking conception in newly-diagnosed HIV-positive persons in four public-sector HIV clinics in Cape Town. Clinics were pair-matched and the two clinics within each pair were randomized to either a three-session provider-delivered enhanced intervention (EI) (onsite contraceptive services and brief milieu intervention for staff) or standard-of-care (SOC) provider-delivered intervention. The futility analysis showed that we cannot rule out the possibility that the EI intervention has a 10 % point or greater success rate in improving adherence to safer sex/safer conception guidelines than does SOC (p = 0.573), indicating that the intervention holds merit, and a larger-scale confirmatory study showing whether the EI is superior to SOC has merit.

  1. Health status and its determinants in South Africa.

    PubMed

    Yach, D

    1994-03-01

    South Africa's apartheid policies have had direct and indirect effects on morbidity and death that will likely remain for decades. Since 1964, the economy has largely been deteriorating, while the population has grown at 2.8%/year, both of which have hampered economic development and health. South Africa needs to supply water, sanitation, and housing to 75% of the population. Rural development is needed to stem malnutrition, soil erosion, and overgrazing. Urban development design and planning must include health. Schooling needs to improve educators can emphasize school health education. Electricity and better lighting are needed to reduce chest diseases and paraffin poisoning and to improve literacy and learning. Labor migration has contributed to a high rate of sexually transmitted diseases and HIV/AIDS in rural areas. In some cases, industry and the public sector have become partners to improve health. The alcohol industry sponsors drive safe campaigns. South Africans need to address inequalities in health status by race, region, and gender, and to follow a holistic development approach. Infant mortality is just 6.4/1000 for Whites, while it is 66.7/1000 for Blacks. It is 1.5 times lower in the best region than it is in the worst region. 2 of every 25 children die before their first birthday among Africans living in the poorest third of South Africa. 42% of Black men who live to 15 years die before their 60th birthday, while just 17.5% of like White women do. Black children less than 5 years old have an almost 9-fold excess in deaths over White children. The tuberculosis rate is among the highest in the world and is likely to increase as HIV/AIDS spreads. Many other preventable diseases occur among South Africans. 5-8% of the population suffer a disability. South Africa has the highest per capita violence mortality rate worldwide (59.2/100,000 vs. 9.6/100,000 in the US). South Africa is likely to face increases in lung cancer, chronic lung disease, heart disease

  2. An interventional model to develop health professionals in West Africa.

    PubMed

    Sanou, Anselme Simeon; Awoyale, Florence Adeola; Diallo, Abdoulaye

    2014-01-01

    The health sector is characterized by a human resource base lacking in numbers, specialized skills, and management skills. West African Health Organization (WAHO) recognizes the need within the West Africa sub-region for bilingual professionals who are skilled in public health, management, leadership, and information technology to build human capacity in public health and developed the Young Professionals Internship Program (YPIP). Our study explores the evolution of the programme. YPIP program has successfully carried out its original aims and objectives to equip young professionals with basic principles of public health, management, and leadership, acquire competence in a second official language (French, English, and Portuguese), information and communication technology. Contributing factors towards this successful evaluation included positive ratings and commentary from previous interns about the relevance, usefulness, and quality of the programme, encouraging feedback from WAHO management, trainers, administrators, and intern employers on the impact of the YPIP program on young professionals, supporting evidence that demonstrates increased knowledge in professional skills and language competency.

  3. NHV and child public health.

    PubMed

    Köhler, Lennart

    2015-08-01

    One of the main interests of the Nordic School of Public Health (NHV) in both education and research was child public health, i.e. an area based on the broad World Health Organisation (WHO) health ideology and on public health methods, while concentrating on the special needs and characteristics of children. The fields of study and action, training, research and service, had the ultimate task to consider the health of children in their full social, economic and political context. Regular courses on child public health were offered as part of the general program in Public Health from 1979 until the closing down of the school, named: Social Paediatrics; Child Health; Child Public Health; and finally, Measuring Children's Health - A Public Health Perspective. Numerous national, Nordic and international conferences were held, and several textbooks were written and edited. A major research project, NordChild, was initiated as a cross-sectional postal study of a random sample of children aged 2-17 years from the five Nordic countries, performed in 1984, 1996 and 2011. So far, 10 doctoral theses and more than 130 other publications from the studies have been produced. Furthermore, the Nordic Network on Research of Refugee Children was created, and a special interest has been devoted to indicators for children's health, both internationally, nationally and locally, which has been demonstrated in major EU projects as well as locally in Sweden and Greenland.

  4. Health for all: a public health vision.

    PubMed Central

    McBeath, W H

    1991-01-01

    The approach of a millennial passage invites public health to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO's multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services. Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new public health" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society--nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and public health professionals. PMID:1746649

  5. Insights in Public Health

    PubMed Central

    Kimura, Lisa J; McGee, Amelia; Baird, Shelagh; Viloria, Joanne; Nagatsuka, Melissa

    2015-01-01

    Healthy Mothers, Healthy Babies Coalition of Hawai‘i (HMHB) is a local nonprofit organization dedicated to eliminating health disparities and improving Hawai‘i's maternal, child, and family health though collaborative efforts in public education, advocacy, and partner development. A review of HMHB services revealed overwhelming requests for both breastfeeding and postpartum depression (PPD) support. The purpose of this article is to present the findings of two surveys that highlight the awareness of existing breastfeeding and PPD resources based on both parents and health care providers; perceptions of where and how care is accessed; and whether mothers throughout Hawai‘i have equitable access to support. Results helped assess gaps in resources and determine barriers to care, as well as provide suggestions for new services or resources. Web-based surveys were sent to 450 providers and 2,955 parents with response rates of 8.9% and 4.0%, respectively. Less than half of parent participants reported that their health provider discussed PPD with them. Participants identified a number of barriers to increasing access and utilization of PPD support resources, including: not feeling like symptoms were server enough, feeling embarrassed to seek help, not knowing where to find support/information, and not able to afford or insurance wouldn't cover PPD support. Only 40% of providers reported screening for PPD and 33% felt they had not received adequate training. Barriers identified by providers were a lack of trained providers, lack of PPD specific support groups, cultural stigma, and lack of PPD awareness among providers. Of the women who did not exclusively breastfeed for the full six-month recommendation, the most common breastfeeding concerns included: perceptions of low milk supply; lack of lactation support; medical reasons; and pain. Providers described an environment of uneven distribution of resources, general lack of awareness of available resources, along

  6. Public Health Education in Florida.

    ERIC Educational Resources Information Center

    Florida State Dept. of Education, Tallahassee.

    This report documents issues related to the work of the Florida Comprehensive Health Professions Education Plan. Public health education prepares students for initial employment or advancement in a number of positions. While the public health work force is primarily employed in various units in local, state, and federal governments, industry also…

  7. Realising social justice in public health law.

    PubMed

    Fox, Marie; Thomson, Michael

    2013-03-01

    Law has played an important, but largely constitutive, role in the development of the public health enterprise. Thus, law has been central to setting up the institutions and offices of public health. The moral agenda has, however, been shaped to a much greater extent by bioethics. While social justice has been placed at the heart of this agenda, we argue that there has been little place within dominant conceptions of social justice for gender equity and women's interests which we see as crucial to a fully realised vision of social justice. We argue that, aside from particular interventions in the field of reproduction, public health practice tends to marginalise women-a claim we support by critically examining strategies to combat the HIV pandemic in sub-Saharan Africa. To counter the marginalisation of women's interests, this article argues that Amartya Sen's capabilities approach has much to contribute to the framing of public health law and policy. Sen's approach provides an evaluative and normative framework which recognises the importance of both gender and health equity to achieving social justice. We suggest that domestic law and international human rights provisions, in particular the emerging human right to health, offer mechanisms to promote capabilities, and foster a robust and inclusive conception of social justice.

  8. Public relations effectiveness in public health institutions.

    PubMed

    Springston, Jeffrey K; Weaver Lariscy, Ruth Ann

    2005-01-01

    This article explores public relations effectiveness in public health institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored.

  9. Assessment of Public Health Infrastructure to Determine Public Health Preparedness

    DTIC Science & Technology

    2006-03-01

    provide a strong concept of the public health infrastructure. It is a useful tool permitting local agencies to compare themselves to national averages...limitations of the system they govern. The concept of articulating program guidelines for local public health activities is a NJDHSS tradition...referral to treatment and social service agencies. • Maternal and Child Health activities a. Infants and preschool – health supervision for infants

  10. The Professions of Public Health

    PubMed Central

    Fox, Daniel M.

    2001-01-01

    Law has been an essential tool of public health practice for centuries. From the 19th century until recent decades, however, most histories of public health described, approvingly, the progression of the field from marginally useful policy, made by persons learned in law, to effective policy, made by persons employing the methods of biomedical and behavioral science. Historians have recently begun to change this standard account by documenting the centrality of law in the development of public health practice. The revised history of public health offers additional justification for the program of public health law reform proposed in this issue of the Journal by Gostin and by Moulton and Matthews, who describe the new program in public health law of the Centers for Disease Control and Prevention. PMID:11527756

  11. Social marketing in public health.

    PubMed

    Grier, Sonya; Bryant, Carol A

    2005-01-01

    Social marketing, the use of marketing to design and implement programs to promote socially beneficial behavior change, has grown in popularity and usage within the public health community. Despite this growth, many public health professionals have an incomplete understanding of the field. To advance current knowledge, we provide a practical definition and discuss the conceptual underpinnings of social marketing. We then describe several case studies to illustrate social marketing's application in public health and discuss challenges that inhibit the effective and efficient use of social marketing in public health. Finally, we reflect on future developments in the field. Our aim is practical: to enhance public health professionals' knowledge of the key elements of social marketing and how social marketing may be used to plan public health interventions.

  12. Fulbright Scholar opportunities for global health and women's health care in HIV/AIDS in sub-Saharan Africa.

    PubMed

    Nicholas, Patrice K; Adejumo, Oluyinka; Nokes, Kathleen M; Ncama, Busisiwe P; Bhengu, Busisiwe R; Elston, Elizabeth; Nicholas, Thomas P

    2009-02-01

    This article addresses global health opportunities related to HIV/AIDS and women's health care in sub-Saharan Africa through Fulbright Scholar and Fulbright Student Awards. Although many universities offer a gateway to the J. William Fulbright awards, some disciplines and areas of specialization, including nursing and women's health, have had fewer scholars or students as recipients of these awards. Resource-limited countries, including the countries of sub-Saharan Africa, offer rich opportunities for cross-cultural exchange and advancement of global health. Amidst the context of the shortage of health care workers, the increasing prevalence of HIV/AIDS and other infectious and chronic diseases in sub-Saharan Africa, and the challenges of public health, this article addresses an example of partnerships in global nursing that can be developed through the Fulbright programs.

  13. Corporate social responsibility in public health: A case-study on HIV/AIDS epidemic by Johnson & Johnson company in Africa

    PubMed Central

    Chattu, Vijay Kumar

    2015-01-01

    HIV/AIDS has claimed millions of lives in the global workforce and continues to remain a threat to many businesses. An estimated 36.5 million of working people are living with HIV; the global workforce has lost 28 million people from AIDS since the beginning of the epidemic. In the absence of access to treatment, this number could grow to 74 million by 2015. The epidemic continues to affect the working population through absenteeism, sickness and death. Corporate Social Responsibility (CSR) is an obligation that corporates have toward their employees, community and society. A review and documentation of one such CSR by Johnson & Johnson (a multinational company) for HIV/AIDS in Africa is presented here. Johnson & Johnson Company is involved in numerous projects around the world to combat the HIV/AIDS epidemic. The company is working to fight the spread of the disease and improve the quality of life for those living with the illness through various donations of its products and sponsorship of local programs. This case study also highlights different categories of CSR activities such as Cause Promotion, Cause related Marketing, Corporate Philanthropy, Corporate Social Marketing, Corporate Volunteering and Socially responsible business practices, which are discussed with specific examples from different countries in Africa. Conclusions: CSR of any business encompasses the economic, legal, ethical & discretionary expectation placed on the organization by society at a given point of time. CSR is therefore the obligation that corporations have toward their stakeholders and society in general which horizons beyond what is prescribed by law or union contracts. Johnson & Johnson has a proved history of being committed to caring for people and a good example of a company with a long history of citizenship and sustainability. PMID:25810667

  14. [Terrorism, public health and health services].

    PubMed

    Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge

    2009-01-01

    Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

  15. Mental health services in South Africa: taking stock.

    PubMed

    Lund, C; Petersen, I; Kleintjes, S; Bhana, A

    2012-11-01

    There is new policy commitment to mental health in South Africa, demonstrated in the national mental health summit of April 2012. This provides an opportunity to take stock of our mental health services. At primary care level key challenges include- training and supervision of staff in the detection and management of common mental disorders, and the development of community-based psychosocial rehabilitation programmes for people with severe mental illness (in collaboration with existing non-governmental organizations). At secondary level, resources need to be invested in 72-hour observation facilities at designated district and regional hospitals, in keeping with the Mental Health Care Act. At tertiary level, greater continuity of care with primary and secondary levels is required to prevent "revolving door" patterns of care. There are major challenges and also opportunities related to the high level of comorbidity between mental illness and a range of other public health priorities, notably HIV/AIDS, cardiovascular disease and diabetes. The agenda for mental health services research needs to shift to a focus on evaluating interventions. With current policy commitment, the time to act and invest in evidence-based mental health services is now.

  16. Zoning should promote public health.

    PubMed

    Hirschhorn, Joel S

    2004-01-01

    Legally, governments use their police powers to protect public health, safety, and welfare through zoning. This paper presents a case for revisiting zoning on the basis of increasing evidence that certain types of community design promote public health, as opposed to the dominant pattern of sprawl development, which does not. Zoning, and the land use planning linked to it, that prohibits or disfavors health-promoting community designs contradicts the inherent public policy goal on which it is based. If there is a paradigm shift underway, from traditional sprawl to health-promoting community designs, then health professionals and others should understand why zoning must be reassessed.

  17. Reenergizing Public Health Through Precaution

    PubMed Central

    Kriebel, David; Tickner, Joel

    2001-01-01

    The precautionary principle has provoked a spirited debate among environmentalists worldwide, but it is equally relevant to public health and shares much with primary prevention. Its central components are (1) taking preventive action in the face of uncertainty; (2) shifting the burden of proof to the proponents of an activity; (3) exploring a wide range of alternatives to possibly harmful actions; and (4) increasing public participation in decision making. Precaution is relevant to public health, because it can help to prevent unintended consequences of well-intentioned public health interventions by ensuring a more thorough assessment of the problems and proposed solutions. It can also be a positive force for change. Three aspects are stressed: promoting the search for safer technologies, encouraging greater democracy and openness in public health policy, and stimulating reevaluation of the methods of public health science. PMID:11527753

  18. Liberalism and Public Health Ethics.

    PubMed

    Rajczi, Alex

    2016-02-01

    Many public health dilemmas involve a tension between the promotion of health and the rights of individuals. This article suggests that we should resolve the tension using our familiar liberal principles of government. The article considers the common objections that (i) liberalism is incompatible with standard public health interventions such as anti-smoking measures or intervention in food markets; (2) there are special reasons for hard paternalism in public health; and (3) liberalism is incompatible with proper protection of the community good. The article argues that we should examine these critiques in a larger methodological framework by first acknowledging that the right theory of public health ethics is the one we arrive at in reflective equilibrium. Once we examine the arguments for and against liberalism in that light, we can see the weaknesses in the objections and the strength of the case for liberalism in public health.

  19. Assessment of the Physicochemical Qualities and Prevalence of Escherichia coli and Vibrios in the Final Effluents of Two Wastewater Treatment Plants in South Africa: Ecological and Public Health Implications.

    PubMed

    Osuolale, Olayinka; Okoh, Anthony

    2015-10-23

    The final effluents of two wastewater treatment plants (WWTPs) in the Eastern Cape Province of South Africa were evaluated for their physicochemical and microbiological qualities over a period of 12 months. The physicochemical parameters assessed ranged as follows both plants. The ranges of values for the physicochemical are: pH (3.9-8.6), total dissolved solids (86.50-336.3 mg/L), electrical conductivity (13.57-52.50 mS/m), temperature (13-28 °C), nitrate (0-21.73 mg/L), nitrite (0.01-0.60 mg/L), orthophosphate (1.29-20.57 mg/L), turbidity (4.02-43.20 NTU), free chlorine (0.05-7.18 mg/L), dissolve oxygen (3.91-9.60 mg/L), biochemical oxygen demand (0.1-9.0 mg/L) and chemical oxygen demand (4.67-211 mg/L). The microbiological assessment for both WWTPs revealed the presence of E. coli in counts ranging between 0 and 1.86 × 10⁴ CFU/100 mL and Vibrio counts ranging between 0 and 9.93 × 10³ CFU/100 mL. We conclude that these WWTPs are important point sources of pollution in surface water with potential public health and ecological risks.

  20. Assessment of the Physicochemical Qualities and Prevalence of Escherichia coli and Vibrios in the Final Effluents of Two Wastewater Treatment Plants in South Africa: Ecological and Public Health Implications

    PubMed Central

    Osuolale, Olayinka; Okoh, Anthony

    2015-01-01

    The final effluents of two wastewater treatment plants (WWTPs) in the Eastern Cape Province of South Africa were evaluated for their physicochemical and microbiological qualities over a period of 12 months. The physicochemical parameters assessed ranged as follows both plants. The ranges of values for the physicochemical are: pH (3.9–8.6), total dissolved solids (86.50–336.3 mg/L), electrical conductivity (13.57–52.50 mS/m), temperature (13–28 °C), nitrate (0–21.73 mg/L), nitrite (0.01–0.60 mg/L), orthophosphate (1.29–20.57 mg/L), turbidity (4.02–43.20 NTU), free chlorine (0.05–7.18 mg/L), dissolve oxygen (3.91–9.60 mg/L), biochemical oxygen demand (0.1–9.0 mg/L) and chemical oxygen demand (4.67–211 mg/L). The microbiological assessment for both WWTPs revealed the presence of E. coli in counts ranging between 0 and 1.86 × 104 CFU/100 mL and Vibrio counts ranging between 0 and 9.93 × 103 CFU/100 mL. We conclude that these WWTPs are important point sources of pollution in surface water with potential public health and ecological risks. PMID:26512686

  1. Foodborne pathogens recovered from ready-to-eat foods from roadside cafeterias and retail outlets in Alice, Eastern Cape Province, South Africa: public health implications.

    PubMed

    Nyenje, Mirriam E; Odjadjare, Collins E; Tanih, Nicoline F; Green, Ezekiel; Ndip, Roland N

    2012-08-01

    This study assessed the microbiological quality of various ready-to-eat foods sold in Alice, South Africa. Microbiological analysis was conducted on 252 samples which included vegetables, potatoes, rice, pies, beef and chicken stew. The isolates were identified using biochemical tests and the API 20E, API 20NE and API Listeria kits; results were analyzed using the one-way-ANOVA test. Bacterial growth was present in all the food types tested; high levels of total aerobic count were observed in vegetables, 6.8 ± 0.07 followed by rice, 6.7 ± 1.7 while pies had the lowest count (2.58 ± 0.24). Organisms isolated included: Listeria spp. (22%), Enterobacter spp. (18%), Aeromonas hydrophila (12%), Klebsiella oxytoca (8%), Proteus mirabilis (6.3%), Staphylococcus aureus (3.2%) and Pseudomonas luteola (2.4%). Interestingly, Salmonella spp. and Escherichia coli were not isolated in any of the samples. There was a statistically significant difference (p < 0.05) in the prevalence of foodborne pathogens from hygienic and unhygienic cafeterias. The results indicated that most of the ready-to-eat food samples examined in this study did not meet bacteriological quality standards, therefore posing potential risks to consumers. This should draw the attention of the relevant authorities to ensure that hygienic standards are improved to curtain foodborne infections.

  2. One Health capacity building in sub-Saharan Africa

    PubMed Central

    Rwego, Innocent B.; Babalobi, Olutayo Olajide; Musotsi, Protus; Nzietchueng, Serge; Tiambo, Christian Keambo; Kabasa, John David; Naigaga, Irene; Kalema-Zikusoka, Gladys; Pelican, Katherine

    2016-01-01

    Background Africa of late has been faced with challenges that require a multidisciplinary and multisectoral approach to address them, and academic and non-academic institutions have played a key role in training and conducting research that would promote the One Health approach. Objectives The objective of this review was to document networks and organizations conducting One Health training, research, and outreach in Africa, as one of a series of articles around the world. Methods Data for this review were collected from organizations through key contacts of the authors and their knowledge of networks they have worked with. Web searches were conducted using One Health, training, and research as key words for work done in Africa. Results Africa has major networks involved in One Health training, research, and outreach, with participation of both academic and non-academic institutions. This review highlights an effort in Africa to form networks to conduct multidisciplinary training and research. The main networks include Afrique One, Southern African Centre for Infectious Disease Surveillance (SACIDS), and One Health Central and Eastern Africa (OHCEA). Conclusions Both academic and non-academic institutions and organizations have shown an interest to conduct multidisciplinary training and research in Africa for managing challenges that Africa is facing currently, especially the outbreak of infectious diseases. PMID:27906125

  3. Public health week: marketing the concept of public health.

    PubMed

    Evans, C A; Margolis, L A

    1992-01-01

    The Public Health Programs and Services (PHP&S) Branch of the Los Angeles County Department of Health Services began a strategic planning effort in January 1986 to meet new disease trends, curb rising health care costs, consolidate limited resources, and handle shifting demographics. A strategic plan was designed to assess the opportunities and challenges facing the agency over a 5-year horizon. Priority areas were recognized, and seven strategic directives were formulated to guide PHP&S in expanding public health services to a changing community. Health promotion was acknowledged as a critical target of the strategic planning process. Among the most significant results of the health promotion directive was the establishment of an annual Public Health Week in Los Angeles County. Beginning in 1988, 1 week per year was selected to enhance the community's awareness of public health programs and the leadership role PHP&S plays in providing these programs to nearly 9 million residents of Los Angeles County. Events in Public Health Week include a professional lecture series and the honoring of an outstanding public health activist and a media personality who has fostered health promotion. Other free community activities such as mobile clinics, screenings, and health fairs are held throughout the county. With intensive media coverage of Public Health Week, PHP&S has been aggressive in promoting its own services and accomplishments while also educating the community on vital wellness issues. The strategic methodology employed by PHP&S, with its emphasis on long-range proactive planning, is receiving national recognition and could be adopted by similar agencies wishing to enhance their image and develop unique health promotion projects in their communities.

  4. NCDs, health promotion and public health.

    PubMed

    McQueen, David V

    2013-12-01

    Though not necessarily using the same terminology historically, people concerned with the public's health have long been addressing the social context of non-communicable diseases (NCDs) and the actions of promoting health. This commentary places the current interest in NCDs within that history and discusses the challenges that continue to face institutions in dealing with NCDs. It makes a particular plea for the role of health promotion as the area of public health that takes actions to address the global burden of NCDs. Without a health promotion focus, we will just continue to describe the NCD burden rather than reduce it.

  5. Working together for public health.

    PubMed

    Martelli, Pompeo

    2009-06-01

    Italy's recent economic growth and strategic position in the Mediterranean Sea have made it a prime destination for immigrants and asylum seekers in Europe. Despite its well-developed health care system, statistics on foreign citizens' health are worrisome. In 1998 public health services were extended to illegal immigrants, giving them the right to necessary urgent and non-urgent medical assistance, even for a prolonged period. This paper examines a two-year joint intervention project between Centre for the Study and Research of Public Health (Mental Health), Local Health Agency ROMA E (LHA RME) and the non-governmental organization Médecins Sans Frontières (MSF) in Rome.

  6. AIDS denialism and public health practice.

    PubMed

    Chigwedere, Pride; Essex, M

    2010-04-01

    In this paper, we respond to AIDS denialist arguments that HIV does not cause AIDS, that antiretroviral drugs are not useful, and that there is no evidence of large-scale deaths from AIDS, and discuss the key implications of the relationship between AIDS denialism and public health practice. We provide a brief history of how the cause of AIDS was investigated, of how HIV fulfills Koch's postulates and Sir Bradford Hil's criteria for causation, and of the inconsistencies in alternatives offered by denialists. We highlight clinical trials as the standard for assessing efficacy of drugs, rather than anecdotal cases or discussions of mechanism of action, and show the unanimous data demonstrating antiretroviral drug efficacy. We then show how statistics on mortality and indices such as crude death rate, life expectancy, child mortality, and population growth are consistent with the high mortality from AIDS, and expose the weakness of statistics from death notification, quoted by denialists. Last we emphasize that when denialism influences public health practice as in South Africa, the consequences are disastrous. We argue for accountability for the loss of hundreds of thousands of lives, the need to reform public health practice to include standards and accountability, and the particular need for honesty and peer review in situations that impact public health policy.

  7. Pathways in dental public health.

    PubMed

    Silverstein, Steven J

    2005-07-01

    Dental public health is one of the nine specialties of dentistry recognized by the American Dental Association Commission on Dental Accreditation. Dental public health has been defined as the "science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice which serves the community as a patient rather than as an individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis." This article will describe the many career and educational pathways dentists may follow to become irvolved in the practice of dental public health.

  8. Alaska public health law reform.

    PubMed

    Meier, Benjamin Mason; Hodge, James G; Gebbie, Kristine M

    2008-04-01

    The Turning Point Model State Public Health Act (Turning Point Act), published in September 2003, provides a comprehensive template for states seeking public health law modernization. This case study examines the political and policy efforts undertaken in Alaska following the development of the Turning Point Act. It is the first in a series of case studies to assess states' consideration of the Turning Point Act for the purpose of public health law reform. Through a comparative analysis of these case studies and ongoing legislative tracking in all fifty states, researchers can assess (1) how states codify the Turning Point Act into state law and (2) how these modernized state laws influence or change public health practice, leading to improved health outcomes.

  9. Declaration on mental health in Africa: moving to implementation.

    PubMed

    Daar, Abdallah S; Jacobs, Marian; Wall, Stig; Groenewald, Johann; Eaton, Julian; Patel, Vikram; dos Santos, Palmira; Kagee, Ashraf; Gevers, Anik; Sunkel, Charlene; Andrews, Gail; Daniels, Ingrid; Ndetei, David

    2014-01-01

    Urgent action is needed to address mental health issues globally. In Africa, where mental health disorders account for a huge burden of disease and disability, and where in general less than 1% of the already small health budgets are spent on these disorders, the need for action is acute and urgent. Members of the World Health Organization, including African countries, have adopted a Comprehensive Mental Health Action Plan. Africa now has an historic opportunity to improve the mental health and wellbeing of its citizens, beginning with provision of basic mental health services and development of national mental health strategic plans (roadmaps). There is need to integrate mental health into primary health care and address stigma and violations of human rights. We advocate for inclusion of mental health into the post-2015 Sustainable Development Goals, and for the convening of a special UN General Assembly High Level Meeting on Mental Health within three years.

  10. Expert searching in public health

    PubMed Central

    Alpi, Kristine M.

    2005-01-01

    Objective: The article explores the characteristics of public health information needs and the resources available to address those needs that distinguish it as an area of searching requiring particular expertise. Methods: Public health searching activities from reference questions and literature search requests at a large, urban health department library were reviewed to identify the challenges in finding relevant public health information. Results: The terminology of the information request frequently differed from the vocabularies available in the databases. Searches required the use of multiple databases and/or Web resources with diverse interfaces. Issues of the scope and features of the databases relevant to the search questions were considered. Conclusion: Expert searching in public health differs from other types of expert searching in the subject breadth and technical demands of the databases to be searched, the fluidity and lack of standardization of the vocabulary, and the relative scarcity of high-quality investigations at the appropriate level of geographic specificity. Health sciences librarians require a broad exposure to databases, gray literature, and public health terminology to perform as expert searchers in public health. PMID:15685281

  11. Equity in the national rollout of public AIDS treatment in South Africa 2004-08.

    PubMed

    McLaren, Zoë M

    2015-11-01

    Low- and middle-income country governments face the challenge of ensuring an equitable distribution of public resources, based on need rather than socioeconomic status, race or political affiliation. This study examines factors that may influence public service provision in developing countries by analysing the 2004-08 implementation of government-provided AIDS treatment in South Africa, the largest programme of its kind in the world. Despite assurances from the National Department of Health, some have raised concerns about whether the rollout was in fact conducted equitably. This study addresses these concerns. This is the first study to assemble high-quality national data on a broad set of census main place (CMP) characteristics that the public health, economic and political science literature have found influence public service provision. Multivariate logistic regression and duration (survival) analysis were used to identify characteristics associated with a more rapid public provision of anti-retroviral therapy (ART) in South Africa. Overall, no clear pattern emerges of the rollout systematically favouring better-off CMPs, and in general the magnitude of statistically significant associations is small. The centralization of the early phases of the rollout to maximize ART enrolment led to higher ART coverage rates in areas where district and regional hospitals were located. Ultimately, these results demonstrate that the provision of life-saving AIDS treatment was not disproportionately delayed in disadvantaged areas. The combination of a clear policy objective, limited bureaucratic discretion and monitoring by civil society ensured equitable access to AIDS treatment. This work highlights the potential for future public investment in South Africa and other developing countries to reduce health and economic disparities.

  12. Economics of health in South Africa: past, present and future.

    PubMed

    Benatar, S R

    1989-01-01

    Some of the background to the present structure of medicine in South Africa, an outline of some economic aspects of our current (inadequate) health care service and tentative suggestions regarding the directions in which our health services should be moving to facilitate the legitimization (political) and accumulation (economic) processes required to meet the needs and demands of all the people of an internationally recognized, just and free South Africa are presented.

  13. The consequences of health service privatisation for equality and equity in health care in South Africa.

    PubMed

    Price, M

    1988-01-01

    The trend towards the privatisation of health services in South Africa reflects a growing use of private sources of finance and the growing proportion of privately owned fee-for-service providers and facilities. Fee-for-service methods of reimbursement aggravate the geographical maldistribution of personnel and facilities, and the competition for scarce personnel resources aggravates the difference in the quality of the public and private services. Thus the growth in demand for these types of providers may be expected to increase inequality of access in these two respects. The potential expansion of medical scheme coverage is shown to be limited to well under 50% of the population, leaving the majority of the population without access to private sector health care. Even for members of the medical schemes, benefits are linked to income, thus clashing with the principle of equal care for equal need. The public funds needed to overcome financial obstacles to access to private providers could be more efficiently deployed by financing publicly owned and controlled health services directly. Taxation also offers the most equitable method of financing health services. Finally, attention is drawn to the dilemma resulting from the strengthening of the private health sector; while in the short term this can offer better care to more people on a racially non-discriminatory basis, in the long term, health care for the population as a whole may become more unequal and for those dependent on the public sector it may even deteriorate.

  14. [Anomie and public mental health].

    PubMed

    Parales-Quenza, Carlos J

    2008-01-01

    This article uses the concept of anomie for understanding public mental-health issues and constructing strategies aimed at promoting health and preventing disease. Studying anomie involves many definitions and approaches; this article conceptualises anomie as dérréglement or derangement and as a total social fact as its effects and consequences are pervasive across all areas of human experience. The article suggests the pertinence of the concept to public health based on several authors' observations depicting Latin-America as being a set of anomic societies and Colombia as the extreme case. Current definitions of mental health in positive terms (not just as being the absence of mental illness) validate the need for considering anomie as an indicator of public mental health. The article proposes that if anomie expresses itself through rules as basic social structure components, then such rules should also be considered as the point of intervention in promoting mental health.

  15. Global Trade and Public Health

    PubMed Central

    Shaffer, Ellen R.; Waitzkin, Howard; Brenner, Joseph; Jasso-Aguilar, Rebeca

    2005-01-01

    Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect public health, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications. Proposals under negotiation for the World Trade Organization’s General Agreement on Trade in Services (GATS) and the regional Free Trade Area of the Americas (FTAA) agreement cover a wide range of health services, health facilities, clinician licensing, water and sanitation services, and tobacco and alcohol distribution services. Public health professionals and organizations rarely participate in trade negotiations or in resolution of trade disputes. The linkages among global trade, international trade agreements, and public health deserve more attention than they have received to date. PMID:15623854

  16. Global trade and public health.

    PubMed

    Shaffer, Ellen R; Waitzkin, Howard; Brenner, Joseph; Jasso-Aguilar, Rebeca

    2005-01-01

    Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect public health, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications. Proposals under negotiation for the World Trade Organization's General Agreement on Trade in Services (GATS) and the regional Free Trade Area of the Americas (FTAA) agreement cover a wide range of health services, health facilities, clinician licensing, water and sanitation services, and tobacco and alcohol distribution services. Public health professionals and organizations rarely participate in trade negotiations or in resolution of trade disputes. The linkages among global trade, international trade agreements, and public health deserve more attention than they have received to date.

  17. Protecting health through public health law.

    PubMed

    Griffith, Richard

    The report into the outbreak of measles in the Swansea area in 2013 has recommended that public health law be used as a routine response to minimising the spread of infectious diseases. In this article, the author considers what powers are available to health and local authorities to minimise the spread of an infectious disease outbreak.

  18. Discover: What Is Public Health?

    MedlinePlus

    ... public health by providing a variety of comprehensive classroom and curriculum resources. Framing The Future Faculty Resources ... and is regularly spotlighted in popular culture and media . The impact is measurable. In the past century, ...

  19. Social marketing for public health.

    PubMed

    Walsh, D C; Rudd, R E; Moeykens, B A; Moloney, T W

    1993-01-01

    Marketing techniques and tools, imported from the private sector, are increasingly being advocated for their potential value in crafting and disseminating effective social change strategies. This paper describes the field of social marketing as it is used to improve the health of the public. A disciplined process of strategic planning can yield promising new insights into consumer behavior and product design. But the "technology" cannot simply be transferred without some translation to reconcile differences between commercial marketing and public health.

  20. Insights in Public Health

    PubMed Central

    Tong, Michelle; Sentell, Tetine

    2017-01-01

    Chinese Americans constitute the largest percentage of Asian Americans. In Hawai‘i, Chinese Americans make up approximately 4.7% of the total state population. Accurately assessing health disparities across specific Asian American subgroups is critically important to health research and policy, as there is often substantial variability in risk and outcomes. However, even for Chinese Americans, the largest of the Asian American subgroups, such analyses can present challenges in population-based surveys. This article considers these challenges generally and then specifically in terms of the issue of health literacy and heart disease in Chinese Americans using existing population-based survey data sets in the United States, California, and Hawai‘i. PMID:28090401

  1. Stigmatization and public health ethics.

    PubMed

    Courtwright, Andrew

    2013-02-01

    Encouraged by the success of smoking denormalization strategies as a tobacco-control measure, public health institutions are adopting a similar approach to other health behaviors. For example, a recent controversial ad campaign in New York explicitly aimed to denormalize HIV/AIDS amongst gay men. Authors such as Scott Burris have argued that efforts like this are tantamount to stigmatization and that such stigmatization is unethical because it is dehumanizing. Others have offered a limited endorsement of denormalization/stigmatization campaigns as being justified on consequentialist grounds; namely, that the potential public health benefits outweigh any stigmatizing side effects. In this paper, I examine and reject the blanket condemnation of stigmatization efforts in public health. I argue that the moral status of such efforts are best evaluated within a contractualist, as opposed to a consequentialist, framework. Contractualism in public health ethics asks whether a particular stigmatizing policy could be justified to reasonable individuals who do not know whether they will be affected by that policy. Using this approach, I argue that it is sometimes permissible for public health institutions to engage in health-related stigmatization.

  2. American Public Health Association

    MedlinePlus

    ... Infectious Diseases has a new Spanish language website! https://t.co… RT @CDCgov: Know when you need ... Together we can fight antibiotic resistance. Be #AntibioticSmart. https://t.… RT @AMJPublicHealth: Whiteness of the #opioidepidemic is ...

  3. Insights in Public Health

    PubMed Central

    Delafield, Rebecca; Wright, Tricia E

    2016-01-01

    Substance use can have serious consequences for the health and well-being of individuals. The problem is of particular concern when it involves pregnant women due to health risks for the mother and the fetus. In utero exposure to either legal (eg, alcohol, cigarettes, and certain prescription drugs) or illicit (eg, amphetamines, cocaine, and opioids) substances can result in potentially serious and long-lasting health problems for infants. Available data from Hawai‘i indicate that substance use among pregnant women is higher than national targets, which reflect the fact that there is essentially no acceptable rate of use of these substances. Developing an effective system to support virtual elimination of substance use in pregnancy requires broad-based strategies. Progress is being made in Hawai‘i to better identify and address substance use in pregnancy. These efforts are being guided by a variety of stakeholders who are dedicated to improving the healthcare and health outcomes for this population. However, significant challenges to the system remain, including provider shortages, lack of local investment, and limited capacity of appropriate, individualized treatment. PMID:27920946

  4. Disasters and public health

    PubMed Central

    Lechat, M. F.

    1979-01-01

    Studies on the health effects of disasters have shown that epidemiological indices can be of value in planning preventive and relief measures and in evaluating their effectiveness. Mortality rates naturally vary considerably, but in earthquakes, for example, the number of deaths per 100 houses destroyed can give an indication of the adequacy of building techniques. Age-specific mortality rates can help to identify particularly vulnerable groups and perhaps indicate what form of education would be valuable. Except in earthquakes, the number of casualties after a disaster is usually low in relation to the number of deaths, and study of the distribution and types of lesions would help in planning the amounts and types of relief supplies and personnel required. Disasters also affect the general level of morbidity in a district because of either interruption of normal health care services or of spraying or other disease control measures. Mental health and nutrition following disasters are particular problems that require further investigation. Study of all these features of disasters has been handicapped by a lack of data, particularly concerning the health situation immediately after the impact. The provision of surveillance teams in disaster-prone areas would appear to be a field in which international cooperation could yield immense benefits. PMID:311707

  5. Insights in Public Health

    PubMed Central

    Yoshimoto, D Kaulana; Robertson, N Tod; Hayes, Donald K

    2014-01-01

    Home visiting services are cost-effective and improve the health of children and families among those at increased risk. From 1985–2008, home visiting services in Hawai‘i were provided primarily through state funding of the Hawai‘i Healthy Start Program, but the program was severely reduced due to the economy and state budget changes over the past decade. The Maternal and Child Health Branch (MCHB) in the Family Health Services Division responded to these changes by seeking out competitive grant opportunities and collaborations in order to continue to promote home visiting services to those children and families in need. In 2010, the MCHB was awarded a federally funded Maternal, Infant and Early Childhood Home Visiting (MIECHV) grant for home visiting services to promote maternal, infant, and early childhood health, safety and development, strong parent-child relationships, and responsible parenting. In 2011, the MCHB was also awarded a competitive MIECHV development grant that funded the re-establishment of the hospital Early Identification program. Families in need of additional support identified through this program are referred for family strengthening services to a network of existing home visiting programs called the Hawai‘i Home Visiting Network (HHVN). The HHVN is supported by MIECHV and a small amount of state funds to assist programs with capacity building, training, professional development, quality assurance, and accreditation/certification support. The MIECHV grant requires that programs are evidence-based and address specific outcome measures and benchmarks. The HHVN provides home visiting services to families prenatally through 5 years of age that reside in specific at-risk communities, and is aimed at fostering positive parenting and reducing child maltreatment using a strength-based approach by targeting six protective factors: (1) social connections, (2) nurturing and attachment, (3) knowledge of parenting and child development, (4

  6. USGS Science Serves Public Health

    USGS Publications Warehouse

    Buxton, Herbert T.

    2010-01-01

    Human health so often depends on the health of the environment and wildlife around us. The presence of naturally occurring or human environmental contaminants and the emergence of diseases transferred between animals and humans are growing concerns worldwide. The USGS is a source of natural science information vital for understanding the quantity and quality of our earth and living resources. This information improves our understanding not only of how human activities affect environmental and ecological health, but also of how the quality of our environment and wildlife in turn affects human health. USGS is taking a leadership role in providing the natural science information needed by health researchers, policy makers, and the public to safeguard public health

  7. Keeping the "public" in schools of public health.

    PubMed

    Freudenberg, Nicholas; Klitzman, Susan; Diamond, Catherine; El-Mohandes, Ayman

    2015-03-01

    In this article, we compared the characteristics of public and private accredited public health training programs. We analyzed the distinct opportunities and challenges that publicly funded schools of public health face in preparing the nation's public health workforce. Using our experience in creating a new, collaborative public school of public health in the nation's largest urban public university system, we described efforts to use our public status and mission to develop new approaches to educating a workforce that meets the health needs of our region and contributes to the goal of reducing health inequalities. Finally, we considered policies that could protect and strengthen the distinct contributions that public schools of public health make to improving population health and reducing health inequalities.

  8. Digital government and public health.

    PubMed

    Fountain, Jane E

    2004-10-01

    Digital government is typically defined as the production and delivery of information and services inside government and between government and the public using a range of information and communication technologies. Two types of government relationships with other entities are government-to-citizen and government-to-government relationships. Both offer opportunities and challenges. Assessment of a public health agency's readiness for digital government includes examination of technical, managerial, and political capabilities. Public health agencies are especially challenged by a lack of funding for technical infrastructure and expertise, by privacy and security issues, and by lack of Internet access for low-income and marginalized populations. Public health agencies understand the difficulties of working across agencies and levels of government, but the development of new, integrated e-programs will require more than technical change - it will require a profound change in paradigm.

  9. Targeted marketing and public health.

    PubMed

    Grier, Sonya A; Kumanyika, Shiriki

    2010-01-01

    Targeted marketing techniques, which identify consumers who share common needs or characteristics and position products or services to appeal to and reach these consumers, are now the core of all marketing and facilitate its effectiveness. However, targeted marketing, particularly of products with proven or potential adverse effects (e.g., tobacco, alcohol, entertainment violence, or unhealthful foods) to consumer segments defined as vulnerable raises complex concerns for public health. It is critical that practitioners, academics, and policy makers in marketing, public health, and other fields recognize and understand targeted marketing as a specific contextual influence on the health of children and adolescents and, for different reasons, ethnic minority populations and other populations who may benefit from public health protections. For beneficial products, such understanding can foster more socially productive targeting. For potentially harmful products, understanding the nature and scope of targeted marketing influences will support identification and implementation of corrective policies.

  10. Prioritizing Sleep Health: Public Health Policy Recommendations.

    PubMed

    Barnes, Christopher M; Drake, Christopher L

    2015-11-01

    The schedules that Americans live by are not consistent with healthy sleep patterns. In addition, poor access to educational and treatment aids for sleep leaves people engaging in behavior that is harmful to sleep and forgoing treatment for sleep disorders. This has created a sleep crisis that is a public health issue with broad implications for cognitive outcomes, mental health, physical health, work performance, and safety. New public policies should be formulated to address these issues. We draw from the scientific literature to recommend the following: establishing national standards for middle and high school start times that are later in the day, stronger regulation of work hours and schedules, eliminating daylight saving time, educating the public regarding the impact of electronic media on sleep, and improving access to ambulatory in-home diagnostic testing for sleep disorders.

  11. Improving resource allocation decisions for health and HIV programmes in South Africa: Bioethical, cost-effectiveness and health diplomacy considerations.

    PubMed

    Kevany, Sebastian; Benatar, Solomon R; Fleischer, Theodore

    2013-01-01

    The escalating expenditure on patients with HIV/AIDS within an inadequately funded public health system is tending towards crowding out care for patients with non-HIV illnesses. Priority-setting decisions are thus required and should increasingly be based on an explicit, transparent and accountable process to facilitate sustainability. South Africa's public health system is eroding, even though the government has received extensive donor financing for specific conditions, such as HIV/AIDS. The South African government's 2007 HIV plan anticipated costs exceeding 20% of the annual health budget with a strong focus on treatment interventions, while the recently announced 2012-2016 National Strategic HIV plan could cost up to US$16 billion. Conversely, the total non-HIV health budget has remained static in recent years, effectively reducing the supply of health care for other diseases. While the South African government cannot meet all demands for health care simultaneously, health funders should attempt to allocate health resources in a fair, efficient, transparent and accountable manner, in order to ensure that publicly funded health care is delivered in a reasonable and non-discriminatory fashion. We recommend a process for resource allocation that includes ethical, economic, legal and policy considerations. This process, adapted for use by South Africa's policy-makers, could bring health, political, economic and ethical gains, whilst allaying a social crisis as mounting treatment commitments generated by HIV have the potential to overwhelm the health system.

  12. Citizen Science for public health.

    PubMed

    Den Broeder, Lea; Devilee, Jeroen; Van Oers, Hans; Schuit, A Jantine; Wagemakers, Annemarie

    2016-12-23

    Community engagement in public health policy is easier said than done. One reason is that public health policy is produced in a complex process resulting in policies that may appear not to link up to citizen perspectives. We therefore address the central question as to whether citizen engagement in knowledge production could enable inclusive health policy making. Building on non-health work fields, we describe different types of citizen engagement in scientific research, or 'Citizen Science'. We describe the challenges that Citizen Science poses for public health, and how these could be addressed. Despite these challenges, we expect that Citizen Science or similar approaches such as participatory action research and 'popular epidemiology' may yield better knowledge, empowered communities, and improved community health. We provide a draft framework to enable evaluation of Citizen Science in practice, consisting of a descriptive typology of different kinds of Citizen Science and a causal framework that shows how Citizen Science in public health might benefit both the knowledge produced as well as the 'Citizen Scientists' as active participants.

  13. Infection Prevention and Control for Ebola in Health Care Settings - West Africa and United States.

    PubMed

    Hageman, Jeffrey C; Hazim, Carmen; Wilson, Katie; Malpiedi, Paul; Gupta, Neil; Bennett, Sarah; Kolwaite, Amy; Tumpey, Abbigail; Brinsley-Rainisch, Kristin; Christensen, Bryan; Gould, Carolyn; Fisher, Angela; Jhung, Michael; Hamilton, Douglas; Moran, Kerri; Delaney, Lisa; Dowell, Chad; Bell, Michael; Srinivasan, Arjun; Schaefer, Melissa; Fagan, Ryan; Adrien, Nedghie; Chea, Nora; Park, Benjamin J

    2016-07-08

    The 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa underscores the need for health care infection prevention and control (IPC) practices to be implemented properly and consistently to interrupt transmission of pathogens in health care settings to patients and health care workers. Training and assessing IPC practices in general health care facilities not designated as Ebola treatment units or centers became a priority for CDC as the number of Ebola virus transmissions among health care workers in West Africa began to affect the West African health care system and increasingly more persons became infected. CDC and partners developed policies, procedures, and training materials tailored to the affected countries. Safety training courses were also provided to U.S. health care workers intending to work with Ebola patients in West Africa. As the Ebola epidemic continued in West Africa, the possibility that patients with Ebola could be identified and treated in the United States became more realistic. In response, CDC, other federal components (e.g., Office of the Assistant Secretary for Preparedness and Response) and public health partners focused on health care worker training and preparedness for U.S. health care facilities. CDC used the input from these partners to develop guidelines on IPC for hospitalized patients with known or suspected Ebola, which was updated based on feedback from partners who provided care for Ebola patients in the United States. Strengthening and sustaining IPC helps health care systems be better prepared to prevent and respond to current and future infectious disease threats.The activities summarized in this report would not have been possible without collaboration with many U.S. and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).

  14. Insights in Public Health

    PubMed Central

    Donohoe Mather, Carolyn M; McGurk, Meghan D

    2014-01-01

    Over half of the adults in Hawai‘i are overweight or obese, exposing them to increased risk for chronic diseases and resulting in higher health care expenses. Poor dietary habits and physical inactivity are important contributors to obesity and overweight. Because adults spend most of their waking hours at work, the workplace is an important setting for interventions to solve this growing problem. Changing the nutrition environment to support healthy eating is a recommended practice for worksite wellness interventions. Following this recommendation, the Hawai‘i State Department of Health (DOH) launched the Choose Healthy Now! Healthy Vending Pilot Project to increase access to healthy options in worksites. Choose Healthy Now! utilized an education campaign and a traffic light nutrition coding system (green = go, yellow = slow, red = uh-oh), based on federal nutrition guidelines, to help employees identify the healthier options in their worksite snack shops. Inventory of healthy items was increased and product placement techniques were used to help make the healthy choice the easy choice. DOH partnered with the Department of Human Services' Ho‘opono Vending Program to pilot the project in six government buildings on O‘ahu between May and September of 2014. Vendors added new green (healthy) and yellow (intermediate) options to their snack shop and cafeteria inventories, and labeled their snacks and beverages with green and yellow point-of-decision stickers. The following article outlines background and preliminary findings from the Choose Healthy Now! pilot. PMID:25414808

  15. Training Physicians for Public Health Careers

    ERIC Educational Resources Information Center

    Hernandez, Lyla M., Ed.; Munthali, A. Wezi, Ed.

    2007-01-01

    Public health efforts have resulted in tremendous improvements in the health of individuals and communities. The foundation for effective public health interventions rests, in large part, on a well-trained workforce. Unfortunately there is a major shortage of public health physicians who are prepared to face today's public health challenges.…

  16. Public health. A tale of two counties.

    PubMed

    Griffiths, S; Wright, J; Grice, D

    2001-02-22

    The development of primary care trusts requires health authority public health departments to work in new ways. Reviews of the public health function in two counties found widely varying views. A common understanding of organisations' responsibilities is crucial when developing public health in primary care. Public health networks can play a key role. Significant investment in training is required.

  17. The Eastern Region Public Health Observatory.

    PubMed

    Wright, Kerri

    2014-06-03

    The Eastern Region Public Health Observatory (ERPHO) became part of Public Health England on April 1 2013. Its website provides population health data, analysis and interpretation to support healthcare professionals in commissioning, prioritising and improving health outcomes.

  18. Inequities in the global health workforce: the greatest impediment to health in sub-Saharan Africa.

    PubMed

    Anyangwe, Stella C E; Mtonga, Chipayeni

    2007-06-01

    increase their health workforce by about 140% to achieve enough coverage for essential health interventions to make a positive difference in the health and life expectancy of their populations. The extent causes and consequences of the health workforce crisis in Sub-Saharan Africa, and the various factors that influence and are related to it are well known and described. Although there is no "magic bullet" solution to the problem, there are several documented, tested and tried best practices from various countries. The global health workforce crisis can be tackled if there is global responsibility, political will, financial commitment and public-private partnership for country-led and country-specific interventions that seek solutions beyond the health sector. Only when enough health workers can be trained, sustained and retained in sub-Saharan African countries will there be meaningful socio-economic development and the faintest hope of attaining the Millennium Development Goals in the sub-continent.

  19. Insights in Public Health

    PubMed Central

    Choy, Lehua B; Smith, Heidi Hansen; Espiritu, Justine; Higa, Earl; Lee, Thomas; Maddock, Jay

    2015-01-01

    Abstract In 2011, a small pilot bike share program was established in the town core of Kailua, Hawai‘i, with funding from the Hawai‘i State Department of Health. The Kailua system consisted of two stations with 12 bicycles, and the goal was to secure additional funding to expand the station network in the future. Community feedback consistently indicated support for the bike share program. However, system metrics showed low levels of usage, averaging 41.5 rides per month (2011–2014). From observational data, users were primarily tourists. With minimal local staff, the bike share program had limited resources for promotion and education, which may have hindered potential use by local residents. Management of station operations and bike maintenance were additional, ongoing barriers to success. Despite the challenges, the pilot bike share program was valuable in several ways. It introduced the bike share concept to Hawai‘i, thereby helping to build awareness and connect an initial network of stakeholders. Furthermore, the pilot bike share program informed the development of a larger bike share program for urban Honolulu. As limited information exists in the literature about the experiences of smaller bike share programs and their unique considerations, this article shares lessons learned for other communities interested in starting similar bike share programs. PMID:26535166

  20. Public health financial management competencies.

    PubMed

    Honoré, Peggy A; Costich, Julia F

    2009-01-01

    The absence of appropriate financial management competencies has impeded progress in advancing the field of public health finance. It also inhibits the ability to professionalize this sector of the workforce. Financial managers should play a critical role by providing information relevant to decision making. The lack of fundamental financial management knowledge and skills is a barrier to fulfilling this role. A national expert committee was convened to examine this issue. The committee reviewed standards related to financial and business management practices within public health and closely related areas. Alignments were made with national standards such as those established for government chief financial officers. On the basis of this analysis, a comprehensive set of public health financial management competencies was identified and examined further by a review panel. At a minimum, the competencies can be used to define job descriptions, assess job performance, identify critical gaps in financial analysis, create career paths, and design educational programs.

  1. Systemic Intervention for Public Health

    PubMed Central

    Midgley, Gerald

    2006-01-01

    Many calls have been made for a systems approach to public health. My response is to offer a methodology for systemic intervention that (1) emphasizes the need to explore stakeholder values and boundaries for analysis, (2) challenges marginalization, and (3) draws upon a wide range of methods (from the systems literature and beyond) to create a flexible and responsive systems practice. I present and discuss several well-tested methods with a view to identifying their potential for supporting systemic intervention for public health. PMID:16449577

  2. Zoological medicine and public health.

    PubMed

    Chomel, Bruno B; Osburn, Bennie I

    2006-01-01

    Public-health issues regarding zoological collections and free-ranging wildlife have historically been linked to the risk of transmission of zoonotic diseases and accidents relating to bites or injection of venom or toxins by venomous animals. It is only recently that major consideration has been given worldwide to the role of the veterinary profession in contributing to investigating zoonotic diseases in free-ranging wildlife and integrating the concept of public health into the management activities of game preserves and wildlife parks. At the veterinary undergraduate level, courses in basic epidemiology, which should include outbreak investigation and disease surveillance, but also in population medicine, in infectious and parasitic diseases (especially new and emerging or re-emerging zoonoses), and in ecology should be part of the core curriculum. Foreign diseases, especially dealing with zoonotic diseases that are major threats because of possible agro-terrorism or spread of zoonoses, need to be taught in veterinary college curricula. Furthermore, knowledge of the principles of ecology and ecosystems should be acquired either during pre-veterinary studies or, at least, at the beginning of the veterinary curriculum. At the post-graduate level, master's degrees in preventive veterinary medicine, ecology and environmental health, or public health with an emphasis on infectious diseases should be offered to veterinarians seeking job opportunities in public health and wildlife management.

  3. Winning the battle and losing the war? Where public health is getting it wrong in the current fight against HIV-AIDS and tuberculosis in Sub-Saharan Africa.

    PubMed

    Bain, Luchuo Engelbert; Clovis, Nkeh Charles

    2015-01-01

    Despite the enormous victory that has been recorded in decreasing significantly HIV-TB related mortality and morbidity in Sub-Saharan Africa, enormous challenges continue to obstruct proper and enviable control of these conditions. These range from prioritization, ethics, funding, drug resistance and research gaps. Resistance to these diseases could constitute key treatment and prevention challenges to health care systems and the international community if not handled appropriately and promptly. This paper presents key shortcomings of the current funding, management and research policies and highlights possible action areas to remedy this situation.

  4. Seriously Implementing Health Capacity Strengthening Programs in Africa

    PubMed Central

    Lapão, Luís Velez

    2015-01-01

    Faced with the challenges of healthcare reform, skills and new capabilities are needed to support the reform and it is of crucial importance in Africa where shortages affects the health system resilience. Edwards et al provides a good example of the challenge of implementing a mentoring program in one province in a sub-Saharan country. From this example, various aspects of strengthening the capacity of managers in healthcare are examined based on our experience in action-training in Africa, as mentoring shares many characteristics with action-training. What practical lessons can be drawn to promote the strengthening so that managers can better intervene in complex contexts? Deeper involvement of health authorities and more rigorous approaches are seriously desirable for the proper development of health capacity strengthening programs in Africa. PMID:26673182

  5. Establishing a health promotion and development foundation in South Africa.

    PubMed

    Perez, A M; Ayo-Yusuf, O A; Hofman, K; Kalideen, S; Maker, A; Mokonoto, D; Morojele, N; Naidoo, P; Parry, C D H; Rendall-Mkosi, K; Saloojee, Y

    2013-01-14

    South Africa has a 'quadruple burden of disease'. One way to reduce this burden, and address the social determinants of health and social inequity, could be through health promotion interventions driven by an independent Health Promotion and Development Foundation (HPDF). This could provide a framework to integrate health promotion and social development into all government and civil society programmes. On priority issues, the HPDF would mobilise resources, allocate funding, develop capacity, and monitor and evaluate health promotion and development work. Emphasis would be on reducing the effects of poverty, inequity and unequal development on disease rates and wellbeing. The HPDF could also decrease the burden on the proposed National Health Insurance (NHI) system. We reflect on such foundations in other countries, and propose a structure for South Africa's HPDF and a dedicated funding stream to support its activities. In particular, an additional 2% levy on alcohol and tobacco products is proposed to be utilised to fund the HPDF.

  6. The Afya Bora Consortium: an Africa-US partnership to train leaders in global health.

    PubMed

    Farquhar, Carey; Nathanson, Neal

    2011-06-01

    The Afya Bora Consortium is a partnership of 8 academic health institutions, 4 in Africa and 4 in the United States. The Consortium is developing a Global Health Leadership Fellowship for medical, nursing, and public health professionals, largely drawn from the 4 African partner countries. The fellowship provides trainees with practical skills to prepare them for future positions leading the design, implementation, and evaluation of large, high-impact programs in governmental agencies, nongovernmental organizations, and academic health institutions in their own countries. This article describes a Pilot of the proposed program.

  7. Africana Acquisitions; Report of a Publication Survey Trip to Nigeria, Southern Africa, and Europe, 1972.

    ERIC Educational Resources Information Center

    Witherell, Julian W.

    A publication survey trip to Nigeria, Southern Africa, and Europe was taken by Julian W. Witherell of the African Section of the Library of Congress in 1972. The purpose of the trip was to improve the flow of publications about Africa to the Library of Congress. The trip was successful in that personal contacts helpful in obtaining local materials…

  8. Privatising Public Schooling in Post-Apartheid South Africa: Equity Considerations

    ERIC Educational Resources Information Center

    Motala, Shireen

    2009-01-01

    Through an analysis of quantitative and qualitative data on school funding in South Africa, this paper aims to analyse the user fee policy option in public schooling in South Africa. Debate is ongoing about the role of private input into public schooling and whether this practice affects access (and the constitutional right) to basic education,…

  9. Parent Involvement in Public School Governance: The United States and South Africa

    ERIC Educational Resources Information Center

    Lewis, Wayne D.; Colditz, Paul; Browne-Ferrigno, Tricia

    2011-01-01

    This article explores parent involvement in decision making in the United States and in postapartheid South Africa and highlights similarities and differences in how parents in these two countries participate in public school governance and decision making. Parents' role in public school governance in South Africa is significant and entrenched in…

  10. Community Public Health Fact Sheet

    EPA Pesticide Factsheets

    EPA’s Community Public Health (CPH) project in the Office of Research and Development (ORD) produces high quality science and tools to understand and assess environmental risks and ecosystem goods and services (EGS) to decision-makers at all levels.

  11. Capacity building in public health nutrition.

    PubMed

    Geissler, Catherine

    2015-11-01

    The aim of the present paper is to review capacity building in public health nutrition (PHN), the need for which has been stressed for many years by a range of academics, national and international organisations. Although great strides have been made worldwide in the science of nutrition, there remain many problems of undernutrition and increasingly of obesity and related chronic diseases. The main emphasis in capacity building has been on the nutrition and health workforce, but the causes of these health problems are multifactorial and require collaboration across sectors in their solution. This means that PHN capacity building has to go beyond basic nutrition and beyond the immediate health workforce to policy makers in other sectors. The present paper provides examples of capacity building activities by various organisations, including universities, industry and international agencies. Examples of web-based courses are given including an introduction to the e-Nutrition Academy. The scope is international but with a special focus on Africa. In conclusion, there remains a great need for capacity building in PHN but the advent of the internet has revolutionised the possibilities.

  12. A national public health service.

    PubMed Central

    Galbraith, N S

    1981-01-01

    The development of the British public health services is briefly reviewed and it is suggested that two types of epidemiologist (Community Physician) are necessary in each locality: one concerned with medical administration and health care planning-the medical administrator, and the other with the prevention of disease-the clinical epidemiologist. A new nation public health service is proposed to revive disease prevention with four main features: (1) A district Clinical Epidemiologist who is a member of the district department of community medicine with responsibility for prevention but with no district administrative duties. (2) A District Epidemiology Unit comprising other appropriate staff. (3) National specialist epidemiology units within the NHS with service roles to support and coordinate the District Clinical Epidemiologists. (4) A national authority within the NHS with responsibility for prevention and for administering the national specialist units. PMID:7007637

  13. Chaos, criticality, and public health.

    PubMed Central

    Fullilove, R. E.; Edgoose, J. C.; Fullilove, M. T.

    1997-01-01

    Self-organized criticality offers more than a descriptive model or a doomsday forecast. We have tried to suggest that it is a paradigm for understanding the interconnections between apparently complex processes. At best, it suggests a method for finding the pressure points that can be used to bring unstable systems of public health services into greater levels of stability. The model enjoins us to understand that our goal is not to achieve equilibrium--that perfect match between the demand for health services and its delivery--but rather stability (or, more precisely, metastability). As is true of the sandpile, our systems of public health are constantly evolving. If we are correct, then the mechanism driving this ostensibly complex pattern of change and growth reflects the existence of simpler and, hopefully, more manageable processes. By monitoring these processes, it may be increasingly possible to adapt to change and even manage it effectively. PMID:9170831

  14. Forced movements of population and health hazards in tropical Africa.

    PubMed

    Prothero, R M

    1994-08-01

    Significant interactions between disease and population mobility have been demonstrated in tropical Africa in recent decades. Problems arising are greater than in the past. During the last two decades forced movements have become important. These are associated with refugees, coerced resettlement and victims of environmental catastrophe. The health hazards associated with them are reviewed from medical and social science literature for North East Africa (refugees and resettlement) and for West Africa (pastoralists affected by drought). Political, social and economic settings are of importance but tend to receive only limited attention. There is need for more social science input in studying and ameliorating problems arising from health hazards associated with and exacerbated by forced movements of population.

  15. A review of health and human rights after five years of democracy in South Africa.

    PubMed

    Sarkin, J

    2000-01-01

    South Africa became a democratic state with a supreme Constitution and Bill of Rights in 1994. Between 1994 and 1996 South Africans drafted a new constitution which came into force in 1997. While, the right to health, as well as socio-economic rights is provided for, the health care system in post-apartheid South Africa still mirrors that which existed during the apartheid years. There are still two health care systems. The poorly funded public sector services the majority, while the well-funded private sector services the privileged few. A lack of resources is blamed by the state for its inability to provide better and more widespread health services. This article examines, from a human rights perspective, the successes and challenges in developing the right to health between 1994 to 1999, and provides an overview of the present state of health in South Africa. This article further examines the constitutional provisions on health, and discusses recent constitutional court decisions relevant to the right to health. New and controversial health laws and regulations, affecting health care professionals, medical aid schemes and the availability of pharmaceuticals, are critiqued. The move to devolving health care to the provinces is described. Also discussed are the controversial steps taken by the Department of Health to restructure health structures and services. Progress on key health issues such as HIV/Aids, tobacco, tuberculosis, polio, measles, hepatitis, malaria and abortion are also described. Attention is focused on the role of the Truth and Reconciliation Commission's health hearings in bringing to light violations of human rights in health during apartheid as well as the recommendations made to address these problems.

  16. Law and public health at CDC.

    PubMed

    Goodman, Richard A; Moulton, A; Matthews, G; Shaw, F; Kocher, P; Mensah, G; Zaza, S; Besser, R

    2006-12-22

    Public health law is an emerging field in U.S. public health practice. The 20th century proved the indispensability of law to public health, as demonstrated by the contribution of law to each of the century's 10 great public health achievements. Former CDC Director Dr. William Foege has suggested that law, along with epidemiology, is an essential tool in public health practice. Public health laws are any laws that have important consequences for the health of defined populations. They derive from federal and state constitutions; statutes, and other legislative enactments; agency rules and regulations; judicial rulings and case law; and policies of public bodies. Government agencies that apply public health laws include agencies officially designated as "public health agencies," as well as health-care, environmental protection, education, and law enforcement agencies, among others.

  17. Policy analysis of oral health promotion in South Africa.

    PubMed

    Singh, Shenuka; Myburgh, Neil G; Lalloo, Ratilal

    2010-03-01

    This article reports an analysis of oral health promotion in South African health policy. The central aim of this research was to determine the form and coherence of oral health promotion elements within health policies of post-apartheid South Africa. The study set out to test the hypothesis that oral health promotion elements are fully integrated into health policy and programmatic efforts. A conceptual framework was developed to systematically analyse oral health promotion policy and subsequent decision-making across the country at national and provincial levels. The information was drawn from policy documents, protocols and programme plans, complemented by interviews. The results indicate distinct contradictions between the policy formulation process and its impact on health system decision-making. South African health policy was found to be strong on the rhetoric of equity, health promotion, integration and several other features of the Primary Health Care Approach, but showed little evidence of translating this into action. The development and implementation of oral health promotion appears to be dominated by the influence of dental professionals that perpetuate a curative focus on service delivery. There is an urgent need to re-examine the process and content of oral health policy-making in South Africa. The conceptual framework developed for this study could facilitate further research in this area.

  18. Establishing a public umbilical cord blood stem cell bank for South Africa: an enquiry into public acceptability.

    PubMed

    Meissner-Roloff, Madelein; Pepper, Michael S

    2013-12-01

    South Africa (SA) faces a large unmet need for bone marrow (BM) transplantation, which could be alleviated in part by establishing a public umbilical cord blood stem cell bank (UCB SCB). Umbilical cord blood is an increasingly utilised source of hematopoietic stem cells for BM transplantation in addition to BM or mobilized peripheral blood stem cells. Establishing a public UCB SCB would therefore be a positive step towards improving the quality of health care in SA by providing for an important unmet need. This study takes the form of an enquiry into the acceptability of establishing a public bank through an interview with and questionnaire completed by mothers-to-be in the antenatal clinic of a large public hospital in SA. Initial results are positive, with 85 % of the participants in favour of establishing a public UCB SCB in SA. This initial probe will serve as a model for a more comprehensive national enquiry into public support and acceptability in different clinics, hospitals and provinces in SA.

  19. Which public and why deliberate?--A scoping review of public deliberation in public health and health policy research.

    PubMed

    Degeling, Chris; Carter, Stacy M; Rychetnik, Lucie

    2015-04-01

    Deliberative methods are of increasing interest to public health researchers and policymakers. We systematically searched the peer-reviewed literature to identify public health and health policy research involving deliberative methods and report how deliberative methods have been used. We applied a taxonomy developed with reference to health policy and science and technology studies literatures to distinguish how deliberative methods engage different publics: citizens (ordinary people who are unfamiliar with the issues), consumers (those with relevant personal experience e.g. of illness) and advocates (those with technical expertise or partisan interests). We searched four databases for empirical studies in English published 1996-2013. This identified 78 articles reporting on 62 distinct events from the UK, USA, Canada, Australasia, Europe, Israel, Asia and Africa. Ten different types of deliberative techniques were used to represent and capture the interests and preferences of different types of public. Citizens were typically directed to consider community interests and were treated as a resource to increase democratic legitimacy. Citizens were preferred in methodological studies (those focused on understanding the techniques). Consumers were directed to focus on personal preferences; thus convened not as a source of policy decisions, but of knowledge about what those affected by the issue would accept. Advocates-who are most commonly used as expert witnesses in juries-were sometimes engaged to deliberate with consumers or citizens. This almost always occurred in projects directly linked to policy processes. This suggests health policymakers may value deliberative methods as a way of understanding disagreement between perspectives. Overall however, the 'type' of public sought was often not explicit, and their role not specified. This review provides new insight into the heterogeneity and rising popularity of deliberative methods, and indicates a need for greater

  20. Mental health law in the community: thinking about Africa.

    PubMed

    Bartlett, Peter; Jenkins, Rachel; Kiima, David

    2011-09-13

    The new United Nations Convention on the Rights of Persons with Disabilities creates a new paradigm for mental health law, moving from a focus on institutional care to a focus on community-based services and treatment. This article considers implementation of this approach in Africa.

  1. Uneven health outcomes and political resistance under residual neoliberalism in Africa.

    PubMed

    Bond, Patrick; Dor, George

    2003-01-01

    Africa has suffered two decades of policy implementation associated with the "neoliberal" macroeconomic as well as micro-development paradigm, and the health status of this continent has deteriorated markedly. Notwithstanding the discrediting of such policies since the late 1990s, they continue to be applied in Africa, especially by the World Bank and IMF, through Poverty Reduction Strategy Papers and the Highly Indebted Poor Countries debt relief initiative. Evidence can be found in the inadequate fiscal allocations to the health sector; the inadequate conceptualization of health in relation to other sectors; insufficient consultation with civil society; ongoing implementation of cost-recovery and user-fee provisions; a failed strategy to access pharmaceutical products, by respecting unnecessary Trade in Intellectual Property Rights provisos; and, most importantly, glaring insufficiencies in reducing Africa's foreign debt. One reflection of the balance of forces between Washington financial agencies and African societies is the adoption of the New Partnership for Africa's Development at the urging of the South African and Nigerian governments. While the WHO has helped to research, publicize, and criticize the problems associated with durable neoliberalism in African health care, it also continues to make serious mistakes as it remains locked within the paradigm. A human rights perspective being developed by the African Social Forum is, in contrast, consistent with broader international trends in the opposition to corporate globalization.

  2. [Social marketing and public health].

    PubMed

    Arcaro, P; Mannocci, A; Saulle, R; Miccoli, S; Marzuillo, C; La Torre, G

    2013-01-01

    Social marketing uses the principles and techniques of commercial marketing by applying them to the complex social context in order to promote changes (cognitive; of action; behavioral; of values) among the target population in the public interest. The advent of Internet has radically modified the communication process, and this transformation also involved medical-scientific communication. Medical journals, health organizations, scientific societies and patient groups are increasing the use of the web and of many social networks (Twitter, Facebook, Google, YouTube) as channels to release scientific information to doctors and patients quickly. In recent years, even Healthcare in Italy reported a considerable application of the methods and techniques of social marketing, above all for health prevention and promotion. Recently the association for health promotion "Social marketing and health communication" has been established to promote an active dialogue between professionals of social marketing and public health communication, as well as among professionals in the field of communication of the companies involved in the "health sector". In the field of prevention and health promotion it is necessary to underline the theme of the growing distrust in vaccination practices. Despite the irrefutable evidence of the efficacy and safety of vaccines, the social-cultural transformation together with the overcoming of compulsory vaccination and the use of noninstitutional information sources, have generated confusion among citizens that tend to perceive compulsory vaccinations as needed and safe, whereas recommended vaccinations as less important. Moreover, citizens scarcely perceive the risk of disease related to the effectiveness of vaccines. Implementing communication strategies, argumentative and persuasive, borrowed from social marketing, also for the promotion of vaccines is a priority of the health system. A typical example of the application of social marketing, as

  3. Promoting public health research in BRICS through a multinational public health prize fund.

    PubMed

    Campbell, Michael

    2014-01-01

    This article proposes the establishment of a prize fund to incentivise public health research within the BRICS association, which comprises the five major emerging world economies: Brazil, Russia, India, China and South Africa. This would stimulate cooperative healthcare research within the group and, on the proviso that the benefits of the research are made freely available within the association, would be rewarding for researchers. The results of the research stimulated by the prize would provide beneficial new healthcare technologies, targeting the most vulnerable and needy groups. The proposed fund is consistent with current international patent law and would not only avoid some of the problems associated with the "Health Impact Fund", but also create a new model for healthcare research.

  4. Investigating the psychosocial determinants of child health in Africa: the Drakenstein Child Health Study

    PubMed Central

    Stein, DJ; Koen, N; Donald, KA; Adnams, CM; Koopowitz, S; Lund, C; Marais, A; Myers, B; Roos, A; Sorsdahl, K; Stern, M; Tomlinson, M; van der Westhuizen, C; Vythilingum, B; Myer, L; Barnett, W; Brittain, K; Zar, HJ

    2015-01-01

    Background Early life psychobiological and psychosocial factors play a key role in influencing child health outcomes. Longitudinal studies may help elucidate the relevant risk and resilience profiles, and the underlying mechanisms that impact on child health, but there is a paucity of birth cohort data from low and middle-income countries (LMIC). We describe the rationale for and present baseline findings from the psychosocial component of the Drakenstein Child Health Study (DCHS). Methods We review the psychosocial measures used in the DCHS, a multidisciplinary birth cohort study in a peri-urban area in South Africa, and provide initial data on psychological distress, depression, substance use, and exposure to traumatic stressors and intimate partner violence (IPV). These and other measures will be assessed longitudinally in mothers in order to investigate associations with child neurodevelopmental and health outcomes. Results Baseline psychosocial data is presented for mothers (n = 634) and fathers (n = 75) who have completed antenatal assessments to date. The sample of pregnant mothers is characterized by multiple psychosocial risk factors, including a high prevalence of psychological distress and depression, high levels of substance use, and high exposure to traumatic stressors and IPV. Discussion These data are consistent with prior South African studies which have documented a high prevalence of a multitude of risk factors during pregnancy. Further longitudinal assessment of mothers and children may clarify the underlying psychobiological and psychosocial mechanisms which impact on child health, and so inform clinical and public health interventions appropriate to the South African and other LMIC contexts. PMID:25797842

  5. Jails, public health, and generalizability.

    PubMed

    Potter, Roberto Hugh

    2010-10-01

    This article outlines and discusses five categories of information about individual jails that should be considered before making general statements about jails. These are (a) the process by which individuals come to and are processed through the jail, (b) the size of the jail, (c) the region of the country where the jail is situated, (d) classification/assessment techniques, and (e) architecture and supervision styles. It is hoped that this discussion will generate a better understanding of the complexity of jail systems across the nation and help public health professionals better target their research, programs, and policies directed at the jail/community health nexus.

  6. Special People in Routine Health Information Systems Implementation in South Africa.

    PubMed

    Hanmer, Lyn A; Nicol, Edward

    2015-01-01

    An analysis of roles and decision making structures to facilitate routine health information system (RHIS) implementation and use in public health facilities in South Africa identified a wide range of stakeholders in these processes. Two broad categories of RHIS 'special people' are analysed, i.e. leaders (administrative and/or clinical) and bridgers/support staff. In addition to health system personnel with specific responsibility for RHIS, users with an interest in effective use of RHIS and RHIS outputs, and staff of external system and/or service providers, can play significant roles in RHIS implementation and use.

  7. Ethics in Public Health Research

    PubMed Central

    Curtis, Valerie A.; Garbrah-Aidoo, Nana; Scott, Beth

    2007-01-01

    Skill in marketing is a scarce resource in public health, especially in developing countries. The Global Public–Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for public health, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships. PMID:17329646

  8. [Internal medicine and public health].

    PubMed

    2009-08-01

    A special Committee on Internal Medicine and Public Health was established by Sociedad Médica de Santiago (Chilean Society of Internal Medicine) in April 2007 with the duty to write a Consensus Paper on the interaction between both branches of medical profession. The main objective was to find the common grounds on which to construct a positive approach to regain space for Internal Medicine, based on prevalent epidemiológical features related to adult health issues. The authors describe the reasons to explain the gap between clinical medicine and population health and identify the nature and evolution of chronic diseases as the point of encounter between both. With Chilean health surveys data, they state that chronic diseases explain the high proportion of burden of disease, mortality and disability, and stress that by the year 2025 one in every five inhabitants will be over 65 years of age, with ageing as another main problem for the health care sector. Population with multiple risks and multimorbidity is the most important challenge for the Chilean Health Care System. A new model of care is needed to tackle this scenario with new skills regarding psychosocial determinants of health. The leading role of internists and ideally geriatricians, will be crucial in this process and will help the implementation of sound population based interventions. Both individual and community level interventions will help to improve quality of life of Chilean families.

  9. Causal Inference in Public Health

    PubMed Central

    Glass, Thomas A.; Goodman, Steven N.; Hernán, Miguel A.; Samet, Jonathan M.

    2014-01-01

    Causal inference has a central role in public health; the determination that an association is causal indicates the possibility for intervention. We review and comment on the long-used guidelines for interpreting evidence as supporting a causal association and contrast them with the potential outcomes framework that encourages thinking in terms of causes that are interventions. We argue that in public health this framework is more suitable, providing an estimate of an action’s consequences rather than the less precise notion of a risk factor’s causal effect. A variety of modern statistical methods adopt this approach. When an intervention cannot be specified, causal relations can still exist, but how to intervene to change the outcome will be unclear. In application, the often-complex structure of causal processes needs to be acknowledged and appropriate data collected to study them. These newer approaches need to be brought to bear on the increasingly complex public health challenges of our globalized world. PMID:23297653

  10. Enhancing access to health information in Africa: a librarian's perspective.

    PubMed

    Gathoni, Nasra

    2012-01-01

    In recent years, tremendous progress has been made toward providing health information in Africa, in part because of technological advancements. Nevertheless, ensuring that information is accessible, comprehensible, and usable remains problematic, and there remain needs in many settings to address issues such as computer skills, literacy, and the infrastructure to access information. To determine how librarians might play a more strategic role in meeting information needs of health professionals in Africa, the author reviewed key components of information systems pertinent to knowledge management for the health sector, including access to global online resources, capacity to use computer technology for information retrieval, information literacy, and the potential for professional networks to play a role in improving access to and use of information. The author concluded that, in regions that lack adequate information systems, librarians could apply their knowledge and skills to facilitate access and use by information seekers. Ensuring access to and use of health information can also be achieved by engaging organizations and associations working to enhance access to health information, such as the Association for Health Information and Libraries in Africa. These groups can provide assistance through training, dissemination, information repackaging, and other approaches known to improve information literacy.

  11. The public health workforce, 2006: new challenges.

    PubMed

    Gebbie, Kristine M; Turnock, Bernard J

    2006-01-01

    Efforts to develop the public health workforce since 2001 have benefited from increased funding resulting from concerns over terrorism and other public health threats. This largesse has been accompanied by the need for greater accountability for results. The size, composition, and distribution of the public health workforce have long been policy concerns. Production and retention of public health workers remain important issues, although new dimensions of readiness are also taking center stage. We offer here policy recommendations in the areas of assessing the public health workforce and its needs, organizing development efforts around essential competencies for public health practice, credentialing workers, and accrediting agencies.

  12. Mental health policy development in Africa.

    PubMed Central

    Gureje, O.; Alem, A.

    2000-01-01

    Mental health issues are usually given very low priority in health service policies. Although this is changing, African countries are still confronted with so many problems caused by communicable diseases and malnutrition that they have not waken up to the impact of mental disorders. Every country must formulate a mental health policy based on its own social and cultural realities. Such policies must take into account the scope of mental health problems, provide proven and affordable interventions, safeguard patients' rights, and ensure equity. PMID:10885166

  13. Progressive and self-limiting neurodegenerative disorders in Africa: a new prominent field of research led by South Africa but without strong health policy

    PubMed Central

    Poreau, Brice

    2016-01-01

    Introduction Neurodegenerative disorders are involved in mortality and morbidity of every country. A high prevalence is estimated in Africa. Neurodegenerative disorders are defined by a progressive or self-limiting alteration of neurons implied in specific functional and anatomical functions. It encompasses a various range of clinical disorders from self-limiting to progressive. Focus on public health policies and scientific research is needed to understand the mechanisms to reduce this high prevalence. We use bibliometrics and mapping tools to explore the area studies and countries involved in scientific research on neurodegenerative disorders in Africa. Methods We used two databases: Web of Science and Pubmed. We analyzed the journals, most cited articles, authors, publication years, organizations, funding agencies, countries and keywords in Web of Science Core collection database and publication years and Medical Subject Headings in Pubmed database. We mapped the data using VOSviewer. Results We accessed 44 articles published between 1975 and 2014 in Web of Science Core collection Database and 669 from Pubmed database. The majority of which were after 2006. The main countries involved in research on neurodegenerative disorders in Africa the USA, the United Kingdom, France and South Africa representing the main network collaboration. Clinical neurology and Genetics hereditary are the main Web of Science categories whereas Neurosciences and Biochemistry and Molecular Biology are the main Web of Science categories for the general search “neurodegenerative disorders” not restrained to Africa. This is confirmed by Medical Subject Headings analysis from Pubmed with one more area study: Treatment. Conclusion Neurodegenerative disorders research is leaded by South Africa with a network involving the USA, the UK, as well as African countries such Zambia. The chief field that emerged was on patient and hereditary as well as treatment. Public health policies were

  14. Noise exposure and public health.

    PubMed Central

    Passchier-Vermeer, W; Passchier, W F

    2000-01-01

    Exposure to noise constitutes a health risk. There is sufficient scientific evidence that noise exposure can induce hearing impairment, hypertension and ischemic heart disease, annoyance, sleep disturbance, and decreased school performance. For other effects such as changes in the immune system and birth defects, the evidence is limited. Most public health impacts of noise were already identified in the 1960s and noise abatement is less of a scientific but primarily a policy problem. A subject for further research is the elucidation of the mechanisms underlying noise-induced cardiovascular disorders and the relationship of noise with annoyance and nonacoustical factors modifying health outcomes. A high priority study subject is the effects of noise on children, including cognitive effects and their reversibility. Noise exposure is on the increase, especially in the general living environment, both in industrialized nations and in developing world regions. This implies that in the twenty-first century noise exposure will still be a major public health problem. Images Figure 2 PMID:10698728

  15. Prescription Tracking and Public Health

    PubMed Central

    2008-01-01

    INTRODUCTION Monitoring and modifying physicians’ prescribing behavior through prescription tracking is integral to pharmaceutical marketing. Health information organizations (HIOs) combine prescription information purchased from pharmacies with anonymized patient medical records purchased from health insurance companies to determine which drugs individual physicians prefer for specific diagnoses and patient populations. This information is used to tailor marketing strategies to individual physicians and to assess the effect of promotions on prescribing behavior. DISCUSSION The American Medical Association (AMA) created the Prescription Data Restriction Plan in an attempt to address both the privacy concerns of physicians and industry concerns that legislation could compromise the availability of prescribing data. However, the PDRP only prohibits sales representatives and their immediate supervisors from accessing the most detailed reports. Less than 2% of US physicians have registered for the PDRP, and those who have signed up are not the physicians who are targeted for marketing. CONCLUSION Although it has been argued that prescription tracking benefits public health, data gathered by HIOs is designed for marketing drugs. These data are sequestered by industry and are not generally available for genuine public health purposes. PMID:18473146

  16. Electromagnetic fields and public health.

    PubMed Central

    Aldrich, T E; Easterly, C E

    1987-01-01

    A review of the literature is provided for the topic of health-related research and power frequency electromagnetic fields. Minimal evidence for concern is present on the basis of animal and plant research. General observation would accord with the implication that there is no single and manifest health effect as the result of exposure to these fields. There are persistent indications, however, that these fields have biologic activity, and consequently, there may be a deleterious component to their action, possibly in the presence of other factors. Power frequency electromagnetic field exposures are essentially ubiquitous in modern society, and their implications in the larger perspective of public health are unclear at this time. Electromagnetic fields represent a methodological obstacle for epidemiologic studies and a quandary for risk assessment; there is need for more data. PMID:3319560

  17. [Social medicine, public health and governance for health].

    PubMed

    Holčík, Jan

    2016-01-01

    Social medicine, public health and governance for health have a long tradition in the Czech Republic but some problems persist. Possible solutions are reliable information, research, education and training. Action plans for Health 2020 implementation are appreciated as well as a valuable help of the WHO Country Office, Czech Republic.Key words: social medicine, public health, health, health governance, governance for health, Health 2020, World Health Organization.

  18. Enhancing public health law communication linkages.

    PubMed

    Silverman, Ross D

    2008-01-01

    Although interest in the field of public health law has dramatically increased over the past two decades, there remain significant challenges in communicating and sharing public health law-related knowledge. Access to quality information, which may assist in a public health department's efforts to protect the public's health, welfare, and safety, varies widely from jurisdiction to jurisdiction, and interjurisdictional communication remains at best a patchwork quilt with many holes. What follows is an analysis of several approaches the Public Health Law Association or other public health law-related organizations might undertake to serve as a conduit for the identification, gathering, and dissemination of extant public health law information, as well as the development of new public health law-related content, with a particular focus on the use of electronic means for such efforts.

  19. Nutrigenomics, individualism and public health.

    PubMed

    Chadwick, Ruth

    2004-02-01

    Issues arising in connection with genes and nutrition policy include both nutrigenomics and nutrigenetics. Nutrigenomics considers the relationship between specifc nutrients or diet and gene expression and, it is envisaged, will facilitate prevention of diet-related common diseases. Nutrigenetics is concerned with the effects of individual genetic variation (single nucleotide polymorphisms) on response to diet, and in the longer term may lead to personalised dietary recommendations. It is important also to consider the surrounding context of other issues such as novel and functional foods in so far as they are related to genetic modification. Ethical issues fall into a number of categories: (1) why nutrigenomics? Will it have important public health benefits? (2) questions about research, e.g. concerning the acquisition of information about individual genetic variation; (3) questions about who has access to this information, and its possible misuse; (4) the applications of this information in terms of public health policy, and the negotiation of the potential tension between the interests of the individual in relation to, for example, prevention of conditions such as obesity and allergy; (5) the appropriate ethical approach to the issues, e.g. the moral difference, if any, between therapy and enhancement in relation to individualised diets; whether the 'technological fix' is always appropriate, especially in the wider context of the purported lack of public confidence in science, which has special resonance in the sphere of nutrition.

  20. [Parmentier hygiene and public health].

    PubMed

    Lafont, O

    2014-05-01

    The legend about Parmentier is quite reductive when it limits his activity to the promotion of potato. This military pharmacist intended mainly to make science serve human being, whatever could be his various activities. Actor of the foundation of food chemistry, reorganizer of military pharmacy, he has always been highly concerned with hygiene and public health. He then studied the quality of water, particularly in the case of river Seine, or the purity of air, especially in hospitals. The affair of Dunkerque exhumations or that of cesspools, or the utilisation of human excrements in agriculture were parts of the occurrences for which he had the opportunity to find a scientific approach allowing to solve the difficult questions that were asked to him, for the best benefit of public health. The exhaustive study he published in "Bulletin de pharmacie" for the conservation of meat shows that he did not ignore anything about freezing of food in order to preserve it. It is necessary not to forget the important role he played, as soon as he were informed of Jenner's discovery, for the diffusion of vaccination in France. It is simply astounding to observe how modern were the questions he solved and how intense was his spirit of dedication to the public good, when exerting his functions in "Comité de Salubrité de la Seine" or "Conseil de Santé des Armées", as well as outside these prestigious institutions.

  1. Oral health finance and expenditure in South Africa.

    PubMed

    Naidoo, L C; Stephen, L X

    1997-12-01

    The objective of this paper was to examine the cost of oral health in South Africa over the past decade Particular emphasis was placed on the contribution made by medical schemes which is the main source of private health care funding. Some of the problems facing this huge industry were also briefly explored. Primary aggregate data on oral health expenditure were obtained from the Department of Health, Pretoria and from the offices of the Registrar of Medical Schemes, Pretoria. The results show that in 1994, 4.7 per cent of the total health care budget was allocated to oral health. Of this amount, 14.2 per cent came from the state, 71.9 per cent from medical schemes and the remainder calculated to be from direct out-of-pocket payments. Furthermore, real expenditure for oral health by medical schemes grew robustly and almost continuously from 1984 through to 1994, generally outstripping medical inflation.

  2. The case for transforming governmental public health.

    PubMed

    Salinsky, Eileen; Gursky, Elin A

    2006-01-01

    Changing threats to the public's health necessitate a profound transformation of the public health enterprise. Despite recent attention to the biodefense role of public health, policymakers have not developed a clear, realistic vision for the structure and functionality of the governmental public health system. Lack of leadership and organizational disconnects across levels of government have prevented strategic alignment of resources and undermined momentum for meaningful change. A transformed public health system is needed to address the demands of emergency preparedness and health protection. Such transformation should include focused, risk-based resource allocation; regional planning; technological upgrades; workforce restructuring; improved integration of private-sector assets; and better performance monitoring.

  3. Public health ethics: the voices of practitioners.

    PubMed

    Bernheim, Ruth Gaare

    2003-01-01

    Public health ethics is emerging as a new field of inquiry, distinct not only from public health law, but also from traditional medical ethics and research ethics. Public health professional and scholarly attention is focusing on ways that ethical analysis and a new public health code of ethics can be a resource for health professionals working in the field. This article provides a preliminary exploration of the ethical issues faced by public health professionals in day-to-day practice and of the type of ethics education and support they believe may be helpful.

  4. [1946: hygienics and public health].

    PubMed

    Bucci, Roberto

    2002-01-01

    In Italy, the year 1946 was characterized, on one hand, by the growing concern for the lack of public structures and, on the other, by the hopes placed in the research sector, namely the apparently inexhaustible properties of penicillin and antibiotics. Consistently, Igiene e Sanità Pubblica reflected the general mood of the hygienists, swinging between the strong protests against a far too slow political system incapable of spurring scientific research, and the constant engagement aimed at enhancing the future role of public health. Besides facing many institutional problems, such as claiming an official recognition for their profession, hygienists also managed to make Italians understand the real value of a discipline conceived for the community service.

  5. Public Health Interventions for School Nursing Practice

    ERIC Educational Resources Information Center

    Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon

    2016-01-01

    School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…

  6. 42 CFR 90.9 - Public health advisory.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of...

  7. 42 CFR 90.9 - Public health advisory.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of...

  8. 42 CFR 90.9 - Public health advisory.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of...

  9. 42 CFR 90.9 - Public health advisory.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of...

  10. 42 CFR 90.9 - Public health advisory.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of...

  11. Uses of electronic health records for public health surveillance to advance public health.

    PubMed

    Birkhead, Guthrie S; Klompas, Michael; Shah, Nirav R

    2015-03-18

    Public health surveillance conducted by health departments in the United States has improved in completeness and timeliness owing to electronic laboratory reporting. However, the collection of detailed clinical information about reported cases, which is necessary to confirm the diagnosis, to understand transmission, or to determine disease-related risk factors, is still heavily dependent on manual processes. The increasing prevalence and functionality of electronic health record (EHR) systems in the United States present important opportunities to advance public health surveillance. EHR data have the potential to further increase the breadth, detail, timeliness, and completeness of public health surveillance and thereby provide better data to guide public health interventions. EHRs also provide a unique opportunity to expand the role and vision of current surveillance efforts and to help bridge the gap between public health practice and clinical medicine.

  12. Science-based health innovation in sub-Saharan Africa.

    PubMed

    Al-Bader, Sara; Masum, Hassan; Simiyu, Ken; Daar, Abdallah S; Singer, Peter A

    2010-12-13

    In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation.This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive on-the-ground research in the form of four country case studies of health and biotechnology innovation, six studies of institutions within Africa involved in health product development, and one study of health venture funds in Africa. To the best of our knowledge it is the first extensive collection of empirical work on African science-based health innovation.The four country cases are Ghana, Rwanda, Tanzania and Uganda. The six case studies of institutions are A to Z Textiles (Tanzania), Acorn Technologies (South Africa), Bioventures venture capital fund (South Africa), the Malagasy Institute of Applied Research (IMRA; Madagascar), the Kenyan Medical Research Institute (KEMRI; Kenya), and Niprisan's development by Nigeria's National Institute for Pharmaceutical Research and Development and Xechem (Nigeria).All of the examples highlight pioneering attempts to build technological capacity, create economic opportunities, and retain talent on a continent significantly affected by brain drain. They point to the practical challenges for innovators on the ground, and suggest potentially helpful policies, funding streams, and other support systems.For African nations, health innovation represents an opportunity to increase domestic capacity to solve health challenges; for international funders, it is an opportunity to move beyond foreign aid and dependency. The shared goal is creating self-sustaining innovation that has both health and development impacts. While this is a long-term strategy

  13. Perceived Discrimination, Race and Health in South Africa

    PubMed Central

    Williams, David R.; Gonzalez, Hector M; Williams, Stacey; Mohammed, Selina A; Moomal, Hashim; Stein, Dan J

    2009-01-01

    To assess the levels of perceived acute and chronic racial and non-racial discrimination in South Africa, their association with health, and the extent to which they contribute to racial differences in physical and mental health, data were used from a national probability sample of adults, the South African Stress and Health Study (SASH). All Black groups in South Africa (African, Coloured and Indian) were two to four times more likely than Whites to report acute and chronic experiences of racial discrimination. Africans and Coloureds report higher levels of ill health than Whites, but acute and chronic racial discrimination were unrelated to ill health and unimportant in accounting for racial differences in self rated health. In contrast, all Black groups had higher levels of psychological distress than Whites, and perceived chronic discrimination, was positively associated with distress. Moreover, these experiences accounted for some of the residual racial differences in distress after adjustment for socioeconomic status. Our main findings indicate that, in a historically racialized society, perceived chronic racial and especially non-racial discrimination acts independently of demographic factors, other stressors, psychological factors (social desirability, self-esteem and personal mastery), and multiple SES indicators to adversely affect mental health. PMID:18486292

  14. Sub-Saharan Africa: beyond the health worker migration crisis?

    PubMed

    Connell, John; Zurn, Pascal; Stilwell, Barbara; Awases, Magda; Braichet, Jean-Marc

    2007-05-01

    Migration of skilled health workers from sub-Saharan African countries has significantly increased in this century, with most countries becoming sources of migrants. Despite the growing problem of health worker migration for the effective functioning of health care systems there is a remarkable paucity and incompleteness of data. Hence, it is difficult to determine the real extent of migration from, and within, Africa, and thus develop effective forecasting or remedial policies. This global overview and the most comprehensive data indicate that the key destinations remain the USA and the UK, and that major sources are South Africa and Nigeria, but in both contexts there is now greater diversity. Migrants move primarily for economic reasons, and increasingly choose health careers because they offer migration prospects. Migration has been at considerable economic cost, it has depleted workforces, diminished the effectiveness of health care delivery and reduced the morale of the remaining workforce. Countries have sought to implement national policies to manage migration, mitigate its harmful impacts and strengthen African health care systems. Recipient countries have been reluctant to establish effective ethical codes of recruitment practice, or other forms of compensation or technology transfer, hence migration is likely to increase further in the future, diminishing the possibility of achieving the United Nations millennium development goals and exacerbating existing inequalities in access to adequate health care.

  15. Public Participation Guide: Container Handling in the Port of Durban, South Africa

    EPA Pesticide Factsheets

    This case study describes the public participation process that was conducted in the context of an Integrated Environmental Management exercise related to the proposed expansion of container handling facilities at the Port of Durban, South Africa.

  16. Health consequences of child marriage in Africa.

    PubMed

    Nour, Nawal M

    2006-11-01

    Despite international agreements and national laws, marriage of girls <18 years of age is common worldwide and affects millions. Child marriage is a human rights violation that prevents girls from obtaining an education, enjoying optimal health, bonding with others their own age, maturing, and ultimately choosing their own life partners. Child marriage is driven by poverty and has many effects on girls' health: increased risk for sexually transmitted diseases, cervical cancer, malaria, death during childbirth, and obstetric fistulas. Girls' offspring are at increased risk for premature birth and death as neonates, infants, or children. To stop child marriage, policies and programs must educate communities, raise awareness, engage local and religious leaders, involve parents, and empower girls through education and employment.

  17. Public Criticism of Health Science Policy

    ERIC Educational Resources Information Center

    Hutt, Peter Barton

    1978-01-01

    Major criticisms of health science policy are that (1) health science research is not presently designed to help the public which pays for it; (2) the public should have greater control over health science research; and (3) federal funding of training for health science research is an inappropriate use of tax funds. (Author/DB)

  18. Physical Education's Role in Public Health.

    ERIC Educational Resources Information Center

    Sallis, James F.; McKenzie, Thomas L.

    1991-01-01

    Analyzes contributions physical education makes to child and adult health. Topics discussed are current levels of U.S. children's physical activity; status of elementary physical education programs; health-related physical activity interventions; public health analysis of elementary physical education; and public health role and goal for physical…

  19. Social capital and health among older adults in South Africa

    PubMed Central

    2013-01-01

    Background Little is known about social capital and health among older adults in South Africa. This study investigates the association between social capital and several health variables, namely: self-rated health, depressive symptoms, cognitive functioning and physical inactivity, among older South Africans. Methods We conducted a national population-based cross-sectional study with a national probability sample of 3840 individuals aged 50 years or older who participated in the Study of Global Ageing and Adults Health (SAGE wave 1) in 2008 in South Africa. Measures included socio-demographic characteristics, health variables, cognitive functioning and physical activity. Social capital was assessed with six components, namely: marital status, social action, sociability, trust and solidarity, safety, and civic engagement. Results The social capital assessment revealed that 56% of the respondents were married or cohabiting, 45% reported low (0) social action, 42% reported medium (2–3) sociability, 43% reported high (2) trust and solidarity, 50% reported high (2–4) civic engagement and 42% reported medium (6) psychological resources. In multivariate analysis, self-reported good health was associated with younger age, having secondary education and higher social capital (being married or cohabiting, high trust and solidarity and greater psychological resources). Depressive symptoms were associated with lower social capital (not being married or cohabiting, lack of high trust and solidarity and low psychological resources). Better cognitive functioning was associated with younger age, higher educational level, greater wealth and higher social capital (being married or cohabiting, high trust and solidarity, lack of safety, higher civic engagement and greater psychological resources). Physical inactivity was associated with older age and lower social capital (lower social action, lack of safety, lower civic engagement and poorer psychological resources). Conclusions

  20. A National Agenda for Public Health Informatics

    PubMed Central

    Yasnoff, William A.; Overhage, J. Marc; Humphreys, Betsy L.; LaVenture, Martin

    2001-01-01

    The AMIA 2001 Spring Congress brought together members of the the public health and informatics communities to develop a national agenda for public health informatics. Discussions of funding and governance; architecture and infrastructure; standards and vocabulary; research, evaluation, and best practices; privacy, confidentiality, and security; and training and workforce resulted in 74 recommendations with two key themes—that all stakeholders need to be engaged in coordinated activities related to public health information architecture, standards, confidentiality, best practices, and research; and that informatics training is needed throughout the public health workforce. Implementation of this consensus agenda will help promote progress in the application of information technology to improve public health. PMID:11687561

  1. Feminism and public health nursing: partners for health.

    PubMed

    Leipert, B D

    2001-01-01

    It is a well-known fact that nursing and feminism have enjoyed an uneasy alliance. In recent years, however, nursing has begun to recognize the importance of feminism. Nevertheless, the literature still rarely addresses the relevance of feminism for public health nursing. In this article, I articulate the relevance of feminism for public health nursing knowledge and practice. First, I define and describe feminism and public health nursing and then I discuss the importance of feminism for public health nursing practice. The importance of feminism for the metaparadigm concepts of public health nursing is then reviewed. Finally, I examine several existing challenges relating to feminism and public health nursing research, education, and practice. The thesis of this article is that feminism is vitally important for the development of public health nursing and for public health care.

  2. Undergraduate Public Health Majors: Why They Choose Public Health or Medicine?

    ERIC Educational Resources Information Center

    Hilton, Warren

    2013-01-01

    This mixed methods study examined the relationship between the motivations for attending college of undergraduate students with a focus on students with a public health major, and their desire to pursue graduate training in public health and subsequently, public health careers. The study highlighted the current public health workforce shortage and…

  3. Public Health, the APHA, and Urban Renewal

    PubMed Central

    2009-01-01

    Joint efforts by fields of public health in the last decade have advocated use of the built environment to protect health. Past involvement by public health advocates in urban policy, however, has had mixed results. Although public health has significantly contributed to health improvements, its participation in urban renewal activities was problematic. Health advocates and the American Public Health Association produced guidelines that were widely used to declare inner-city areas blighted and provided a scientific justification for demolishing neighborhoods and displacing mostly poor and minority people. Furthermore, health departments failed to uphold their legal responsibility to ensure that relocated families received safe, affordable housing alternatives. These failures have important implications for future health-related work on the built environment and other core public health activities. PMID:19608955

  4. Public health, the APHA, and urban renewal.

    PubMed

    Lopez, Russ P

    2009-09-01

    Joint efforts by fields of public health in the last decade have advocated use of the built environment to protect health. Past involvement by public health advocates in urban policy, however, has had mixed results. Although public health has significantly contributed to health improvements, its participation in urban renewal activities was problematic. Health advocates and the American Public Health Association produced guidelines that were widely used to declare inner-city areas blighted and provided a scientific justification for demolishing neighborhoods and displacing mostly poor and minority people. Furthermore, health departments failed to uphold their legal responsibility to ensure that relocated families received safe, affordable housing alternatives. These failures have important implications for future health-related work on the built environment and other core public health activities.

  5. Health-care-associated infection in Africa: a systematic review

    PubMed Central

    Bagheri Nejad, Sepideh; Allegranzi, Benedetta; Syed, Shamsuzzoha B; Ellis, Benjamin

    2011-01-01

    Abstract Objective To assess the epidemiology of endemic health-care-associated infection (HAI) in Africa. Methods Three databases (PubMed, the Cochrane Library, and the WHO regional medical database for Africa) were searched to identify studies published from 1995 to 2009 on the epidemiology of HAI in African countries. No language restriction was applied. Available abstract books of leading international infection control conferences were also searched from 2004 to 2009. Findings The eligibility criteria for inclusion in the review were met by 19 articles, only 2 of which met the criterion of high quality. Four relevant abstracts were retrieved from the international conference literature. The hospital-wide prevalence of HAI varied between 2.5% and 14.8%; in surgical wards, the cumulative incidence ranged from 5.7% to 45.8%. The largest number of studies focused on surgical site infection, whose cumulative incidence ranged from 2.5% to 30.9%. Data on causative pathogens were available from a few studies only and highlighted the importance of Gram-negative rods, particularly in surgical site infection and ventilator-associated pneumonia. Conclusion Limited information is available on the endemic burden of HAI in Africa, but our review reveals that its frequency is much higher than in developed countries. There is an urgent need to identify and implement feasible and sustainable approaches to strengthen HAI prevention, surveillance and control in Africa. PMID:22084514

  6. Oil for health in sub-Saharan Africa: health systems in a 'resource curse' environment

    PubMed Central

    Calain, Philippe

    2008-01-01

    Background In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomised by oil extraction in sub-Saharan Africa. Methods Based on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan), I propose a framework for analysing the effects of the resource curse on the structure of health systems at sub-national levels. Qualitative attributes are emphasised. The role of the corporate sector, the influence of conflicts, and the value of classical mitigation measures (such as health impact assessments) are further examined. Results Health systems in a resource curse environment are classically fractured into tripartite components, including governmental health agencies, non-profit non-governmental organisations, and the corporate extractive sector. The three components entertain a range of contractual relationships generally based on operational considerations which are withdrawn from social or community values. Characterisation of agencies in this system should also include: values, operating principles, legitimacy and operational spaces. From this approach, it appears that community health is at the same time marginalised and instrumentalised toward economic and corporate interests in resource curse settings. Conclusion From a public health point of view, the resource curse represents a fundamental failure of dominant development theories, rather than a delay in creating the proper economy and governance environment for social progress. The scope of research on the resource curse should be broadened to include more accurate or comprehensive indicators of destitution (including health components) and more open perspectives on causal mechanisms. PMID:18939986

  7. Measuring the Value of Public Health Systems: The Disconnect Between Health Economists and Public Health Practitioners

    PubMed Central

    Jacobson, Peter D.; Palmer, Jennifer A.

    2008-01-01

    We investigated ways of defining and measuring the value of services provided by governmental public health systems. Our data sources included literature syntheses and qualitative interviews of public health professionals. Our examination of the health economic literature revealed growing attempts to measure value of public health services explicitly, but few studies have addressed systems or infrastructure. Interview responses demonstrated no consensus on metrics and no connection to the academic literature. Key challenges for practitioners include developing rigorous, data-driven methods and skilled staff; being politically willing to base allocation decisions on economic evaluation; and developing metrics to capture “intangibles” (e.g., social justice and reassurance value). Academic researchers evaluating the economics of public health investments should increase focus on the working needs of public health professionals. PMID:18923123

  8. Enhancing crisis leadership in public health emergencies.

    PubMed

    Deitchman, Scott

    2013-10-01

    Reviews of public health emergency responses have identified a need for crisis leadership skills in health leaders, but these skills are not routinely taught in public health curricula. To develop criteria for crisis leadership in public health, published sources were reviewed to identify attributes of successful crisis leadership in aviation, public safety, military operations, and mining. These sources were abstracted to identify crisis leadership attributes associated with those disciplines and compare those attributes with crisis leadership challenges in public health. Based on this review, the following attributes are proposed for crisis leadership in public health: competence in public health science; decisiveness with flexibility; ability to maintain situational awareness and provide situational assessment; ability to coordinate diverse participants across very different disciplines; communication skills; and the ability to inspire trust. Of these attributes, only competence in public health science is currently a goal of public health education. Strategies to teach the other proposed attributes of crisis leadership will better prepare public health leaders to meet the challenges of public health crises.

  9. The Courts, Public Health, and Legal Preparedness

    PubMed Central

    Stier, Daniel D.; Nicks, Diane; Cowan, Gregory J.

    2007-01-01

    The judicial branch’s key roles, as guardian of civil liberties and protector of the rule of law, can be acutely relevant during public health emergencies when courts may need to issue orders authorizing actions to protect public health or restraining public health actions that are determined to unduly interfere with civil rights. Legal preparedness for public health emergencies, therefore, necessitates an understanding of the court system and how courts are involved in public health issues. In this article we briefly describe the court system and then focus on what public health practitioners need to know about the judicial system in a public health emergency, including the courts’ roles and the consequent need to keep courts open during emergencies. PMID:17413084

  10. Climate change and ecological public health.

    PubMed

    Goodman, Benny

    2015-02-17

    Climate change has been identified as a serious threat to human health, associated with the sustainability of current practices and lifestyles. Nurses should expand their health promotion role to address current and emerging threats to health from climate change and to address ecological public health. This article briefly outlines climate change and the concept of ecological public health, and discusses a 2012 review of the role of the nurse in health promotion.

  11. Effect of health development assistance on health status in sub-Saharan Africa

    PubMed Central

    Negeri, Keneni Gutema; Halemariam, Damen

    2016-01-01

    Introduction Data on the effect of health aid on the health status in developing countries are inconclusive. Moreover, studies on this issue in sub-Saharan Africa are scarce. Therefore, this study aims to analyze the effect of health development aid in sub-Saharan Africa. Methods Using panel data analytic method, as well as infant mortality rate as a proxy for health status, this study examines the effect of health aid on infant mortality rate in sub-Saharan Africa. The panel was constructed from data on 43 countries for the period 1990–2010. Fixed effect, random effect, and first difference generalized method of moments estimator were used for estimation. Results Health development aid has a statistically significant positive effect. A 1% increase of health development assistance per capita saves the lives of two infants per 1,000 live births (P=0.000) in the region. Conclusion Contrary to health aid pessimists’ view, this study observes the fact that health development assistance has strong favorable effect in improving health status in sub-Saharan Africa. PMID:27103844

  12. Public Housing, Health, and Health Behaviors: Is There a Connection?

    ERIC Educational Resources Information Center

    Fertig, Angela R.; Reingold, David A.

    2007-01-01

    This paper explores the relationship between public housing, health outcomes, and health behaviors among low-income housing residents. While public housing can be a dangerous and unhealthy environment in which to live, the subsidized rent may free up resources for nutritious food and health care. In addition, public housing may be of higher…

  13. Interprofessional Fellowship Training for Emerging Global Health Leaders in Africa to Improve HIV Prevention and Care: The Afya Bora Consortium.

    PubMed

    Ousman, Kevin; Polomano, Rosemary C; Seloilwe, Esther; Odero, Theresa; Tarimo, Edith; Mashalla, Yohana J; Voss, Joachim G; O'Malley, Gabrielle; Chapman, Susan A; Gachuno, Onesmus; Manabe, Yukari; Nakanjako, Damalie; Sewankambo, Nelson; Urassa, David; Wasserheit, Judith N; Wiebe, Douglas J; Green, Wendy; Farquhar, Carey

    2016-01-01

    HIV continues to challenge health systems, especially in low- and middle-income countries in Sub-Saharan Africa. A qualified workforce of transformational leaders is required to strengthen health systems and introduce policy reforms to address the barriers to HIV testing, treatment, and other HIV services. The 1-year Afya Bora Consortium Fellowship in Global Health capitalizes on academic partnerships between African and U.S. universities to provide interprofessional leadership training through classroom, online, and service-oriented learning in 5 countries in Africa. This fellowship program prepares health professionals to design, implement, scale-up, evaluate, and lead health programs that are population-based and focused on prevention and control of HIV and other public health issues of greatest importance to African communities and health service settings. Afya Bora nurse fellows acquire leadership attributes and competencies that are continuously and systematically tested during the entire program. This multinational training platform promotes interprofessional networks and career opportunities for nurses.

  14. Nuclear education in public health and nursing

    SciTech Connect

    Winder, A.E.; Stanitis, M.A.

    1988-08-01

    Twenty-three public health schools and 492 university schools of nursing were surveyed to gather specific information on educational programs related to nuclear war. Twenty public health schools and 240 nursing schools responded. Nuclear war-related content was most likely to appear in disaster nursing and in environmental health courses. Three schools of public health report that they currently offer elective courses on nuclear war. Innovative curricula included political action projects for nuclear war prevention.

  15. Public and private health initiatives in Kansas.

    PubMed

    Fonner, E

    1998-01-01

    This article summarizes several health initiatives in Kansas that are being forwarded by way of public/private partnerships. Consensus is being shaped on the standardization of health data and use of actionable indicators. Statewide public health improvement planning is also being pursued. A group of large employers and state agencies are creating a basis for group purchasing, consumer assessments of health plans, and coordinated public policy formulation.

  16. Socio-medical indicators of health in South Africa.

    PubMed

    Jinabhai, C C; Coovadia, H M; Abdool-Karim, S S

    1986-01-01

    Socio-medical indicators developed by WHO for monitoring progress towards Health-for-All have been adapted to reveal, clearly and objectively, the devastating impact of state planning based on an outmoded immoral and unscientific philosophy of race superiority in South Africa on the health of the disenfranchised majority within the context of social and economic discrimination; Health policy indicators confirm that the government is committed to three options (Bantustans, A New Constitution, and A Health Services Facilities Plan) all of which are inconsistent with the attainment of Health-for-All; Social and economic indicators reveal gross disparities between African, Coloured, Indian, and White living and working conditions; Provision of health care indicators show the overwhelming dominance of high technology curative medical care consuming about 97 percent of the health budget with only minor shifts towards community-based comprehensive care; and Health status indicators illustrate the close nexus between privilege, dispossession and disease with Whites falling prey to health problems related to affluence and lifestyle, while Africans, Coloureds, and Indians suffer from disease due to poverty. All four categories of the indicator system reveal discrepancies which exist between Black and White, rich and poor, urban and rural. To achieve the social goal of Health-for-All requires a greater measure of political commitment from the state. We conclude that it is debatable whether a system which maintains race discrimination and exploitation can in fact be adapted to provide Health-for-All.

  17. Public health reform and health promotion in Canada.

    PubMed

    Kirk, Megan; Tomm-Bonde, Laura; Schreiber, Rita

    2014-06-01

    More than 25 years have passed since the release of the Ottawa Charter for Health Promotion. This document represented a substantial contribution to public health in its emphasis on the economic, legal, political and cultural factors that influence health. With public health renewal underway across Canada, and despite overwhelming support in the public health community for the Ottawa Charter, how much its principles will be included in the renewal process remains unclear. In this paper, we present the historical understanding of health promotion in Canada, namely highlighting the contributions from the Lalonde Report, Alma Ata Declaration, the Ottawa Charter for Health Promotion and the more recent population health movement. We discuss public health renewal, using the province of British Columbia in Canada as an example. We identify the potential threats to health promotion in public health renewal as it unfolds.

  18. (Public) Health and Human Rights in Practice.

    PubMed

    Annas, George J; Mariner, Wendy K

    2016-02-01

    Public health's reliance on law to define and carry out public activities makes it impossible to define a set of ethical principles unique to public health. Public health ethics must be encompassed within--and consistent with--a broader set of principles that define the power and limits of governmental institutions. These include human rights, health law, and even medical ethics. The human right to health requires governments not only to respect individual human rights and personal freedoms, but also, importantly, to protect people from harm from external sources and third parties, and to fulfill the health needs of the population. Even if human rights are the natural language for public health, not all public health professionals are comfortable with the language of human rights. Some argue that individual human rights--such as autonomy and privacy--unfairly limit the permissible means to achieve the goal of health protection. We argue that public health should welcome and promote the human rights framework. In almost every instance, this will make public health more effective in the long run, because the goals of public health and human rights are the same: to promote human flourishing.

  19. "Harnessing genomics to improve health in Africa" – an executive course to support genomics policy

    PubMed Central

    Smith, Alyna C; Mugabe, John; Singer, Peter A; Daar, Abdallah S

    2005-01-01

    Background Africa in the twenty-first century is faced with a heavy burden of disease, combined with ill-equipped medical systems and underdeveloped technological capacity. A major challenge for the international community is to bring scientific and technological advances like genomics to bear on the health priorities of poorer countries. The New Partnership for Africa's Development has identified science and technology as a key platform for Africa's renewal. Recognizing the timeliness of this issue, the African Centre for Technology Studies and the University of Toronto Joint Centre for Bioethics co-organized a course on Genomics and Public Health Policy in Nairobi, Kenya, the first of a series of similar courses to take place in the developing world. This article presents the findings and recommendations that emerged from this process, recommendations which suggest that a regional approach to developing sound science and technology policies is the key to harnessing genome-related biotechnology to improve health and contribute to human development in Africa. Methods The objectives of the course were to familiarize participants with the current status and implications of genomics for health in Africa; to provide frameworks for analyzing and debating the policy and ethical questions; and to begin developing a network across different sectors by sharing perspectives and building relationships. To achieve these goals the course brought together a diverse group of stakeholders from academic research centres, the media, non-governmental, voluntary and legal organizations to stimulate multi-sectoral debate around issues of policy. Topics included scientific advances in genomics innovation systems and business models, international regulatory frameworks, as well as ethical and legal issues. Results Seven main recommendations emerged: establish a network for sustained dialogue among participants; identify champions among politicians; use the New Plan for African

  20. Public health problems of urbanization.

    PubMed

    Mutatkar, R K

    1995-10-01

    Developing countries have been peasant societies. The cities in traditional societies have been pilgrimage centres, seats of administration and educational centres. These cities had homogeneous relationships with the villages. Industrialization has developed modern megacities whose way of life is heterogeneous with that in the villages. Rural poverty has pushed villagers to the cities, which were never planned to accommodate immigrants. Public health and social problems have arisen lowering the quality of life. Communicable diseases among the urban poor coexist with non-communicable diseases among the comparatively affluent. Problems of pollution, crime and chronic morbidity increase. The NGOs provide relief to the poor and needy but do nothing toward creating an infrastructure for balanced development. The election of women as a result of non-discriminatory legislation provides good ground for hope.

  1. A Review of Model Public Health Laws

    PubMed Central

    Hartsfield, DeKeely; Moulton, Anthony D.; McKie, Karen L.

    2007-01-01

    Model public health laws (public health laws or private policies publicly recommended by at least 1 organization for adoption by government bodies or by specified private entities) are promoted as exemplary. We assessed the information sponsors of model public health laws provide on the methods used in developing their models and on their models’ adoption and effectiveness. Through a systematic search, we identified 107 model public health laws published from 1907 to 2004. As of our assessment in 2005, only 18 (44%) of the sponsors presented any information on the procedures and evidence used in developing their model public health laws; information on adoption was provided for only 7 (6.5%) model laws. No sponsors provided information on model effectiveness. We recommend sponsors improve their disclosure of information about the methods and evidence used in developing model public health laws and about their adoption and effectiveness. PMID:17413072

  2. Using Health Information Exchange to Improve Public Health

    PubMed Central

    Mostashari, Farzad; Hripcsak, George; Soulakis, Nicholas; Kuperman, Gilad

    2011-01-01

    Public health relies on data reported by health care partners, and information technology makes such reporting easier than ever. However, data are often structured according to a variety of different terminologies and formats, making data interfaces complex and costly. As one strategy to address these challenges, health information organizations (HIOs) have been established to allow secure, integrated sharing of clinical information among numerous stakeholders, including clinical partners and public health, through health information exchange (HIE). We give detailed descriptions of 11 typical cases in which HIOs can be used for public health purposes. We believe that HIOs, and HIE in general, can improve the efficiency and quality of public health reporting, facilitate public health investigation, improve emergency response, and enable public health to communicate information to the clinical community. PMID:21330598

  3. Public health nursing, ethics and human rights.

    PubMed

    Ivanov, Luba L; Oden, Tami L

    2013-05-01

    Public health nursing has a code of ethics that guides practice. This includes the American Nurses Association Code of Ethics for Nurses, Principles of the Ethical Practice of Public Health, and the Scope and Standards of Public Health Nursing. Human rights and Rights-based care in public health nursing practice are relatively new. They reflect human rights principles as outlined in the Universal Declaration of Human Rights and applied to public health practice. As our health care system is restructured and there are new advances in technology and genetics, a focus on providing care that is ethical and respects human rights is needed. Public health nurses can be in the forefront of providing care that reflects an ethical base and a rights-based approach to practice with populations.

  4. Public Health Interventions for School Nursing Practice.

    PubMed

    Schaffer, Marjorie A; Anderson, Linda J W; Rising, Shannon

    2016-06-01

    School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic survey on their use of public health interventions as defined by the wheel. Although 67% of the participants were not familiar with the Public Health Intervention Wheel, respondents reported conducting activities that were consistent with the Wheel interventions. Screening, referral and follow-up, case management, and health teaching were the most frequently performed interventions. Intervention use varied by educational level, age of nurse, years of practice, and student population. The Public Health Intervention Wheel is a relevant and useful framework that provides a language to explain population-based school nursing practice.

  5. Public Health and Midwifery in Indonesia.

    DTIC Science & Technology

    2007-11-02

    JPRS: ^472 21 March 1961 PUBLIC HEALTH AND MIDWIFERY IN INDONESIA 3y M. Joedono DISTRIBUTION STATEMENT A Approved for Public Release...established to service the translation and research needs of the various government departments. ,-^’ JPRS: J^72 CSO: 1335-S/d PUBLIC HEALTH AND MIDWIFERY

  6. The 'medical humanities' in health sciences education in South Africa.

    PubMed

    Reid, S

    2014-02-01

    A new masters-level course, 'Medicine and the Arts" will be offered in 2014 at the University of Cape Town, setting a precedent for interdisciplinary education in the field of medical humanities in South Africa. The humanities and social sciences have always been an implicit part of undergraduate and postgraduate education in the health sciences, but increasingly they are becoming an explicit and essential component of the curriculum, as the importance of graduate attributes and outcomes in the workplace is acknowledged. Traditionally, the medical humanities have included medical ethics, history, literature and anthropology. Less prominent in the literature has been the engagement with medicine of the disciplines of sociology, politics, philosophy, linguistics, education, and law, as well as the creative and expressive arts. The development of the medical humanities in education and research in South Africa is set to expand over the next few years, and it looks as if it will be an exciting inter-disciplinary journey.

  7. Regulating the for-profit private health sector: lessons from East and Southern Africa.

    PubMed

    Doherty, Jane E

    2015-03-01

    International evidence shows that, if poorly regulated, the private health sector may lead to distortions in the type, quantity, distribution, quality and price of health services, as well as anti-competitive behaviour. This article provides an overview of legislation governing the for-profit private health sector in East and Southern Africa. It identifies major implementation problems and suggests strategies Ministries of Health could adopt to regulate the private sector more effectively and in line with key public health objectives. This qualitative study was based on a document review of existing legislation in the region, and seven semi-structured interviews with individuals selected purposively on the basis of their experience in policymaking and legislation. Legislation was categorized according to its objectives and the level at which it operates. A thematic content analysis was conducted on interview transcripts. Most legislation focuses on controlling the entry of health professionals and organizations into the market. Most countries have not developed adequate legislation around behaviour following entry. Generally the type and quality of services provided by private practitioners and facilities are not well-regulated or monitored. Even where there is specific health insurance regulation, provisions seldom address open enrolment, community rating and comprehensive benefit packages (except in South Africa). There is minimal control of prices. Several countries are updating and improving legislation although, in most cases, this is without the benefit of an overarching policy on the private sector, or reference to wider public health objectives. Policymakers in the East and Southern African region need to embark on a programme of action to strengthen regulatory frameworks and instruments in relation to private health care provision and insurance. They should not underestimate the power of the private health sector to undermine efforts for increased

  8. Foreword: Public health, public policy, politics and policing

    PubMed Central

    2012-01-01

    Reducing harm from drug use lies at the intersection of public health, public policy, politics and policing. In an ideal world, evidence of public health gains achievable through new approaches or technologies should inform public policy, should help shape political agendas in support of policy change, which should translate into law and regulations – and then to their application. The goal of this transformative process should be to yield the highest attainable health benefits to vulnerable individuals and communities and to society as a whole. PMID:22769027

  9. The benefits of 'One Health' for pastoralists in Africa.

    PubMed

    Greter, Helena; Jean-Richard, Vreni; Crump, Lisa; Béchir, Mahamat; Alfaroukh, Idriss O; Schelling, Esther; Bonfoh, Bassirou; Zinsstag, Jakob

    2014-04-23

    'One health' is particularly suited to serve mobile pastoralists. Dinka pastoralists in Sudan inspired Calvin Schwabe to coin the term 'one medicine', indicating that there is no difference in paradigm between human and veterinary medicine. Our contemporary definition of 'one health' is any added value in terms of improved health of humans and animals or financial savings or environmental services resulting from a closer cooperation of human and animal health sectors. Here we present a summary of 'one health' studies with mobile pastoralists in Africa which were done in research partnership, demonstrating such an added value. Initial joint human and animal health studies revealed higher livestock vaccination coverage than in the pastoralist community, leading to joint animal and human vaccination intervention studies which demonstrated a better access to primary health care services for pastoralists in Chad. Further simultaneous animal and human serological studies showed that camel breeding was associated with human Q-fever seropositivity. In Borana communities in Ethiopia, human cases of Mycobacterium bovis infection could be related to strains isolated from cattle. A challenge remained with regard to how to assess vaccination coverage in mobile populations. With the advent of mobile phones, health and demographic surveillance could be established for mobile pastoralists and their animals. This presents vast possibilities for surveillance and control of human and animal diseases. Pastoralists prefer a 'one health' approach and therefore contribute toward the validation of this concept by showing real added value of the cooperation between human and animal health services.

  10. Public health significance of neuroticism.

    PubMed

    Lahey, Benjamin B

    2009-01-01

    The personality trait of neuroticism refers to relatively stable tendencies to respond with negative emotions to threat, frustration, or loss. Individuals in the population vary markedly on this trait, ranging from frequent and intense emotional reactions to minor challenges to little emotional reaction even in the face of significant difficulties. Although not widely appreciated, there is growing evidence that neuroticism is a psychological trait of profound public health significance. Neuroticism is a robust correlate and predictor of many different mental and physical disorders, comorbidity among them, and the frequency of mental and general health service use. Indeed, neuroticism apparently is a predictor of the quality and longevity of our lives. Achieving a full understanding of the nature and origins of neuroticism, and the mechanisms through which neuroticism is linked to mental and physical disorders, should be a top priority for research. Knowing why neuroticism predicts such a wide variety of seemingly diverse outcomes should lead to improved understanding of commonalities among those outcomes and improved strategies for preventing them.

  11. International environmental law and global public health.

    PubMed Central

    Schirnding, Yasmin von; Onzivu, William; Adede, Andronico O.

    2002-01-01

    The environment continues to be a source of ill-health for many people, particularly in developing countries. International environmental law offers a viable strategy for enhancing public health through the promotion of increased awareness of the linkages between health and environment, mobilization of technical and financial resources, strengthening of research and monitoring, enforcement of health-related standards, and promotion of global cooperation. An enhanced capacity to utilize international environmental law could lead to significant worldwide gains in public health. PMID:12571726

  12. Global public health today: connecting the dots.

    PubMed

    Lomazzi, Marta; Jenkins, Christopher; Borisch, Bettina

    2016-01-01

    Background Global public health today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of Public Health Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt public health to its future role in global health. Design A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Results Stakeholders underscored that global public health today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging public health in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and public health reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of public health. Resources should be allocated in a sustainable and accountable way. Public health professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. Conclusions The study highlighted some of the main public health challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating public health at the global level and should lead

  13. Global public health today: connecting the dots

    PubMed Central

    Lomazzi, Marta; Jenkins, Christopher; Borisch, Bettina

    2016-01-01

    Background Global public health today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of Public Health Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt public health to its future role in global health. Design A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Results Stakeholders underscored that global public health today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging public health in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and public health reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of public health. Resources should be allocated in a sustainable and accountable way. Public health professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. Conclusions The study highlighted some of the main public health challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating public health at the global level and should lead

  14. Conflicts of Interest: Manipulating Public Health

    ERIC Educational Resources Information Center

    Stein, Richard; Davis, Devra Lee

    2014-01-01

    Evaluating the potential health impacts of chemical, physical, and biological environmental factors represents a challenging task with profound medical, public health, and historical implications. The history of public health is replete with instances, ranging from tobacco to lead and asbestos, where the ability to obtain evidence on potential…

  15. Engaging local public health system partnerships to educate the future public health workforce.

    PubMed

    Caron, Rosemary M; Hiller, Marc D; Wyman, William J

    2013-04-01

    The Institute of Medicine concluded that keeping the public healthy required a well-educated public health workforce, thus leading to its recommendation that "all undergraduates should have access to education in public health" [2]. In response to this call, the authors examined the current practice, feasibility, and value in strengthening (or building) a functional collaborative model between academic institutions and practitioners from local health departments to educate tomorrow's public health workforce. Local and regional health departments in New England were surveyed to: (1) establish a baseline of existing working relationships between them and nearby academic institutions; (2) examine the barriers that inhibit the development of collaborations with academic partners; (3) assess how they jointly promote public health workforce development; and (4) analyze which essential public health services their partnership addresses. Despite the lack of financial resources often cited for the absence of academic-local health department collaborations, some New England states reported that their academic institution and local public health department partnerships were valued and productive. The authors discuss how effective academic-community collaborations have the potential to facilitate a broad-based appreciation of public health among students via a wide array of public health curricula and applied experiential learning opportunities in public health settings. The authors propose a model for how to combine basic public health lessons with practical experience and leadership offered by local health departments, in order to foster a real understanding of public health, its importance, practice, and relevance in today's society from a public health workforce perspective.

  16. [Professionalization of public health officers in Japan].

    PubMed

    Yokota, Yoko

    2008-01-01

    In this paper, I describe how public health officers in Japan in the period of the late Taisho and early Showa eras claimed their position as professionals in the sanitary administrations of central and local governments. In the background of this push for recognition, there were related international and national movements. Internationally, public health ministries were established in developed countries and the League of Nations Health Organization (LNHO) was created. LNHO wanted to improve the level of public health officials world-wide, so the organization sponsored international exchanges of officials. These activities made a strong impression on Japanese public health officials, who realized that they belonged to an internationally recognized profession and that they needed to work hard to improve the substandard Japanese public health situation. Meanwhile, at the level of domestic politics, there were several movements of technical experts in different fields of government administration that worked to fight the unfair treatment of administrative officials, a situation that had existed since Meiji Period. The public health officers collaborated with the other technical experts to improve their positions and to play key roles in society. But while the other technical experts actively pursued social leadership, public health officials wanted to remain scientists. This is because the sanitary departments in the local governments were organized within police departments. In this environment, the law was dominant and science was secondary. But public health officials insisted that the basis of public health should be science, so they emphasized their scientific expertise.

  17. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES......

  18. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES...

  19. Constructing violence as a public health problem.

    PubMed Central

    Winett, L B

    1998-01-01

    Once viewed primarily as a criminal justice problem, violence and its prevention are now often claimed by public health professionals as being within their purview. The author reviewed 282 articles published in public health and medical journals from 1985 through 1995 that discussed violence as a public health problem. She found that while authors tended to identify social and structural causes for violence, they suggested interventions that targeted individuals' attitudes or behaviors and improved public health practice. Her study illuminates the tension between public health professionals' vision of the social precursors of violence and their attempts to apply a traditional set of remedies. In targeting individuals to rid the nation of violence, the public health community is deemphasizing societal causes. Images p[498]-a p499-a p500-a p501-a p502-a p503-a p504-a p506-a PMID:9847921

  20. Public Health Legal Preparedness in Indian Country

    PubMed Central

    Schaefer, Rebecca McLaughlin; DeBruyn, Lemyra; Stier, Daniel D.

    2009-01-01

    American Indian/Alaska Native tribal governments are sovereign entities with inherent authority to create laws and enact health regulations. Laws are an essential tool for ensuring effective public health responses to emerging threats. To analyze how tribal laws support public health practice in tribal communities, we reviewed tribal legal documentation available through online databases and talked with subject-matter experts in tribal public health law. Of the 70 tribal codes we found, 14 (20%) had no clearly identifiable public health provisions. The public health–related statutes within the remaining codes were rarely well integrated or comprehensive. Our findings provide an evidence base to help tribal leaders strengthen public health legal foundations in tribal communities. PMID:19150897

  1. The linkage of Baltimore's mental health and public health systems.

    PubMed

    Collier, M T; Lambropoulos, A S; Williams-Glasser, G; Baron, S T; Birkmeyer, J

    1991-01-01

    The Institute of Medicine's The Future of Public Health calls for a strengthening of linkages between public health and mental health, with a view to integrating the functions at the service delivery level. This paper details the history of the mental health/public health interface in Baltimore, Maryland. In 1977, mental health and addiction services were merged into the Department of Health. More recently, in 1988 adult mental health services were split off into a quasi-public corporation. Children's mental health, however, was retained as a distinct service within the Department of Health in order to enhance coordination with other health services for children. Replication of such coordinated-care models is certainly feasible.

  2. Bioterrorism, public health, and human rights.

    PubMed

    Annas, George J

    2002-01-01

    It is unnecessary and counterproductive to sacrifice basic human rights to respond to bioterrorism. Constructive public health legislation, which must be federal, cannot be carefully drafted under panic conditions. When it is, like the "model act," it will predictably rely on broad, arbitrary state authority exercised without public accountability. Public health should resist reverting to its nineteenth-century practices of forced examination and quarantine, which will simply encourage people to avoid physicians, hospitals, and public health practitioners they now trust and actively seek out in emergencies. Upholding human rights is essential to public trust and is ultimately our best defense against the threat of terrorism in the twenty-first century.

  3. Public health research in congenital heart disease.

    PubMed

    Lara, Diego A; Lopez, Keila N

    2014-01-01

    Public health research is an integral part of the study of congenital heart disease. While this type of research has become more popular, particularly over the past decade, it has a history that stretches back to almost the beginnings of pediatric cardiology as a field. This review aims to introduce the concepts and methodologies of public health and how they relate to congenital heart disease, describe some of the challenges of traditional research methods in congenital heart disease, describe the history of public health research, and demonstrate the relevance of public health research, particularly databases, to pediatric cardiology fellows.

  4. Ethics, Practice, and Research in Public Health

    PubMed Central

    MacQueen, Kathleen M.; Buehler, James W.

    2004-01-01

    Ethical issues that can arise in distinguishing public health research from practice are highlighted in 2 case studies—an investigation of a tuberculosis outbreak in a prison and an evaluation of a program for improving HIV prevention services. Regardless of whether such public health investigations represent research or practice, we see a need for ethics oversight procedures that reflect actual risks and enable timely responses to crises. Such oversight should accommodate the perspectives of persons and communities affected by public health threats and by governmental responses to those threats; it should further recognize that public health ethics is a distinct field combining bioethics, political philosophy, human rights, and law. PMID:15249291

  5. How Health Reform is Recasting Public Psychiatry.

    PubMed

    Shaner, Roderick; Thompson, Kenneth S; Braslow, Joel; Ragins, Mark; Parks, Joseph John; Vaccaro, Jerome V

    2015-09-01

    This article reviews the fiscal, programmatic, clinical, and cultural forces of health care reform that are transforming the work of public psychiatrists. Areas of rapid change and issues of concern are discussed. A proposed health care reform agenda for public psychiatric leadership emphasizes (1) access to quality mental health care, (2) promotion of recovery practices in primary care, (3) promotion of public psychiatry values within general psychiatry, (4) engagement in national policy formulation and implementation, and (5) further development of psychiatric leadership focused on public and community mental health.

  6. Disability from a public health perspective.

    PubMed

    Möller, Anders

    2015-08-01

    At the Nordic School of Public Health (NHV), methods to alleviate problems with disability have been seen as an important part of actions to support public health. A programme for universal design was started in 2006. Some issues of public health perspectives on disability are presented in this paper, based on discussions from a PhD course held at the NHV. During the course, the students presented papers in which they reflected on the relationship between disability and public health. These essays were collected and published in 2012 at NHV.

  7. The Problem With Estimating Public Health Spending.

    PubMed

    Leider, Jonathon P

    2016-01-01

    Accurate information on how much the United States spends on public health is critical. These estimates affect planning efforts; reflect the value society places on the public health enterprise; and allows for the demonstration of cost-effectiveness of programs, policies, and services aimed at increasing population health. Yet, at present, there are a limited number of sources of systematic public health finance data. Each of these sources is collected in different ways, for different reasons, and so yields strikingly different results. This article aims to compare and contrast all 4 current national public health finance data sets, including data compiled by Trust for America's Health, the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), and the Census, which underlie the oft-cited National Health Expenditure Account estimates of public health activity. In FY2008, ASTHO estimates that state health agencies spent $24 billion ($94 per capita on average, median $79), while the Census estimated all state governmental agencies including state health agencies spent $60 billion on public health ($200 per capita on average, median $166). Census public health data suggest that local governments spent an average of $87 per capita (median $57), whereas NACCHO estimates that reporting LHDs spent $64 per capita on average (median $36) in FY2008. We conclude that these estimates differ because the various organizations collect data using different means, data definitions, and inclusion/exclusion criteria--most notably around whether to include spending by all agencies versus a state/local health department, and whether behavioral health, disability, and some clinical care spending are included in estimates. Alongside deeper analysis of presently underutilized Census administrative data, we see harmonization efforts and the creation of a standardized expenditure reporting system as a way to

  8. Legacy, legitimacy, and possibility: an exploration of community health worker experience across the generations in Khayelitsha, South Africa.

    PubMed

    Swartz, Alison

    2013-06-01

    In South Africa, the response to HIV and TB epidemics is complex, varied, and contextually defined. "Task-shifting" and a movement toward a decentralized model of care have led to an increased reliance on community health workers (CHWs) providing health care services to residents of impoverished, peri-urban areas. Public health policy tends to present CHWs as a homogeneous group, with little attention paid to the nuances of experience, motivation, and understanding, which distinguish these care workers from one another and from other kinds of health workers. An exploration of the layered meanings of providing community health care services under financially, politically, and socially difficult conditions reveals clear distinctions of experience across the generations. Many older CHWs say that ubuntu, a notion of shared African humanity, is being "killed off" by the younger generation, whereas younger CHWs often describe older women as being "jealous" of the opportunities that this younger generation has for education, training, and employment. The structure of the South African health system, past and present responses to disease epidemics, and the legacy of apartheid's structural violence have amplified these generational differences among CHWs. Using ethnographic data collected from approximately 20 CHWS in a peri-urban settlement in Cape Town, South Africa, I explore how CHWs experience and understand legitimacy in the moral economy of care. A call for closer attention to the experiences of CHWs is critical when designing public health policies for the delivery of health care services in impoverished communities in South Africa.

  9. Enacting Identity and Transition: Public Events and Rituals in the University (Mexico and South Africa)

    ERIC Educational Resources Information Center

    Pansters, Wil G.; van Rinsum, Henk J.

    2016-01-01

    On the basis of ethnographic and historical material this article makes a comparative analysis of the relationship between public events, ceremonies and academic rituals, institutional identity, and processes of transition and power at two universities, one in Mexico and the other in South Africa. The public events examined here play a major role…

  10. Strategies for health promotion: facing the challenge in South Africa.

    PubMed

    Temple, Norman J

    2007-01-01

    Many health promotion intervention studies have been conducted with the goal of encouraging people to change their lifestyles. These include interventions in the community, at worksites, in a medical setting, and on patients at high risk of disease. These interventions have had, in general, a limited impact (eg, risk of heart disease is lowered by 5%-15%). These interventions were carried out in developed countries, and little is known as to their effectiveness in developing countries such as South Africa. Numerous barriers impede the success of health promotion interventions, including the cost of healthy food, advertising for unhealthy food, and food labels that are confusing. Policy measures are proposed, including government interventions using taxes and subsidies so as to manipulate prices and bring about desirable changes in eating patterns and other aspects of lifestyle. A new type of healthcare professional is suggested with a specialization in health promotion.

  11. Applications of health information exchange information to public health practice.

    PubMed

    Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

    2014-01-01

    Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US' investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health.

  12. Applications of Health Information Exchange Information to Public Health Practice

    PubMed Central

    Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

    2014-01-01

    Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US’ investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health. PMID:25954386

  13. Social Marketing and Public Health Intervention.

    ERIC Educational Resources Information Center

    Lefebvre, R. Craig; Flora, June A.

    1988-01-01

    The proliferation of community-based health education programs has outpaced the knowledge base of behavior change strategies that are appropriate for public health interventions. This article discusses eight essential aspects of the social marketing process. (JOW)

  14. [Public health ethics and reproduction].

    PubMed

    Alexandrova-Yankulovska, S; Bozhinov, P; Bojinova, S

    2014-01-01

    Medical progress has enabled achievements that were not even thinkable earlier but at the same time society and public health have had to face new challenges. What are we ready to accept in the area of human reproduction? This paper aims at ethical analysis of Bulgarian laws on reproduction. The abortion debate nowadays has got new dimiension focusing not that much on its moral acceptability but rather on the acceptable indications for its performance. Is it ethical to perform abortion in case of undesired gender of the embryo or genetic malformations? Lots of moral issues mark the area of assisted reproduction which is due to the separation of the reproductive functions (ova, sperm and embryo donation, surrogacy), fragmentation of motherhood and fatherhood, differentiation of biological and social parenthood. Defining limits of acceptable interference or non-interference in human reproduction will never be easy, but dynamics of moral judgment shouldn't bother us. The rigidity of moral norms is what should be alarming because it threatens procreative autonomy.

  15. Harm Reduction: Front Line Public Health.

    PubMed

    Stancliff, Sharon; Phillips, Benjamin W; Maghsoudi, Nazlee; Joseph, Herman

    2015-01-01

    Drug use is a public health problem associated with high mortality and morbidity, and is often accompanied by suboptimal engagement in health care. Harm reduction is a pragmatic public health approach encompassing all goals of public health: improving health, social well-being, and quality of life. Harm reduction prioritizes improving the lives of people who use drugs in partnership with those served without a narrow focus on abstinence from drugs. Evidence has shown that harm reduction oriented practice can reduce transmission of blood-borne illnesses, and other injection related infections, as well as preventing fatal overdose.

  16. Climate Change: The Public Health Response

    PubMed Central

    Frumkin, Howard; Hess, Jeremy; Luber, George; Malilay, Josephine; McGeehin, Michael

    2008-01-01

    There is scientific consensus that the global climate is changing, with rising surface temperatures, melting ice and snow, rising sea levels, and increasing climate variability. These changes are expected to have substantial impacts on human health. There are known, effective public health responses for many of these impacts, but the scope, timeline, and complexity of climate change are unprecedented. We propose a public health approach to climate change, based on the essential public health services, that extends to both clinical and population health services and emphasizes the coordination of government agencies (federal, state, and local), academia, the private sector, and nongovernmental organizations. PMID:18235058

  17. Meeting the millennium development goals in Sub-saharan Africa: what about mental health?

    PubMed

    Skeen, Sarah; Lund, Crick; Kleintjes, Sharon; Flisher, Alan

    2010-01-01

    Mental health is a crucial public health and development issue in sub-Saharan Africa (SSA), a region where little progress has been made towards achieving the Millennium Development Goals (MDGs). In this paper we argue that not only will limited progress in achieving these targets have a significant impact on mental health, but it will be impossible to achieve some of these aspirations in the absence of addressing mental health concerns. We consider the strong relationship of mental health with dimensions of human development represented in the MDGs, including reducing poverty, achieving universal primary education, decreasing child mortality rates, improving maternal health, HIV, environmental factors and improving the lives of those living in informal settlements. With these links in mind, we examine the mental health context in SSA settings and provide some specific examples of best practice for addressing mental health and the MDGs. It is recommended that the role of mental health interventions in accelerating the realization of the MDGs is investigated; further efforts are dedicated to probing the impact of different development projects upon mental health outcomes, and that mental health is declared a global development priority for the remainder of the MDG period and beyond.

  18. Public health and high volume hydraulic fracturing.

    PubMed

    Korfmacher, Katrina Smith; Jones, Walter A; Malone, Samantha L; Vinci, Leon F

    2013-01-01

    High-volume horizontal hydraulic fracturing (HVHF) in unconventional gas reserves has vastly increased the potential for domestic natural gas production. HVHF has been promoted as a way to decrease dependence on foreign energy sources, replace dirtier energy sources like coal, and generate economic development. At the same time, activities related to expanded HVHF pose potential risks including ground- and surface water contamination, climate change, air pollution, and effects on worker health. HVHF has been largely approached as an issue of energy economics and environmental regulation, but it also has significant implications for public health. We argue that public health provides an important perspective on policymaking in this arena. The American Public Health Association (APHA) recently adopted a policy position for involvement of public health professionals in this issue. Building on that foundation, this commentary lays out a set of five perspectives that guide how public health can contribute to this conversation.

  19. Achieving effective cervical screening coverage in South Africa through human resources and health systems development.

    PubMed

    Kawonga, Mary; Fonn, Sharon

    2008-11-01

    South Africa's cervical screening policy recommends three free Pap smears at ten-year intervals for all women over 30 years of age, aiming to achieve 70% coverage by 2010 by targeting the age group most at risk of developing pre-cancerous cervical lesions. Attaining wide coverage requires an adequate supply of motivated and supported public sector health workers with appropriate training and skills, working in a functional health system. Given the dearth of doctors in South Africa, professional nurses were tasked with performing the bulk of Pap smears at primary care level. Coverage remains sub-optimal and a significant proportion of women with precursor lesions do not receive treatment. Further, health system strengthening - essential for cytology-based screening - has not happened. Research to evaluate alternative screening technologies has proliferated in recent years, but regrettably, strengthening of the health system required to make the new technology work has not received similar attention. Using the South African experience, this article argues that technological interventions and innovations alone are not sufficient to improve cervical screening programmes. Task-shifting is limited unless other human resource concerns (e.g. training, increasing demands on personnel, attrition, and skills mix) are concurrently addressed within a comprehensive workforce development strategy, alongside work to make the health care delivery system functional.

  20. Perspectives on public health workforce research.

    PubMed

    Crawford, Carol A Gotway; Summerfelt, Wm Thomas; Roy, Kakoli; Chen, Zhuo Adam; Meltzer, David O; Thacker, Stephen B

    2009-11-01

    The Centers for Disease Control and Prevention Office of Workforce and Career Development is committed to developing a competent, sustainable, and diverse public health workforce through evidence-based training, career and leadership development, and strategic workforce planning to improve population health outcomes. This article reviews the previous efforts in identifying priorities of public health workforce research, which are summarized as eight major research themes. We outline a strategic framework for public health workforce research that includes six functional areas (ie, definition and standards, data, methodology, evaluation, policy, and dissemination and translation). To conceptualize and prioritize development of an actionable public health research agenda, we constructed a matrix of key challenges in workforce analysis by public health workforce categories. Extensive reviews were conducted to identify valuable methods, models, and approaches to public health workforce research. We explore new tools and approaches for addressing priority areas for public health workforce and career development research and assess how tools from multiple disciplines of social sciences can guide the development of a research framework for advancing public health workforce research and policy.

  1. Work satisfaction of professional nurses in South Africa: a comparative analysis of the public and private sectors

    PubMed Central

    Pillay, Rubin

    2009-01-01

    Background Work satisfaction of nurses is important, as there is sufficient empirical evidence to show that it tends to affect individual, organizational and greater health and social outcomes. Although there have been several studies of job satisfaction among nurses in South Africa, these are limited because they relate to studies of individual organizations or regions, use small samples or are dated. This paper presents a national study that compares and contrasts satisfaction levels of nurses in both public and private sectors. Methods This was a cross-sectional survey of professional nurses conducted throughout South Africa using a pretested and self-administered questionnaire. Univariate and bivariate statistical models were used to evaluate levels of satisfaction with various facets of work and to elicit the differences in satisfaction levels between different groups of nurses. A total of 569 professional nurses participated in the study. Results Private-sector nurses were generally satisfied, while public-sector nurses were generally dissatisfied. Public-sector nurses were most dissatisfied with their pay, the workload and the resources available to them. They were satisfied only with the social context of the work. Private-sector nurses were dissatisfied only with their pay and career development opportunities. Professional nurses in the more rural provinces, those intending to change sectors and those more likely not to be in their current positions within the next five years were also more likely to be dissatisfied with all facets of their work. Conclusion This study highlighted the overall dissatisfaction among South African nurses and confirmed the disparity between the levels of job satisfaction between the public and private sectors. Health managers should address those factors that affect job satisfaction, and therefore retention, of nurses in South Africa. Improving the work environment so that it provides a context congruent with the aspirations

  2. Obesity Stigma: Important Considerations for Public Health

    PubMed Central

    Heuer, Chelsea A.

    2010-01-01

    Stigma and discrimination toward obese persons are pervasive and pose numerous consequences for their psychological and physical health. Despite decades of science documenting weight stigma, its public health implications are widely ignored. Instead, obese persons are blamed for their weight, with common perceptions that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. We examine evidence to address these assumptions and discuss their public health implications. On the basis of current findings, we propose that weight stigma is not a beneficial public health tool for reducing obesity. Rather, stigmatization of obese individuals threatens health, generates health disparities, and interferes with effective obesity intervention efforts. These findings highlight weight stigma as both a social justice issue and a priority for public health. PMID:20075322

  3. Latest OECD figures confirm Canada as a public health laggard.

    PubMed

    Raphael, Dennis

    2012-11-06

    Despite the Canadian public health community's commitments to promoting public policy that supports health, evidence indicates that Canada's public health picture continues to decline. This may be due in part to the failure of public health agencies and local public health units to engage in public policy advocacy and public education about the social determinants of health. Examples of such activities by local public health units are now available and provide a model for such activity.

  4. Recommendations for Undergraduate Public Health Education

    ERIC Educational Resources Information Center

    Riegelman, Richard K.; Albertine, Susan

    2008-01-01

    This curriculum guide serves to assist faculty who are developing undergraduate courses in public health as well as educational administrators and faculty curriculum committees who are designing undergraduate public health curricula. The approach outlined in these recommendations focuses on the development of three core courses, each of which is…

  5. CHARACTERIZING AIR QUALITY FOR ENVIRONMENTAL PUBLIC HEALTH

    EPA Science Inventory

    NERL's Human Exposure and Atmospheric Sciences Division and other participants in the Public Health Air Surveillance Evaluation (PHASE) project will be presenting their results to the Environmnetal Public Health Tracking (EPHT) workshop in Tampa FL. The PHASE project is a collab...

  6. Physical Activity, Public Health, and Elementary Schools

    ERIC Educational Resources Information Center

    McKenzie, Thomas L.; Kahan, David

    2008-01-01

    Physical inactivity is a serious public health problem that is associated with numerous preventable diseases. Public health concerns, particularly those related to the increased prevalence of overweight, obesity, and diabetes, call for schools to become proactive in the promotion of healthy, physically active lifestyles. This article begins by…

  7. Law as a tool of public health.

    PubMed

    Akintola, S O

    2009-06-01

    The preservation of the public's health is one of the most important goals of government. The enactment and enforcement of law is the primary means by which government can encourage as well as compel conditions for healthier and safer lifestyles. The Law creates and assigns functions for public health authorities. In this regard, law is a fundamental element of effective public health policy and practice. It has played a crucial role in many of public health's greatest achievements. In spite of its contribution to effective Public Health practice, the potential for the application of law to chronic disease prevention and control is yet to be fully recognized. The development and implementation of legal frameworks could broaden the range of effective public health strategies and provide valuable tools for the public health workforce. In order to expand the range of effective public health interventions, the government should use the law as a tool to achieve the goal of preventing chronic diseases and ameliorate the growing epidemic of obesity, heart disease, stroke, cancer and other chronic diseases and their risk factors.

  8. Profiles of Grant Programs: Public Health Service.

    ERIC Educational Resources Information Center

    Department of Health , Education, and Welfare, Washington., DC. Office of the Secretary.

    For potential grant applicants and for the general public, the booklet describes the programs of the six Public Health Service agencies in the American health care system. Each program is described concisely in terms of: its purpose and legal basis; applicants' eligibility for grants and the basis for their award; the special requirements made of…

  9. Health rights pamphlets: critical literacy and inclusive citizenship, South Africa.

    PubMed

    Strecker, Morgan; Stuttaford, Maria; London, Leslie

    2014-06-01

    The Ottawa Charter recognizes the importance of strengthening community action for health and developing personal skills. At the same time, a rights-based approach to health includes the right to information, participation and accountability. The Learning Network for Health and Human Rights is a research and learning collaboration between Civil Society Organisations (CSOs) and universities in the Western Cape, South Africa. For the purposes of this article, a CSO is understood to be any organization that is outside of the state and private market sector. As part of a wider programme of action research, the learning network developed six pamphlets aimed at enhancing individual and collective skills to support action related to the implementation of the right to health. The research reported here analyses how the pamphlets, coupled with directed training, strengthened skills, promoted critical literacy and supported inclusive citizenship. Eighteen semi-structured interviews and eight focus groups were conducted with 59 participants from eight CSOs, their members, beneficiaries and communities. The success of the pamphlets was found to be attributed to the role they played in a wider training programme, requested by the CSOs and developed jointly by CSOs and university-based researchers. Community action on the right to health is contingent on personal as well as collective skills development. Understanding of the right to health and skills for participation and accountability were extended in breadth and depth, which enabled inclusive citizenship.

  10. Perceptions and experiences of allopathic health practitioners on collaboration with traditional health practitioners in post-apartheid South Africa

    PubMed Central

    Hendricks, Stephen J.; Mulaudzi, Mavis F.

    2016-01-01

    Background The indigenous health system was perceived to be a threat to the allopathic health system. It was associated with ‘witchcraft’, and actively discouraged, and repressed through prohibition laws. The introduction of the Traditional Health Practitioners Act No 22 of 2007 brought hope that those centuries of disrespect for traditional health systems would change. The study examined the perceptions and experiences of allopathic health practitioners on collaboration with traditional health practitioners in post-apartheid South Africa. Methods Qualitative descriptive research methodology was used to collect data from allopathic health practitioners employed by Limpopo’s Department of Health. In-depth focus group discussions and meetings were conducted between January and August 2014. Perceptions and experiences of working with traditional health practitioners were explored. Ethical clearance was obtained from the University of Pretoria and approval from the Department’s Research Committee. Results Dominant views were that the two health systems were not compatible with respect to the science involved and the source of knowledge. Overall, quality of health care will be compromised if traditional health practitioners are allowed to work in public health facilities. Conclusion Allopathic health practitioners do not appear ready to work with traditional health practitioners, citing challenges of quality of health care, differences regarding concept of sciences and source of knowledge; and lack of policy on collaboration. Lack of exposure to traditional medicine seems to impede opportunities to accept and work with traditional healers. Exposure and training at undergraduate level regarding the traditional health system is recommended. Policy guidelines on collaborations are urgently required. PMID:27380856

  11. Increasing the priority of mental health in Africa: findings from qualitative research in Ghana, South Africa, Uganda and Zambia.

    PubMed

    Bird, Philippa; Omar, Maye; Doku, Victor; Lund, Crick; Nsereko, James Rogers; Mwanza, Jason

    2011-09-01

    Despite the high prevalence of mental illness, mental health remains a low priority in Africa. There has been no investigation of the views of stakeholders in Africa on why this is and what can be done. This paper reports a comparison of the views of stakeholders in Ghana, South Africa, Uganda and Zambia, focusing on the priority given to mental health by the government at the national and regional/province levels. We conducted semi-structured interviews with key stakeholders and used a two-stage approach to analysis: firstly framework analysis in each study country, followed by comparative analysis of the country data. Mental health was largely considered a low priority at national and regional/provincial levels in all four countries. We identified nine factors affecting the priority of mental health, which were grouped into three categories: legitimacy of the problem, feasibility of response and support for response. Respondents put forward a range of experiences and suggestions for increasing the priority given to mental health. We conclude with broad suggestions to raise the priority of mental health. These suggestions are particularly relevant as mental health increases in priority on the international agenda, in order to inform advocacy for increased priority for mental health in Africa.

  12. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Health, and the Substance Abuse and Mental Health Services Administration, and the offices of the... 42 Public Health 1 2011-10-01 2011-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  13. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Health, and the Substance Abuse and Mental Health Services Administration, and the offices of the... 42 Public Health 1 2013-10-01 2013-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  14. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Health, and the Substance Abuse and Mental Health Services Administration, and the offices of the... 42 Public Health 1 2012-10-01 2012-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  15. Public health: a best buy for America.

    PubMed

    Rein, Andrew S; Ogden, Lydia L

    2012-01-01

    Public health has considerable capacity to reduce the drag of health spending on our nation by preventing the leading causes of disease, death, and disability with cost-efficient, population-based interventions and innovative, boundary-spanning approaches that link clinical care and community prevention. Public health is uniquely able to identify the burdens of disease and analyze the best strategies for addressing them. A 3-pronged strategy can help assure the value needed from our public health investments. First, we must center our efforts on prevention. Second, we must optimize our public health investments to achieve the greatest value for our investment. Third, public health must collaborate with traditional and new partners on initiatives and in funding. How we finance public health is critical to maximizing public health's benefits and requires thoughtful analysis of how federal funding affects state and local health agencies' programming and how allocation drives choices and design, among other topics, as discussed in this special issue of the journal.

  16. Moving from Intersection to Integration: Public Health Law Research and Public Health Systems and Services Research

    PubMed Central

    Burris, Scott; Mays, Glen P; Douglas Scutchfield, F; Ibrahim, Jennifer K

    2012-01-01

    Context For three decades, experts have been stressing the importance of law to the effective operation of public health systems. Most recently, in a 2011 report, the Institute of Medicine recommended a review of state and local public health laws to ensure appropriate authority for public health agencies; adequate access to legal counsel for public health agencies; evaluations of the health effects and costs associated with legislation, regulations, and policies; and enhancement of research methods to assess the strength of evidence regarding the health effects of public policies. These recommendations, and the continued interest in law as a determinant of health system performance, speak to the need for integrating the emerging fields of Public Health Law Research (PHLR) and Public Health Systems and Services Research (PHSSR). Methods Expert commentary. Findings This article sets out a unified framework for the two fields and a shared research agenda built around three broad inquiries: (1) the structural role of law in shaping the organization, powers, prerogatives, duties, and limitations of public health agencies and thereby their functioning and ultimately their impact on public health (“infrastructure”); (2) the mechanisms through which public health system characteristics influence the implementation of interventional public health laws (“implementation”); and (3) the individual and system characteristics that influence the ability of public health systems and their community partners to develop and secure enactment of legal initiatives to advance public health (“innovation”). Research to date has laid a foundation of evidence, but progress requires better and more accessible data, a new generation of researchers comfortable in both law and health research, and more rigorous methods. Conclusions The routine integration of law as a salient factor in broader PHSSR studies of public health system functioning and health outcomes will enhance the

  17. How health affects small business in South Africa.

    PubMed

    Chao, Li-Wei; Pauly, Mark V

    2007-03-01

    Preventable and treatable diseases have taken a devastating human and economic toll on many developing countries. That economic toll is likely to be underestimated because most studies focus on productivity losses in the formal, or large-firm, sector; yet, a large portion of the population of developing countries works in the informal sector in very small businesses, either as an owner-worker or as an employee. It is plausible that ill health might affect small businesses most severely, possibly putting the entire business at risk. This Issue Brief summarizes a three-year study that tracks small businesses in Durban, South Africa, and investigates the connection between the owner's health and business growth, survival, or closure. The results bolster the economic case for investing resources in the prevention and treatment of disease in developing countries.

  18. Public health practice is not research.

    PubMed

    Otto, Jean Lin; Holodniy, Mark; DeFraites, Robert F

    2014-04-01

    Scientific and clinical activities undertaken by public health agencies may be misconstrued as medical research. Most discussions of regulatory and legal oversight of medical research focus on activities involving either patients in clinical practice or volunteers in clinical trials. These discussions often exclude similar activities that constitute or support core functions of public health practice. As a result, public health agencies and practitioners may be held to inappropriate regulatory standards regarding research. Through the lens of the Departments of Defense and Veterans Affairs, and using several case studies from these departments, we offer a framework for the adjudication of activities common to research and public health practice that could assist public health practitioners, research oversight authorities, and scientific journals in determining whether such activities require regulatory review and approval as research.

  19. Firearms, youth homicide, and public health.

    PubMed

    Levine, Robert S; Goldzweig, Irwin; Kilbourne, Barbara; Juarez, Paul

    2012-02-01

    Homicide is seven times as common among U.S. non-Hispanic Black as among non-Hispanic White youth ages 15 to 24 years. In 83% of these youth homicides, the murder weapon is a firearm. Yet, for more than a decade, the national public health position on youth violence has been largely silent about the role of firearms, and tools used by public health professionals to reduce harm from other potential hazards have been unusable where guns are concerned. This deprives already underserved populations from the full benefits public health agencies might be able to deliver. In part, political prohibitions against research about direct measures of firearm control and the absence of valid public health surveillance are responsible. More refined epidemiologic theories as well as traditional public health methods are needed if the U.S. aims to reduce disparate Black-White youth homicide rates.

  20. Public Health Practice Is Not Research

    PubMed Central

    Holodniy, Mark; DeFraites, Robert F.

    2014-01-01

    Scientific and clinical activities undertaken by public health agencies may be misconstrued as medical research. Most discussions of regulatory and legal oversight of medical research focus on activities involving either patients in clinical practice or volunteers in clinical trials. These discussions often exclude similar activities that constitute or support core functions of public health practice. As a result, public health agencies and practitioners may be held to inappropriate regulatory standards regarding research. Through the lens of the Departments of Defense and Veterans Affairs, and using several case studies from these departments, we offer a framework for the adjudication of activities common to research and public health practice that could assist public health practitioners, research oversight authorities, and scientific journals in determining whether such activities require regulatory review and approval as research. PMID:24524499

  1. Patient safety: this is public health.

    PubMed

    Card, Alan J

    2014-01-01

    Avoidable patient harm is a major public health concern, and may already have surpassed heart disease as the leading cause of death in the United States. While the public health community has contributed much to one aspect of patient harm prevention, infection control, the tools and techniques of public health have far more to offer to the emerging field of patient safety science. Patient safety practice has become increasingly professionalized in recent years, but specialist degree programs in the field remain scarce. Healthcare organizations should consider graduate training in public health as an avenue for investing in the professional development of patient safety practitioners, and schools and programs of public health should support further research and teaching to support patient safety improvement.

  2. Systems Science Methods in Public Health

    PubMed Central

    Luke, Douglas A.; Stamatakis, Katherine A.

    2012-01-01

    Complex systems abound in public health. Complex systems are made up of heterogeneous elements that interact with one another, have emergent properties that are not explained by understanding the individual elements of the system, persist over time and adapt to changing circumstances. Public health is starting to use results from systems science studies to shape practice and policy, for example in preparing for global pandemics. However, systems science study designs and analytic methods remain underutilized and are not widely featured in public health curricula or training. In this review we present an argument for the utility of systems science methods in public health, introduce three important systems science methods (system dynamics, network analysis, and agent-based modeling), and provide three case studies where these methods have been used to answer important public health science questions in the areas of infectious disease, tobacco control, and obesity. PMID:22224885

  3. Education Improves Public Health and Promotes Health Equity

    PubMed Central

    Hahn, Robert A.; Truman, Benedict I.

    2015-01-01

    This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health – an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits. PMID:25995305

  4. Education Improves Public Health and Promotes Health Equity.

    PubMed

    Hahn, Robert A; Truman, Benedict I

    2015-01-01

    This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health - an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits.

  5. Petroleum Scarcity and Public Health: Considerations for Local Health Departments

    PubMed Central

    Parker, Cindy L.; Caine, Virginia A.; McKee, Mary; Shirley, Lillian M.; Links, Jonathan M.

    2011-01-01

    Recognition of petroleum as a finite global resource has spurred increasing interest in the intersection between petroleum scarcity and public health. Local health departments represent a critical yet highly vulnerable component of the public health infrastructure. These frontline agencies currently face daunting resource constraints and rely heavily on petroleum for vital population-based health services. Against this backdrop, petroleum scarcity may necessitate reconfiguring local public health service approaches. We describe the anticipated impacts of petroleum scarcity on local health departments, recommend the use of the 10 Essential Public Health Services as a framework for examining attendant operational challenges and potential responses to them, and describe approaches that local health departments and their stakeholders could consider as part of timely planning efforts. PMID:21778471

  6. Housing and Health: Time Again for Public Health Action

    PubMed Central

    Krieger, James; Higgins, Donna L.

    2002-01-01

    Poor housing conditions are associated with a wide range of health conditions, including respiratory infections, asthma, lead poisoning, injuries, and mental health. Addressing housing issues offers public health practitioners an opportunity to address an important social determinant of health. Public health has long been involved in housing issues. In the 19th century, health officials targeted poor sanitation, crowding, and inadequate ventilation to reduce infectious diseases as well as fire hazards to decrease injuries. Today, public health departments can employ multiple strategies to improve housing, such as developing and enforcing housing guidelines and codes, implementing “Healthy Homes” programs to improve indoor environmental quality, assessing housing conditions, and advocating for healthy, affordable housing. Now is the time for public health to create healthier homes by confronting substandard housing. PMID:11988443

  7. Demographic, epidemiological, and health transitions: are they relevant to population health patterns in Africa?

    PubMed Central

    Kuate Defo, Barthélémy

    2014-01-01

    Background Studies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed. Objective The aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa. Results Notwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1) theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2) simple summary indicators that can be used to evaluate their descriptive and predictive features; 3) marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4) the rapid decline in infant mortality and gains

  8. How Many Principles for Public Health Ethics?

    PubMed Central

    Coughlin, Steven S.

    2009-01-01

    General moral (ethical) principles play a prominent role in certain methods of moral reasoning and ethical decision-making in bioethics and public health. Examples include the principles of respect for autonomy, beneficence, nonmaleficence, and justice. Some accounts of ethics in public health have pointed to additional principles related to social and environmental concerns, such as the precautionary principle and principles of solidarity or social cohesion. This article provides an overview of principle-based methods of moral reasoning as they apply to public health ethics including a summary of advantages and disadvantages of methods of moral reasoning that rely upon general principles of moral reasoning. Drawing upon the literature on public health ethics, examples are provided of additional principles, obligations, and rules that may be useful for analyzing complex ethical issues in public health. A framework is outlined that takes into consideration the interplay of ethical principles and rules at individual, community, national, and global levels. Concepts such as the precautionary principle and solidarity are shown to be useful to public health ethics to the extent that they can be shown to provide worthwhile guidance and information above and beyond principles of beneficence, nonmaleficence, and justice, and the clusters of rules and maxims that are linked to these moral principles. Future directions likely to be productive include further work on areas of public health ethics such as public trust, community empowerment, the rights of individuals who are targeted (or not targeted) by public health interventions, individual and community resilience and wellbeing, and further clarification of principles, obligations, and rules in public health disciplines such as environmental science, prevention and control of chronic and infectious diseases, genomics, and global health. PMID:20072707

  9. Patients as consumers of health care in South Africa: the ethical and legal implications

    PubMed Central

    2013-01-01

    Background South Africa currently has a pluralistic health care system with separate public and private sectors. It is, however, moving towards a socialised model with the introduction of National Health Insurance. The South African legislative environment has changed recently with the promulgation of the Consumer Protection Act and proposed amendments to the National Health Act. Patients can now be viewed as consumers from a legal perspective. This has various implications for health care systems, health care providers and the doctor-patient relationship. Discussion Calling a recipient of health care a ‘consumer’ as opposed to a ‘patient’ has distinct connotations and may result in differential behaviour. Labels reflect the ideals of the context in which they are used. Various models of the doctor-patient relationship exist and different metaphors have been used to describe it. Increasingly there are third parties involved within the doctor-patient relationship making it more difficult for the doctor to play the fiduciary role. In certain parts of the world, there has been a shift from a traditional paternalistic model to a consumerist model. The ethical implications of the commodification of health care are complex. As health care becomes a ‘product’ supplied by the health care ‘provider’, there is the risk that doctors will replace professional ethics with those of the marketplace. Health care is a universal human need and cannot be considered a mere commodity. In modern medical ethics, great emphasis is placed on the principle of respect for patient autonomy. Patients are now the ultimate decision-makers. The new Consumer Protection Act in South Africa applies to consumers and patients alike. It enforces strict liability for harm caused by goods and services. Everyone in the supply chain, including the doctor, can be held jointly and severally liable. This may lead to enormous challenges in health care delivery. Summary Viewing patients as

  10. Africa.

    ERIC Educational Resources Information Center

    Happel, Sue; Loeb, Joyce

    Although the activities in this unit are designed primarily for students in the intermediate grades, the document's text, illustrations, and bibliographic references are suitable for anyone interested in learning about Africa. Following a brief introduction and map work, the document is arranged into six sections. Section 1 traces Africa's history…

  11. The individual, social justice and public health.

    PubMed

    Peñaranda, Fernando

    2015-04-01

    A theoretical reflection on public health from a standpoint of social justice, which does not overlook the individual, is presented. Based on a conceptualization of social justice, human rights and health in the framework of an epistemological analysis, a particular perspective on social justice and its implications for public health praxis, using a public health program as an example, is revealed. Some routes are identified in order to orient and put into practice the actions developed in public health programs. This requires a different way of understanding the scenarios and interchanges among people in the field of clinical practice. It is understood that these fields can also be seen as a suitable opportunity for the establishment of individuals and individualities committed to the political struggle for human rights, equity in health and recognition of a life worthy of human dignity.

  12. Informatics and public health at CDC.

    PubMed

    McNabb, Scott J N; Koo, D; Seligman, J

    2006-12-22

    Since CDC acquired its first mainframe computer in 1964, the use of information technology in public health practice has grown steadily and, during the past 2 decades, dramatically. Public health informatics (PHI) arrived on the scene during the 1990s after medical informatics (intersecting information technology, medicine, and health care) and bioinformatics (intersecting mathematics, statistics, computer science, and molecular biology). Similarly, PHI merged the disciplines of information science and computer science to public health practice, research, and learning. Using strategies and standards, practitioners employ PHI tools and training to maximize health impacts at local, state, and national levels. They develop and deploy information technology solutions that provide accurate, timely, and secure information to guide public health action.

  13. Trade policy and public health.

    PubMed

    Friel, Sharon; Hattersley, Libby; Townsend, Ruth

    2015-03-18

    Twenty-first-century trade policy is complex and affects society and population health in direct and indirect ways. Without doubt, trade policy influences the distribution of power, money, and resources between and within countries, which in turn affects the natural environment; people's daily living conditions; and the local availability, quality, affordability, and desirability of products (e.g., food, tobacco, alcohol, and health care); it also affects individuals' enjoyment of the highest attainable standard of health. In this article, we provide an overview of the modern global trade environment, illustrate the pathways between trade and health, and explore the emerging twenty-first-century trade policy landscape and its implications for health and health equity. We conclude with a call for more interdisciplinary research that embraces complexity theory and systems science as well as the political economy of health and that includes monitoring and evaluation of the impact of trade agreements on health.

  14. A comparative analysis of communication about sex, health and sexual health in India and South Africa: Implications for HIV prevention.

    PubMed

    Lambert, Helen; Wood, Kate

    2005-01-01

    This paper provides a comparative analysis of modes of dialogue, non-verbal communication and embodied action relating to sex and health in two contrasting countries-India and South Africa-which have the world's two most heavily HIV-affected populations (in terms of numbers of people living with HIV). Drawing on material derived from multiple studies, including ethnographic and other forms of qualitative and multi-disciplinary research, the paper identifies commonalities as well as differences in communication relating to sex and sexual health in these diverse settings. The paper considers: first, how and by whom sex is and is not talked about, in public discourse and private conversation; second, how sexual intention and desire are communicated through indirect, non-verbal means in everyday life; and third, how references to sexuality and the sexual body re-enter within a more explicit set of indigenous discourses about health (rather than 'sexual health' per se), such as semen loss in India and womb 'dirtiness' in South Africa. The concluding section reflects on the implications of a comparative analysis such as this for current policy emphases on the importance of promoting verbal communication skills as part of 'life skills' for HIV prevention.

  15. Sexuality and sexual health: constructs and expressions in the extended Middle East and North Africa.

    PubMed

    El-Kak, Faysal

    2013-12-30

    The extended Middle East and North Africa (EMENA) region is the world region with the second youngest population, where globalization, migration, information technology, and political changes are contributing to the shaping of sexuality and sexual behaviors. Understanding the various sociocultural, demographic and public health dimensions of sexual and reproductive health of young people is fundamental to understanding the pattern of sexual behavior and the burden of sexually transmitted infections (STIs), including human papillomavirus-related diseases. New norms and forms of marriage have emerged to accommodate the changing trends in sexual behavior of premarital and extra-marital sex, as well as reports of increased prevalence of premarital penetrative and non-penetrative sexual behavior. Despite these trends, the burden of sexual illnesses remains low and is estimated at 7% of the general population being infected with curable STIs. Other STIs, such as herpes simplex virus 2, are also prevalent. The existing policies and health systems remain short of promoting youth reproductive and sexual health. Efforts should address establishing national preventive programmes, such as screening for STIs, primary prevention, comprehensive sexuality education, as well as youth-friendly services. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in the Extended Middle East and North Africa Region" Vaccine Volume 31, Supplement 6, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.

  16. Application of GIS technology in public health: successes and challenges.

    PubMed

    Fletcher-Lartey, Stephanie M; Caprarelli, Graziella

    2016-04-01

    The uptake and acceptance of Geographic Information Systems (GIS) technology has increased since the early 1990s and public health applications are rapidly expanding. In this paper, we summarize the common uses of GIS technology in the public health sector, emphasizing applications related to mapping and understanding of parasitic diseases. We also present some of the success stories, and discuss the challenges that still prevent a full scope application of GIS technology in the public health context. Geographical analysis has allowed researchers to interlink health, population and environmental data, thus enabling them to evaluate and quantify relationships between health-related variables and environmental risk factors at different geographical scales. The ability to access, share and utilize satellite and remote-sensing data has made possible even wider understanding of disease processes and of their links to the environment, an important consideration in the study of parasitic diseases. For example, disease prevention and control strategies resulting from investigations conducted in a GIS environment have been applied in many areas, particularly in Africa. However, there remain several challenges to a more widespread use of GIS technology, such as: limited access to GIS infrastructure, inadequate technical and analytical skills, and uneven data availability. Opportunities exist for international collaboration to address these limitations through knowledge sharing and governance.

  17. Informational Privacy and the Public's Health: The Model State Public Health Privacy Act

    PubMed Central

    Gostin, Lawrence O.; Hodge, James G.; Valdiserri, Ronald O.

    2001-01-01

    Protecting public health requires the acquisition, use, and storage of extensive health-related information about individuals. The electronic accumulation and exchange of personal data promises significant public health benefits but also threatens individual privacy; breaches of privacy can lead to individual discrimination in employment, insurance, and government programs. Individuals concerned about privacy invasions may avoid clinical or public health tests, treatments, or research. Although individual privacy protections are critical, comprehensive federal privacy protections do not adequately protect public health data, and existing state privacy laws are inconsistent and fragmented. The Model State Public Health Privacy Act provides strong privacy safeguards for public health data while preserving the ability of state and local public health departments to act for the common good. PMID:11527765

  18. The University–Public Health Partnership for Public Health Research Training in Quebec, Canada

    PubMed Central

    Hamelin, Anne-Marie; Malowany, Maureen; Levy, Joseph; Rossignol, Michel; Bergeron, Pierre; Kishchuk, Natalie

    2017-01-01

    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. PMID:27854518

  19. The University-Public Health Partnership for Public Health Research Training in Quebec, Canada.

    PubMed

    Paradis, Gilles; Hamelin, Anne-Marie; Malowany, Maureen; Levy, Joseph; Rossignol, Michel; Bergeron, Pierre; Kishchuk, Natalie

    2017-01-01

    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.

  20. [Empowerment in the public health practice].

    PubMed

    Chia, Shu-Li

    2011-02-01

    Public health personnel are the first-line workers of preventive care and medical services. In the face of rapid social and demographic changes, empowerment and on-job training have become important approaches to enhance the function of nurses. Health centers act like the "peripheral nerves" of the government healthcare system, as they must both reflect the needs of community residents and fully implement government mandated services. While widely distributed, health centers face manpower shortages and disorderly information collection and distribution systems. Empowerment and on-job training programs can enhance public heath staff knowledge in order to cope with heavy workloads and shift toward multi-dimensional development. This paper examines the experience of the New Taipei City Public Health Bureau in conducting health center empowerment programs from four perspectives, including personal cultivation and organizational cultivation. It was found that public health staff self-recognition of professional values can also be further strengthened through alliances within the community, and that establishing personal relationships with patients by "treating patients as relatives" was effective in realizing health center objectives. This paper also reminds agency supervisors that staff training is a critical management task. Health authorities should thus introduce in a timely manner organizational management, on-job training, service reengineering, and other related corporate philosophies; facilitate staff empowerment; consolidate core professional knowledge; and construct intellectual and social capital that meets health unit needs in order to enhance health center competitiveness and public health staff knowledge.

  1. Collaboration or renunciation? The role of traditional medicine in mental health care in Rwanda and Eastern Cape Province, South Africa.

    PubMed

    Schierenbeck, Isabell; Johansson, Peter; Andersson, Lena M; Krantz, Gunilla; Ntaganira, Joseph

    2016-10-07

    Traditional medicine (TM) and biomedicine represent parallel health systems in many developing countries; the latter dominating in public policies, while the former still retain considerable influence among the general public. This study investigates how mental health care professionals responsible for mental health care implementation comprehend and relate to the intersection between TM and biomedicine in the cases of Rwanda and the Eastern Cape Province, South Africa. The material is based on semi-structured interviews with mental health care stakeholders in Eastern Cape, South Africa and Rwanda. The findings confirm an impact of TM in the treatment of mental health issues in Rwanda and South Africa due to TM being more accessible than biomedical medicine, widespread traditional perceptions of mental illness in society, and the lack of knowledge of biomedical treatments. Furthermore, the respondents identified three strategies to manage the impact of TM; improved accessibility of biomedical facilities, outreach education about mental illness, and, in the Eastern Cape case, collaboration between traditional healers and biomedicine. The study points to the necessity to take TM into consideration as an important component of health systems and policies in the Global south.

  2. Public policy involvement by health commissioners.

    PubMed

    Thompson, Amy; Boardley, Debra; Kerr, Dianne; Greene, Tiffany; Jenkins, Melissa

    2009-08-01

    The purpose of this national study was to determine advocacy activities and level of involvement of health commissioners regarding public policy. Benefits, barriers, and perceived outcomes of advocacy efforts were also explored. A previously validated (Holtrop et al., Am J Health Behav 24(2):132-142, 2000) four-page survey was mailed to 700 health commissioners, who were randomly selected from the National Association of County and City Health Officials (NACCHO) database. A three-wave mailing was performed which yielded a 50% response rate. Of these respondents, the majority (70%) were female and (88%) Caucasian. Overall, 31% of health commissioners reported being involved in influencing public policy in the last 4 years. The most common reported activities engaged in by health commissioners included voting (84%), and providing policy information to consumers or other professionals (77%). Perceived barriers to influencing policy were time, (64%), and other priorities (46%). Perceived benefits to influencing policy included improving the health of the public (94%) and making a difference in others' lives (87%). Only 15% perceived their knowledge regarding the process of changing public policy was excellent. Although health commissioners are often spokespersons for health agencies and communities, their public policy involvement is marginal. Professional preparation programs and continuing education opportunities should focus on advocacy, public policy development, and removing barriers to action.

  3. Use of applied theatre in health research dissemination and data validation: a pilot study from South Africa

    PubMed Central

    Stuttaford, Maria; Bryanston, Claudette; Hundt, Gillian Lewando; Connor, Myles; Thorogood, Margaret; Tollman, Steve

    2010-01-01

    This article reports on a pilot study of the use of applied theatre in the dissemination of health research findings and validation of data. The study took place in South Africa, as part of the Southern Africa Stroke Prevention Initiative (SASPI) and was based at the University/Medical Research Council Rural Public Health and Health Transitions Research Unit (also known as the Agincourt Unit). The aim of SASPI was to investigate the prevalence of stroke and understand the social context of stroke. It was decided to use an applied theatre approach for validating the data and disseminating findings from the anthropological component of the study. The pilot study found that applied theatre worked better in smaller community groups. It allowed data validation and it elicited ideas for future interventions resulting from the health research findings. Evaluation methods of the impact of applied theatre as a vehicle for the dissemination and communication of research findings require further development. PMID:16322042

  4. Political Science Theory for Public Health Practice

    ERIC Educational Resources Information Center

    Watson, Tyler

    2014-01-01

    Community health educators are well versed in the behavior sciences, including intervention theories. However, most public health professionals are not familiar with the policy theories related to political advocacy. Because health educators are engaging in policy advocacy more frequently, and as a result of the profession including policy…

  5. Where Is the Future in Public Health?

    PubMed Central

    Graham, Hilary

    2010-01-01

    Context: Today's societies have far-reaching impacts on future conditions for health. Against this backdrop, this article explores how the future is represented in contemporary public health, examining both its conceptual base and influential approaches through which evidence is generated for policy. Methods: Mission statements and official reviews provide insight into how the future is represented in public health's conceptual and ethical foundations. For its research practices, the article takes examples from epidemiological, intervention, and economic research, selecting risk-factor epidemiology, randomized controlled trials, and economic evaluation as exemplars. Findings: Concepts and ethics suggest that public health research and policy will be concerned with protecting both today's and tomorrow's populations from conditions that threaten their health. But rather than facilitating sustained engagement with future conditions and future health, exemplary approaches to gathering evidence focus on today's population. Thus, risk-factor epidemiology pinpoints risks in temporal proximity to the individual; controlled trials track short-term effects of interventions on the participants’ health; and economic evaluations weigh policies according to their value to the current population. While their orientation to the present and near future aligns well with the compressed timescales for policy delivery on which democratic governments tend to work, it makes it difficult for the public health community to direct attention to conditions for future health. Conclusions: This article points to the need for research perspectives and practices that, consistent with public health's conceptual and ethical foundations, represent the interests of both tomorrow's and today's populations. PMID:20579281

  6. Public health and disability: emerging opportunities.

    PubMed

    Lollar, Donald J

    2002-01-01

    The public health community has traditionally paid little attention to the health needs of people with disabilities. Recent activities, however, on the part of federal and international organizations mark a shift toward engaging the health concerns of this large and growing population. First, the World Health Organization published the International Classification of Functioning, Disability, and Health (ICF), a companion to the International Classification of Diseases. The ICF describes both a conceptual framework and a classification system, providing the foundation for public health science and policy. Second, a vision for the future of public health and disability is outlined in Healthy People 2010 that, for the first time, includes people with disabilities as a targeted population. The article briefly describes activities and emerging opportunities for a public health focus on people with disabilities with the ICF as a foundation and Healthy People 2010 as a vision. Public health has traditionally responded to emerging needs; people with disabilities are a group whose health needs should be targeted.

  7. Modelling the affordability and distributional implications of future health care financing options in South Africa.

    PubMed

    McIntyre, Di; Ataguba, John E

    2012-03-01

    South Africa is considering introducing a universal health care system. A key concern for policy-makers and the general public is whether or not this reform is affordable. Modelling the resource and revenue generation requirements of alternative reform options is critical to inform decision-making. This paper considers three reform scenarios: universal coverage funded by increased allocations to health from general tax and additional dedicated taxes; an alternative reform option of extending private health insurance coverage to all formal sector workers and their dependents with the remainder using tax-funded services; and maintaining the status quo. Each scenario was modelled over a 15-year period using a spreadsheet model. Statistical analyses were also undertaken to evaluate the impact of options on the distribution of health care financing burden and benefits from using health services across socio-economic groups. Universal coverage would result in total health care spending levels equivalent to 8.6% of gross domestic product (GDP), which is comparable to current spending levels. It is lower than the status quo option (9.5% of GDP) and far lower than the option of expanding private insurance cover (over 13% of GDP). However, public funding of health services would have to increase substantially. Despite this, universal coverage would result in the most progressive financing system if the additional public funding requirements are generated through a surcharge on taxable income (but not if VAT is increased). The extended private insurance scheme option would be the least progressive and would impose a very high payment burden; total health care payments on average would be 10.7% of household consumption expenditure compared with the universal coverage (6.7%) and status quo (7.5%) options. The least pro-rich distribution of service benefits would be achieved under universal coverage. Universal coverage is affordable and would promote health system equity, but

  8. The political economy of health policy in Sub-Saharan Africa.

    PubMed

    Cook, Cynthia T; Kalu, Kelechi

    2008-03-01

    This paper discusses the health status of Sub-Saharan Africa focusing on infectious and parasitic diseases, HIV/AIDS, maternal and child health, famine, and political instability. Its contention is that Africa is stuck in the second stage of the demographic transition (high birth rate, low death rate) and the first stage of the epidemiological transition (deaths related to pestilence, famine, and war). Africa's lack of sustainable development is attributed to ineffective governmental policy and leadership. The prognosis is that the health and well-being of Africa's most vulnerable population, women and children, will improve when government shifts its attention from external funding and affairs to internal and concentrates on retaining Africa's 'talented tenth'; that the 'brain drain' and political instability has robbed Africa of its most talented young people, medical and science professionals, who are needed to provide primary care and development to a region with a high mortality rate, a low life expectancy, and a low per capita income.

  9. Prenatal Screening, Reproductive Choice, and Public Health

    PubMed Central

    Wilkinson, Stephen

    2015-01-01

    One widely held view of prenatal screening (PNS) is that its foremost aim is, or should be, to enable reproductive choice; this is the Pure Choice view. The article critiques this position by comparing it with an alternative: Public Health Pluralism. It is argued that there are good reasons to prefer the latter, including the following. (1) Public Health Pluralism does not, as is often supposed, render PNS more vulnerable to eugenics-objections. (2) The Pure Choice view, if followed through to its logical conclusions, may have unpalatable implications, such as extending choice well beyond health screening. (3) Any sensible version of Public Health Pluralism will be capable of taking on board the moral seriousness of abortion and will advocate, where practicable, alternative means of reducing the prevalence of disease and disability. (4) Public Health Pluralism is at least as well-equipped as the Pure Choice model to deal with autonomy and consent issues. PMID:25521971

  10. Reuniting public health and medicine: the University of New Mexico School of Medicine Public Health Certificate.

    PubMed

    Geppert, Cynthia M A; Arndell, Cynthia L; Clithero, Amy; Dow-Velarde, Lily A; Eldredge, Jonathan D; Eldredge, Jonathan P; Kalishman, Summers; Kaufman, Arthur; McGrew, Martha C; Snyder, Tiffany M; Solan, Brian G; Timm, Craig T; Tollestrup, Kristine; Wagner, Lana K; Wiese, William H; Wiggins, Charles L; Cosgrove, Ellen M

    2011-10-01

    The University of New Mexico School of Medicine (UNMSOM) sought to train medical students in public health concepts, knowledge, and skills as a means of improving the health of communities statewide. Faculty members from every UNMSOM department collaborated to create and integrate a public health focus into all years of the medical school curriculum. They identified key competencies and developed new courses that would synchronize students' learning public health subjects with the mainstream medical school content. New courses include: Health Equity: Principles of Public Health; Epidemiology and Biostatistics; Evidence-Based Practice; Community-Based Service Learning; and Ethics in Public Health. Students experiencing the new courses, first in pilot and then final forms, gave high quantitative ratings to all courses. Some students' qualitative comments suggest that the Public Health Certificate has had a profound transformative effect. Instituting the integrated Public Health Certificate at UNMSOM places it among the first medical schools to require all its medical students to complete medical school with public health training. The new UNMSOM Public Health Certificate courses reunite medicine and public health in a unified curriculum.

  11. Modernizing public health law: protection and enforcement.

    PubMed

    Griffith, Richard; Tengnah, Cassam

    2011-08-01

    Health protection legislation has been updated through amendments to the Public Health (Control of Disease) Act 1984 to take account of emerging diseases and the risk of contamination by adopting an all hazard approach to disease protection. To further strengthen safeguards for protecting health, new health protection powers have been given to local authorities and magistrates. The powers can be used to prevent and control the spread of infectious diseases and contamination. Health professionals, including district nurses, need to be aware of the health protection powers. This will enable them to take appropriate decisions in cases where voluntary measures to protect health are not possible.

  12. Advancing Public Health through Continuing Education of Health Care Professionals

    ERIC Educational Resources Information Center

    Hudmon, Karen Suchanek; Addleton, Robert L.; Vitale, Frank M.; Christiansen, Bruce A.; Mejicano, George C.

    2011-01-01

    This article describes how the CS2day (Cease Smoking Today) initiative positioned continuing education (CE) in the intersection between medicine and public health. The authors suggest that most CE activities address the medical challenges that clinicians confront, often to the neglect of the public health issues that are key risk factors for the…

  13. Risk equalisation and voluntary health insurance: The South Africa experience.

    PubMed

    McLeod, Heather; Grobler, Pieter

    2010-11-01

    South Africa intends implementing major reforms in the financing of healthcare. Free market reforms in private health insurance in the late 1980s have been reversed by the new democratic government since 1994 with the re-introduction of open enrolment, community rating and minimum benefits. A system of national health insurance with income cross-subsidies, risk-adjusted payments and mandatory membership has been envisaged in policy papers since 1994. Subsequent work has seen the design of a Risk Equalisation Fund intended to operate between competing private health insurance funds. The paper outlines the South African health system and describes the risk equalisation formula that has been developed. The risk factors are age, gender, maternity events, numbers with certain chronic diseases and numbers with multiple chronic diseases. The Risk Equalisation Fund has been operating in shadow mode since 2005 with data being collected but no money changing hands. The South African experience of risk equalisation is of wider interest as it demonstrates an attempt to introduce more solidarity into a small but highly competitive private insurance market. The measures taken to combat over-reporting of chronic disease should be useful for countries or funders considering adding chronic disease to their risk equalisation formulae.

  14. Globalization and occupational health: a perspective from southern Africa.

    PubMed Central

    Loewenson, R.

    2001-01-01

    Increased world trade has generally benefited industrialized or strong economies and marginalized those that are weak. This paper examines the impact of globalization on employment trends and occupational health, drawing on examples from southern Africa. While the share of world trade to the world's poorest countries has decreased, workers in these countries increasingly find themselves in insecure, poor-quality jobs, sometimes involving technologies which are obsolete or banned in industrialized countries. The occupational illness which results is generally less visible and not adequately recognized as a problem in low-income countries. Those outside the workplace can also be affected through, for example, work-related environmental pollution and poor living conditions. In order to reduce the adverse effects of global trade reforms on occupational health, stronger social protection measures must be built into production and trade activities, including improved recognition, prevention, and management of work-related ill-health. Furthermore, the success of production and trade systems should be judged on how well they satisfy both economic growth and population health. PMID:11584735

  15. Public health emergencies and the public health/managed care challenge.

    PubMed

    Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

    2002-01-01

    The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

  16. Integrating Advanced Molecular Technologies into Public Health.

    PubMed

    Gwinn, Marta; MacCannell, Duncan R; Khabbaz, Rima F

    2017-03-01

    Advances in laboratory and information technologies are transforming public health microbiology. High-throughput genome sequencing and bioinformatics are enhancing our ability to investigate and control outbreaks, detect emerging infectious diseases, develop vaccines, and combat antimicrobial resistance, all with increased accuracy, timeliness, and efficiency. The Advanced Molecular Detection (AMD) initiative has allowed the Centers for Disease Control and Prevention (CDC) to provide leadership and coordination in integrating new technologies into routine practice throughout the U.S. public health laboratory system. Collaboration and partnerships are the key to navigating this transition and to leveraging the next generation of methods and tools most effectively for public health.

  17. Parks, Recreation and Public Health.

    ERIC Educational Resources Information Center

    Ho, Ching-Hua; Payne, Laura; Orsega-Smith, Elizabeth; Godbey, Geoffrey

    2003-01-01

    Reviews what current research says about the holistic health benefits of park and recreation services, focusing on: health benefits according to park users; physical activities in parks; stress reduction benefits of park use; social support, self-determination, and stress reduction; observing nature in parks and associated benefits; and the…

  18. South Africa: a 21st century apartheid in health and health care?

    PubMed

    Mooney, Gavin H; McIntyre, Diane E

    The current crisis in health and health care in South Africa results from a combination of factors: the legacy of apartheid; issues of poverty, income inequality and AIDS; and the more recent influence of neoliberal economic policies and globalisation. The legacy of apartheid has meant that both health and health care are skewed along racial lines, and 60% of health care expenditure goes largely to the 14% of the population who have private health insurance. A more equitable distribution of health care resources will result from the promised National Health Insurance, the details of which are still being debated. The AIDS epidemic in South Africa was exacerbated by the government not introducing antiretroviral treatment (ART) until the early 2000s. In 2005, it was estimated that more than 5.5 million South Africans were infected with HIV. Now all those with a CD4 count below 200 are eligible for ART. A better health service will not be enough to improve the health of South Africans. A whole-of-government approach is needed to address the persistent problems of poverty and inequality.

  19. [Health and environment: the 2nd public health revolution.].

    PubMed

    Cicolella, André

    2010-01-01

    As of the mid-19th century, most infectious disease epidemics have been fought and slowed down by taking action on the environment (water, housing, waste) and education. This constitutes the 1st public health revolution paradigm. As we face the current epidemic of chronic diseases and the failure of the dominant biomedical model to stop them, a 2nd public health revolution is needed. The vision for this 2nd public health revolution requires a new paradigm built upon an eco-systemic definition of health and the recognition of the legitimacy for citizen participation based on the precautionary principle.

  20. Public health responses to climate change health impacts in Indonesia.

    PubMed

    Wirawan, I Made Ady

    2010-01-01

    Although climate change is a global concern, there are particular considerations for Indonesia as an archipelagic nation. These include the vulnerability of people living in small islands and coastal areas to rising sea levels; the expansion of the important mosquito-borne diseases, particularly malaria and dengue, into areas that lack of immunity; and the increase in water-borne diseases and malnutrition. This article proposes a set of public health responses to climate change health impacts in Indonesia. Some important principles and practices in public health are highlighted, to develop effective public health approaches to climate change in Indonesia.

  1. Innovation and technology for global public health.

    PubMed

    Piot, Peter

    2012-01-01

    Recent decades have been marked by the explosive development of innovative scientific, technological and business products and processes. Despite their immense impact on health globally, little has been accomplished in the field of global public health to incorporate, address and harness such innovations in practice. In order to meet the world's growing health needs, it is essential that global public health accepts and adapts to these innovations. Moreover, such innovations must be implemented equitably in ways that will best serve their intended recipients, without deepening health- and access-related disparities. This article will briefly discuss the wide array of technologies in the pipeline that will affect global public health practice, their impact on the field and on populations and the issues facing the field in adopting these innovations.

  2. The Oregon Public Health Policy Institute: Building Competencies for Public Health Practice.

    PubMed

    Luck, Jeff; Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice

    2015-08-01

    The Oregon Public Health Policy Institute (PHPI) was designed to enhance public health policy competencies among state and local health department staff. The Oregon Health Authority funded the College of Public Health and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state public health programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in public health policy competencies and high satisfaction with PHPI overall.

  3. [Brazilian bibliographical output on public oral health in public health and dentistry journals].

    PubMed

    Celeste, Roger Keller; Warmling, Cristine Maria

    2014-06-01

    The scope of this paper is to describe characteristics of the scientific output in the area of public oral health in journals on public health and dentistry nationwide. The Scopus database of abstracts and quotations was used and eight journals in public health, as well as ten in dentistry, dating from 1947 to 2011 were selected. A research strategy using key words regarding oral health in public health and key words about public health in dentistry was used to locate articles. The themes selected were based on the frequency of key words. Of the total number of articles, 4.7% (n = 642) were found in oral health journals and 6.8% (n = 245) in public health journals. Among the authors who published most, only 12% published in both fields. There was a percentile growth of public oral health publications in dentistry journals, though not in public health journals. In dentistry, only studies indexed as being on the topic of epidemiology showed an increase. In the area of public health, planning was predominant in all the phases studied. Research to evaluate the impact of research and postgraduate policies in scientific production is required.

  4. A critical review of sanctioned knowledge production concerning abortion in Africa: Implications for feminist health psychology.

    PubMed

    Macleod, Catriona; Chiweshe, Malvern; Mavuso, Jabulile

    2016-04-22

    Taking a feminist health psychology approach, we conducted a systematic review of published research on abortion featured in PsycINFO over a 7-year period. We analysed the 39 articles included in the review in terms of countries in which the research was conducted, types of research, issues covered, the way the research was framed and main findings. Despite 97 per cent of abortions performed in Africa being classifiable as unsafe, there has been no engagement in knowledge production about abortion in Africa from psychologists, outside of South Africa. Given this, we outline the implications of the current knowledge base for feminism, psychology and feminist health psychology in Africa.

  5. [The characteristics of public health resources management].

    PubMed

    2011-01-01

    The article analyses the position of human health in the system of social economic relationships. The notion of material and technical resources in health institutions is defined. It is demonstrated that they are characterized by number of health institutions, their structure according levels and stages of medical care provision, costs of fixed assets, their structure and wear. The conceptual characteristics of actual management of public health resources are analyzed.

  6. Defining and Developing a Global Public Health Course for Public Health Graduates

    PubMed Central

    Karkee, Rajendra; Comfort, Jude; Alfonso, Helman

    2015-01-01

    Global public health is increasingly being seen as a speciality field within the university education of public health. However, the exact meaning of global public health is still unclear, resulting in varied curricula and teaching units among universities. The contextual differences between high- and low- and middle-income countries, and the process of globalization need to be taken into account while developing any global public health course. Global public health and public health are not separable and global public health often appears as an extension of public health in the era of globalization and interdependence. Though global public health is readily understood as health of global population, it is mainly practiced as health problems and their solutions set within low- and middle-income countries. Additional specialist competencies relevant to the context of low- and middle-income countries are needed to work in this field. Although there can be a long list of competencies relevant to this broad topic, available literature suggests that knowledge and skills related with ethics and vulnerable groups/issues; globalization and its impact on health; disease burden; culture, society, and politics; and management are important. PMID:26191520

  7. Public health through a different lens.

    PubMed

    Deber, Raisa; McDougall, Christopher; Wilson, Kumanan

    2007-01-01

    Although public health in Canada faces concerns similar to those noted by Tilson and Berkowitz in the US, a review we conducted of how public health is financed and delivered in Canada also highlights some key differences. In both systems, public health labours under similar disadvantages: it is invisible when it succeeds; it has overtones of a "nanny state" and it focuses on often unpopular vulnerable populations. Prevention is always at risk of being raided to finance treatment. Yet, Canada, because there are fewer financial barriers to receiving medically necessary personal services, can focus more attention on what Tilson and Berkowitz term "the ecology of health." We highlight some of the strengths and ongoing challenges of the Canadian public health system. We conclude that the issue appears less the need to measure performance, than the recognition that one size does not fit all. In particular, for threats to public health that transcend borders, local failure can affect wider populations and suggests a need to look beyond local, provincial or national sovereignty. Public health is heterogeneous, and many roads may lead us to the promised land.

  8. Economic Choices for Educational Policy in Africa. Research Publication No. 88.1.

    ERIC Educational Resources Information Center

    LeBel, Phillip

    In many countries in Africa today formal education is in a state of crisis. While curricular reform continues to serve as an ongoing source of public policy debate, African leaders are confronting increasing difficulty in allotting educational resources to meet present and future levels of demand. The paralysis that has been unfolding is one…

  9. Integrating child health information systems in public health agencies.

    PubMed

    Bara, Debra; McPhillips-Tangum, Carol; Wild, Ellen L; Mann, Marie Y

    2009-01-01

    Public health agencies at state and local levels are integrating information systems to improve health outcomes for children. An assessment was conducted to describe the extent to which public health agencies are currently integrating child health information systems (CHIS). Using online technology information was collected, to assess completed and planned activities related to integration of CHIS, maturity of these systems, and factors that influence decisions by public health agencies to pursue integration activities. Of the 39 public health agencies that participated, 18 (46%) reported already integrating some or all of their CHIS, and 13 (33%) reported to be planning to integrate during the next 3 years. Information systems most commonly integrated include Early Hearing Detection and Intervention (EHDI), immunization, vital records, and Newborn Dried Bloodspot Screening (NDBS). Given the high priority that has been placed on using technology to improve health status in the United States, the emphasis on expanding the capability for the electronic exchange of health information, and federal support for electronic health records by 2014, public health agencies should be encouraged and supported in their efforts to develop, implement, and maintain integrated CHIS to facilitate the electronic exchange of health information with the clinical healthcare sector.

  10. Public health communications for safe motherhood.

    PubMed

    Kessel, E

    1994-03-30

    Public health communication aims to influence health practices of large populations, including maternal health care providers (traditional birth attendants, (TBAs), nurse-midwives, other indigenous practitioners, and physicians). A quality assurance process is needed to give public sector health providers feedback. Computerized record keeping is needing for quality assurance of maternal health programs. The Indian Rural Medical Association has trained more than 20,000 rural indigenous practitioners in West Bengal. Training of TBAs is expensive and rarely successful. However, trained health professional leading group discussions of TBAs is successful at teaching them about correct maternity care. Health education messages integrated into popular songs and drama is a way to reach large illiterate audiences. Even though a few donor agencies and governments provide time and technical assistance to take advantage of the mass media as a means to communicate health messages, the private sector has most of the potential. Commercial advertisements pay for Video on Wheels, which, with 100 medium-sized trucks each fitted with a 100-inch screen, plays movies for rural citizens of India. They are exposed to public and family planning messages. Jain Satellite Television (JST) broadcasts 24 hours a day and plans to broadcast programs on development, health and family planning, women's issues, and continuing education for all health care providers (physicians, nurses, TBAs, community workers, and indigenous practitioners). JST and the International Federation for Family Health plan to telecast courses as part of an Open University of Health Sciences.

  11. Holding the World Bank accountable for leakage of funds from Africa's health sector.

    PubMed

    Marouf, Fatma E

    2010-06-15

    This article explores the accountability of international financial institutions (IFIs), such as the World Bank, for human rights violations related to the massive leakage of funds from sub-Saharan Africa's health sector. The article begins by summarizing the quantitative results of Public Expenditure Tracking Surveys performed in six African countries, all showing disturbingly high levels of leakage in the health sector. It then addresses the inadequacy of good governance and anticorruption programs in remedying this problem. After explaining how the World Bank's Inspection Panel may serve as an accountability mechanism for addressing the leakage of funds, discussing violations of specific Bank policies and procedures that would support a claim related to leakage and examining the relevance of human rights concerns to such as claim, the article explores some of the Panel's limitations and the positive steps taken to address these concerns.

  12. Science and social responsibility in public health.

    PubMed Central

    Weed, Douglas L; McKeown, Robert E

    2003-01-01

    Epidemiologists and environmental health researchers have a joint responsibility to acquire scientific knowledge that matters to public health and to apply the knowledge gained in public health practice. We examine the nature and source of these social responsibilities, discuss a debate in the epidemiological literature on roles and responsibilities, and cite approaches to environmental justice as reflective of them. At one level, responsibility refers to accountability, as in being responsible for actions taken. A deeper meaning of responsibility corresponds to commitment to the pursuit and achievement of a valued end. Epidemiologists are committed to the scientific study of health and disease in human populations and to the application of scientific knowledge to improve the public's health. Responsibility is also closely linked to reliability. Responsible professionals reliably perform the tasks they set for themselves as well as the tasks society expects them to undertake. The defining axiom for our approach is that the health of the public is a social good we commit ourselves to pursue, thus assuming an obligation to contribute to its achievement. Epidemiologists cannot claim to be committed to public health as a social good and not accept the responsibility of ensuring that the knowledge gained in their roles as scientists is used to achieve that good. The social responsibilities of environmental health researchers are conspicuous in the environmental justice movement, for example, in community-based participatory research. Responsibility is an ethical concept particularly well suited to frame many key aspects of the ethics of our profession. PMID:14602514

  13. Science and social responsibility in public health.

    PubMed

    Weed, Douglas L; McKeown, Robert E

    2003-11-01

    Epidemiologists and environmental health researchers have a joint responsibility to acquire scientific knowledge that matters to public health and to apply the knowledge gained in public health practice. We examine the nature and source of these social responsibilities, discuss a debate in the epidemiological literature on roles and responsibilities, and cite approaches to environmental justice as reflective of them. At one level, responsibility refers to accountability, as in being responsible for actions taken. A deeper meaning of responsibility corresponds to commitment to the pursuit and achievement of a valued end. Epidemiologists are committed to the scientific study of health and disease in human populations and to the application of scientific knowledge to improve the public's health. Responsibility is also closely linked to reliability. Responsible professionals reliably perform the tasks they set for themselves as well as the tasks society expects them to undertake. The defining axiom for our approach is that the health of the public is a social good we commit ourselves to pursue, thus assuming an obligation to contribute to its achievement. Epidemiologists cannot claim to be committed to public health as a social good and not accept the responsibility of ensuring that the knowledge gained in their roles as scientists is used to achieve that good. The social responsibilities of environmental health researchers are conspicuous in the environmental justice movement, for example, in community-based participatory research. Responsibility is an ethical concept particularly well suited to frame many key aspects of the ethics of our profession.

  14. [Drug use in the public health debate].

    PubMed

    Tirado-Otálvaro, Andrés Felipe

    2016-07-21

    This article addresses illegal drug use within the current debate in traditional public health and in proposals from Latin America, while emphasizing the need to approach the issue from an alternative public health perspective centered on individual users, groups, and social movements as protagonists. This counterhegemonic approach thus aims to orient the discussion on the need for inclusive and democratic public policies. Illegal drug use has been addressed from various perspectives: clinical medicine, viewing it as a problem that generates mental disorders and infectious diseases, both through risky sexual practices and/or use of injecting paraphernalia; from a legal perspective, as a problem related to delinquency; and according to traditional public health, as a problem that generates school dropout and work absenteeism and increases the demand on health services, in addition to increasing violence and death. However, not all forms of drug consumption involve problematic use, nor do they all trigger disorders related to substance use.

  15. Public health nutrition in Latin America.

    PubMed

    Solomons, Noel W

    2003-01-01

    An inquiry into options for Masters-level training and into attitudes and perceptions among a convenience sample of nutrition students and professionals from 11 countries suggests that the term, "Public Health Nutrition", as such, is poorly represented and poorly understood in the Latin American region. At least six countries (Brazil, Chile, Cuba, Mexico, Peru, Puerto Rico) at seven sites have Masters programs to provide training for nutrition in a public health context or public health with an emphasis in nutrition. Exploring alliances from the Americas with the formal PHN discipline emerging in Europe should enrich the mutual perspective on curriculum design. However, the form and context of postgraduate training in Latin America must consider first and foremost its own job-markets, diverse public health needs, and resource allocations in building or transforming training programs.

  16. Bed Bugs are Public Health Pests

    EPA Pesticide Factsheets

    EPA and the Centers for Disease Control and Prevention (CDC) issued a joint statement on the public health impacts of bed bugs, which are blood-sucking ectoparasites (external parasites). EPA also has a pesticide registration notice on this topic.

  17. Knowledge networks for global public health.

    PubMed

    Natividad, Maria Dulce F; Fiereck, Kirk J; Parker, Richard

    2012-01-01

    The challenges posed by a globalised world have made it imperative for society to search for solutions to emerging issues and to develop new ways of looking at old problems. Current discussions about global public health demand a shift in paradigms and the strategic positioning of public health within broader policy discussions that will enable it to influence political and action agendas. Critical to responding to these challenges is the generation, transmission and dissemination of new knowledge to create value. Recognising the cutting-edge role of knowledge, as a new form of capital that drives innovation and transforms society, the formation of knowledge networks is viewed as a strategy for developing a shared intellectual, conceptual and ethical infrastructure for the field of global public health. These knowledge networks are envisioned as a vehicle for sharing diverse perspectives, encouraging debate and sustaining alternative ways of thinking about and responding to the challenges that confront global public health today and in the future.

  18. Field Epidemiology and Laboratory Training Programs in West Africa as a model for sustainable partnerships in animal and human health.

    PubMed

    Becker, Karen M; Ohuabunwo, Chima; Ndjakani, Yassa; Nguku, Patrick; Nsubuga, Peter; Mukanga, David; Wurapa, Frederick

    2012-09-01

    The concept of animal and human health experts working together toward a healthier world has been endorsed, but challenges remain in identifying concrete actions to move this one health concept from vision to action. In 2008, as a result of avian influenza outbreaks in West Africa, international donor support led to a unique opportunity to invest in Field Epidemiology and Laboratory Training Programs (FELTPs) in the region that engaged the animal and human health sectors to strengthen the capacity for prevention and control of zoonotic diseases. The FELTPs mixed 25% to 35% classroom and 65% to 75% field-based training and service for cohorts of physicians, veterinarians, and laboratory scientists. They typically consisted of a 2-year course leading to a master's degree in field epidemiology and public health laboratory management for midlevel public health leaders and competency-based short courses for frontline public health surveillance workers. Trainees and graduates work in multidisciplinary teams to conduct surveillance, outbreak investigations, and epidemiological studies for disease control locally and across borders. Critical outcomes of these programs include development of a cadre of public health leaders with core skills in integrated disease surveillance, outbreak investigation, vaccination campaigns, laboratory diagnostic testing, and epidemiological studies that address priority public health problems. A key challenge exists in identifying ways to successfully scale up and transform this innovative donor-driven program into a sustainable multisectoral one health workforce capacity development model.

  19. Obstacles to HIV prevention, treatment and care in selected public universities in South Africa.

    PubMed

    Mbatha, Blessing

    2014-09-01

    South Africa, like the rest of Southern Africa, is ravaged by AIDS. Higher education in South Africa has a significant role to play in the fight against the spread of HIV and AIDS. This article reports the factors contributing to the spread of HIV and AIDS in three selected public universities in South Africa. To achieve the stated aim, the study answered the following research question: What are the factors contributing to the spread of HIV and AIDS in South African public universities? The problem in this study stems from South Africa's HIV and AIDS infection rate, one of the highest in the world, especially in KwaZulu-Natal. A qualitative approach was adopted by conducting focus group interviews with the students. The data were analysed using axial coding and open coding, where dominant themes from the discussions were identified and discussed in detail. The findings show that barriers to HIV and AIDS prevention, care and treatment exist in the tertiary institutions under study. Social and economic interventions are needed to stem the spread of HIV and AIDS at tertiary institutions. A range of recommendations for halting the spread of HIV and AIDS in these institutions is provided.

  20. Status report - Public Health 2016: time for a cultural shift in the field of public health.

    PubMed

    Mallach, E Rm; Ferrao, T; MacLean, R; Kirk, S Fl

    2016-11-01

    Public Health 2016, the Canadian Public Health Association's annual conference, was held from June 13 to 16, 2016, in Toronto, Canada, and showcased a wide variety of public health issues that fostered considerable discussion at the conference and on social media. The four plenary sessions, while on seemingly disparate topics including technology, violence prevention, racism and harm reduction, all revealed the need for a cultural shift in the field of public health that acknowledges and addresses the broader inequities that influence the health and well-being of populations. They also highlighted some of the key challenges that society faces in achieving the UN Sustainable Development Goals released in 2015.

  1. Protecting labor rights: roles for public health.

    PubMed

    Bhatia, Rajiv; Gaydos, Megan; Yu, Karen; Weintraub, June

    2013-11-01

    Federal, state, and local labor laws establish minimum standards for working conditions, including wages, work hours, occupational safety, and collective bargaining. The adoption and enforcement of labor laws protect and promote social, economic, and physical determinants of health, while incomplete compliance undermines these laws and contributes to health inequalities. Using existing legal authorities, some public health agencies may be able to contribute to the adoption, monitoring, and enforcement of labor laws. We describe how routine public health functions have been adapted in San Francisco, California, to support compliance with minimum wage and workers' compensation insurance standards. Based on these experiences, we consider the opportunities and obstacles for health agencies to defend and advance labor standards. Increasing coordinated action between health and labor agencies may be a promising approach to reducing health inequities and efficiently enforcing labor standards.

  2. Protecting Labor Rights: Roles for Public Health

    PubMed Central

    Gaydos, Megan; Yu, Karen; Weintraub, June

    2013-01-01

    Federal, state, and local labor laws establish minimum standards for working conditions, including wages, work hours, occupational safety, and collective bargaining. The adoption and enforcement of labor laws protect and promote social, economic, and physical determinants of health, while incomplete compliance undermines these laws and contributes to health inequalities. Using existing legal authorities, some public health agencies may be able to contribute to the adoption, monitoring, and enforcement of labor laws. We describe how routine public health functions have been adapted in San Francisco, California, to support compliance with minimum wage and workers' compensation insurance standards. Based on these experiences, we consider the opportunities and obstacles for health agencies to defend and advance labor standards. Increasing coordinated action between health and labor agencies may be a promising approach to reducing health inequities and efficiently enforcing labor standards. PMID:24179278

  3. Africa's neglected area of human resources for health research - the way forward.

    PubMed

    Ijsselmuiden, C; Marais, D L; Becerra-Posada, F; Ghannem, H

    2012-03-07

    Building the skills for doing, managing and delivering health research is essential for every country's development. Yet, human resources for health research (HRHR) are seldom considered in Africa and elsewhere. Africa's health research capacity has grown considerably, with potential to increase this growth. However, a systemic way of defining, co-ordinating and growing the HRHR needed to support health systems development is missing. Reviewing the status of HRHR in Africa, we assert that it consists of uncoordinated, small-scale activities, primarily driven from outside Africa. We present examples of ongoing HRHR capacity building initiatives in Africa. There is no overarching framework, strategy or body for African countries to optimise research support and capacity in HRHR. A simple model is presented to help countries plan and strategise for a comprehensive approach to research capacity strengthening. Everyone engaged with global, regional and national research for health enterprises must proactively address human resource planning for health research in Africa. Unless this is made explicit in global and national agendas, Africa will remain only an interested spectator in the decisions, prioritisation, funding allocations, conduct and interpretation, and in the institutional, economic and social benefits of health research, rather than owning and driving its own health research agendas.

  4. Corporate Philanthropy, Lobbying, and Public Health Policy

    PubMed Central

    Tesler, Laura E.

    2008-01-01

    To counter negative publicity about the tobacco industry, Philip Morris has widely publicized its philanthropy initiatives. Although corporate philanthropy is primarily a public relations tool, contributions may be viewed as offsetting the harms caused by corporate products and practices. That such donations themselves have harmful consequences has been little considered. Drawing on internal company documents, we explored the philanthropy undertaken as part of Philip Morris's PM21 image makeover. Philip Morris explicitly linked philanthropy to government affairs and used contributions as a lobbying tool against public health policies. Through advertising, covertly solicited media coverage, and contributions to legislators’ pet causes, Philip Morris improved its image among key voter constituencies, influenced public officials, and divided the public health field as grantees were converted to stakeholders. PMID:18923118

  5. Corporate philanthropy, lobbying, and public health policy.

    PubMed

    Tesler, Laura E; Malone, Ruth E

    2008-12-01

    To counter negative publicity about the tobacco industry, Philip Morris has widely publicized its philanthropy initiatives. Although corporate philanthropy is primarily a public relations tool, contributions may be viewed as offsetting the harms caused by corporate products and practices. That such donations themselves have harmful consequences has been little considered. Drawing on internal company documents, we explored the philanthropy undertaken as part of Philip Morris's PM21 image makeover. Philip Morris explicitly linked philanthropy to government affairs and used contributions as a lobbying tool against public health policies. Through advertising, covertly solicited media coverage, and contributions to legislators' pet causes, Philip Morris improved its image among key voter constituencies, influenced public officials, and divided the public health field as grantees were converted to stakeholders.

  6. Dental public health in India: An insight

    PubMed Central

    Gambhir, Ramandeep Singh; Kaur, Amanpreet; Singh, Arshdeep; Sandhu, Anmol Rattan Singh; Dhaliwal, Angad Prakash Singh

    2016-01-01

    Oral diseases are a major public health problem, and their burden is on increase in many low- and middle-income countries. Dental public health (DPH) aims to improve the oral health of the population through preventive and curative services. However, its achievements in India are being questioned probably because of lack of proficiency and skill among DPH personnel. The literature search for the present study was conducted utilizing various search engines and electronic databases such as PubMed and MEDLINE. Documents related to the Central and State Governments of India were also considered. Finally, 26 articles were selected for the present study from which relevant information can be extracted. The present study focuses on some of the important aspects relating to DPH in India such as priority for oral health, DPH workforce and curriculum, utilization of DPH personnel in providing primary oral health care, role of mobile dental vans, and research in DPH. It was concluded that more attention should be given toward preventive oral health care by employing more number of public health dentists in public sector, strengthening DPH education and research, and combining oral health programs with general health-care programs. PMID:28348984

  7. Labor unions: a public health institution.

    PubMed

    Malinowski, Beth; Minkler, Meredith; Stock, Laura

    2015-02-01

    Using a social-ecological framework, we drew on a targeted literature review and historical and contemporary cases from the US labor movement to illustrate how unions address physical and psychosocial conditions of work and the underlying inequalities and social determinants of health. We reviewed labor involvement in tobacco cessation, hypertension control, and asthma, limiting articles to those in English published in peer-reviewed public health or medical journals from 1970 to 2013. More rigorous research is needed on potential pathways from union membership to health outcomes and the facilitators of and barriers to union-public health collaboration. Despite occasional challenges, public health professionals should increase their efforts to engage with unions as critical partners.

  8. Applying Behavioral Economics to Public Health Policy

    PubMed Central

    Matjasko, Jennifer L.; Cawley, John H.; Baker-Goering, Madeleine M.; Yokum, David V.

    2016-01-01

    Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853

  9. Labor Unions: A Public Health Institution

    PubMed Central

    Malinowski, Beth; Stock, Laura

    2015-01-01

    Using a social–ecological framework, we drew on a targeted literature review and historical and contemporary cases from the US labor movement to illustrate how unions address physical and psychosocial conditions of work and the underlying inequalities and social determinants of health. We reviewed labor involvement in tobacco cessation, hypertension control, and asthma, limiting articles to those in English published in peer-reviewed public health or medical journals from 1970 to 2013. More rigorous research is needed on potential pathways from union membership to health outcomes and the facilitators of and barriers to union–public health collaboration. Despite occasional challenges, public health professionals should increase their efforts to engage with unions as critical partners. PMID:25521905

  10. Development of Systematic Knowledge Management for Public Health: A Public Health Law Ontology

    ERIC Educational Resources Information Center

    Keeling, Jonathan

    2012-01-01

    The Institute of Medicine has stated that legal structures and the authority vested in health agencies and other partners within the public health system are essential to improving the public's health. Variation between the laws of different jurisdictions within the United States allows for natural experimentation and research into their…

  11. Law, liability, and public health emergencies.

    PubMed

    Hoffman, Sharona; Goodman, Richard A; Stier, Daniel D

    2009-06-01

    According to many experts, a public health emergency arising from an influenza pandemic, bioterrorism attack, or natural disaster is likely to develop in the next few years. Meeting the public health and medical response needs created by such an emergency will likely involve volunteers, health care professionals, public and private hospitals and clinics, vaccine manufacturers, governmental authorities, and many others. Conducting response activities in emergency circumstances may give rise to numerous issues of liability, and medical professionals and other potential responders have expressed concern about liability exposure. Providers may face inadequate resources, an insufficient number of qualified personnel, overwhelming demand for services, and other barriers to providing optimal treatment, which could lead to injury or even death in some cases. This article describes the different theories of liability that may be used by plaintiffs and the sources of immunity that are available to public health emergency responders in the public sector, private sector, and as volunteers. It synthesizes the existing immunity landscape and analyzes its gaps. Finally, the authors suggest consideration of the option of a comprehensive immunity provision that addresses liability protection for all health care providers during public health emergencies and that, consequently, assists in improving community emergency response efforts.

  12. Eugenics and public health in American history.

    PubMed Central

    Pernick, M S

    1997-01-01

    Supporters of eugenics, the powerful early 20th-century movement for improving human heredity, often attacked that era's dramatic improvements in public health and medicine for preserving the lives of people they considered hereditarily unfit. Eugenics and public health also battled over whether heredity played a significant role in infectious diseases. However, American public health and eugenics had much in common as well. Eugenic methods often were modeled on the infection control techniques of public health. The goals, values, and concepts of disease of these two movements also often overlapped. This paper sketches some of the key similarities and differences between eugenics and public health in the United States, and it examines how their relationship was shaped by the interaction of science and culture. The results demonstrate that eugenics was not an isolated movement whose significance is confined to the histories of genetics and pseudoscience, but was instead an important and cautionary part of past public health and a general medical history as well. PMID:9366633

  13. Globalization of public health law and ethics.

    PubMed

    Sohn, Myongsei

    2012-09-01

    The Constitution of the World Health Organization (1946) states that the "enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social position." The international legal framework for this right was laid by the Universal Declaration of Human Rights (1948) and reaffirmed in the International Covenant on Economic, Social, and Cultural Rights (1966) and the Declaration of Alma-Ata (1978). In recent years, the framework has been developed on 10 key elements: national and international human rights, laws, norms, and standards; resource constraints and progressive realization; obligations of immediate effect; freedoms and entitlements; available, accessible, acceptable, and good quality; respect, protect, and fulfill; non-discrimination, equality, and vulnerability; active and informed participation; international assistance and cooperation; and monitoring and accountability. Whereas public health law plays an essential role in the protection and promotion of the right to health, the emergence of SARS (2003) highlighted the urgent need to reform national public health laws and international obligations relating to public health in order to meet the new realities of a globalized world, leading to the WHO Framework Convention on Tobacco Control (2003) and the revision of the WHO International Health Regulations (2005). The Asian Institute for Bioethics and Health Law, in conjunction with the Republic of Korea's Ministry of Health and Welfare and the WHO International Digest of Health Legislation, conducted a comparative legal analysis of national public health laws in various countries through a project entitled Domestic Profiles of Public/Population Health Legislation (2006), which underscored the importance of recognizing the political and social contexts of distinct legal cultures, including Western, Asian, Islamic, and African.

  14. The MESH approach: strengthening public health systems for the MDGs.

    PubMed

    Thomas, Stephen; Mooney, Gavin; Mbatsha, Sandi

    2007-10-01

    This article addresses some of the complexities in the interactions both within the public health system and between that and civil society. It examines what needs to be done to improve the capacity of health systems, primarily through building relevant infrastructure (what is called MESH--management, economic, social and human - infrastructure) where this is lacking. This lack is most likely to occur in poorer communities and health districts. The problem of absorption and appropriate use of funds in disadvantaged areas has been highlighted as a critical bottleneck to the achievement of the millennium development goals (MDGs). MESH is defined as infrastructure which is built to improve the capacity of communities and other entities to implement health service programs efficiently. We employ this concept to determine how best to invest in health in poor areas so that they can better use any additional resources they receive. The article reviews some initial explorations of the relevance of MESH building strategies in South Africa. The research shows the usefulness of the MESH approach which requires inter alia a more developmental approach that goes beyond the vertical silos of much influential prioritization literature over the last two decades. In practice it is clear that MESH will vary from location to location which reflects the fact that investing in successful health strategies must take into account the voices of the local people with respect to what they want from their health services.

  15. [Public health, genetics and ethics].

    PubMed

    Kottow, Miguel H

    2002-10-01

    Genetics research has shown enormous developments in recent decades, although as yet with only limited clinical application. Bioethical analysis has been unable to deal with the vast problems of genetics because emphasis has been put on the principlism applied to both clinical and research bioethics. Genetics nevertheless poses its most complex moral dilemmas at the public level, where a social brand of ethics ought to supersede the essentially interpersonal perspective of principlism. A more social understanding of ethics in genetics is required to unravel issues such as research and clinical explorations, ownership and patents, genetic manipulation, and allocation of resources. All these issues require reflection based on the requirements of citizenry, consideration of common assets, and definition of public policies in regulating genetic endeavors and protecting the society as a whole Bioethics has privileged the approach to individual ethical issues derived from genetic intervention, thereby neglecting the more salient aspects of genetics and social ethics.

  16. Is there any solution to the "brain drain" of health professionals and knowledge from Africa?

    PubMed

    Muula, Adamson S

    2005-02-01

    African public health care systems suffer from significant "brain drain" of its health care professionals and knowledge as health workers migrate to wealthier countries such as Australia, Canada, USA, and the United Kingdom. Knowledge generated on the continent is not readily accessible to potential users on the continent. In this paper, the brain drain is defined as both a loss of health workers (hard brain drain) and unavailability of research results to users in Africa (soft brain drain). The "pull" factors of "hard brain drain" include better remuneration and working conditions, possible job satisfaction, and prospects for further education, whereas the "push" factors include a lack of better working conditions including promotion opportunities and career advancement. There is also a lack of essential equipment and non-availability or limited availability of specialist training programs on the continent. The causes of "soft brain drain" include lack of visibility of research results in African journals, better prospects for promotion in academic medicine when a publication has occurred in a northern high impact journal, and probably a cultural limitation because many things of foreign origin are considered superior. Advocates are increasingly discussing not just the pull factors but also the "grab" factors emanating from the developed nations. In order to control or manage the outflow of vital human resources from the developing nations to the developed ones, various possible solutions have been discussed. The moral regard to this issue cannot be under-recognized. However, the dilemma is how to balance personal autonomy, right to economic prosperity, right to personal professional development, and the expectations of the public in relation to adequate public health care services in the developing nations.

  17. Stemming the Impact of Health Professional Brain Drain from Africa: A Systemic Review of Policy Options

    PubMed Central

    2013-01-01

    Africa has been losing professionally trained health workers who are the core of the health system of this continent for many years. Faced with an increased burden of disease and coupled by a massive exodus of the health workforce, the health systems of many African nations are risking complete paralysis. Several studies have suggested policy options to reduce brain drain from Africa. The purpose of this paper is to review possible policies, which can stem the impact of health professional brain drain from Africa. A systemic literature review was conducted. Cinahl, Science Direct and PubMed databases were searched with the following terms: health professional brain drain from Africa and policies for reducing impact of brain drain from Africa. References were also browsed for relevant articles. A total of 425 articles were available for the study but only 23 articles met the inclusion criteria. The review identified nine policy options, which were being implemented in Africa, but the most common was task shifting which had success in several African countries. This review has demonstrated that there is considerable consensus on task shifting as the most appropriate and sustainable policy option for reducing the impact of health professional brain drain from Africa.

  18. Addressing health disparities: Brown University School of Public Health.

    PubMed

    Wetle, Terrie Fox; Scanlan, Karen

    2014-09-02

    Health disparities are a public health concern in Rhode Island and around the world. Faculty members and students in the Brown University School of Public Health are working to understand, address, and ultimately eliminate disparities in health and health care affecting diverse populations. Our educational offerings and research efforts are directed toward understanding and addressing the social, cultural, and environmental factors that contribute to these health disparities. Research methods to carry out this work include implementing interdisciplinary, community-based, quantitative and qualitative research with the goal of preventing, reducing, and eliminating health disparities. This article focuses on some of the School's work with vulnerable communities confronting issues around the following: HIV/AIDS, obesity, nutrition, physical activity and delivery of health services.

  19. Career Guidance and Public Mental Health

    ERIC Educational Resources Information Center

    Robertson, Peter J.

    2013-01-01

    Career guidance may have the potential to promote public health by contributing positively to both the prevention of mental health conditions and to population level well-being. The policy implications of this possibility have received little attention. Career guidance agencies are well placed to reach key target groups. Producing persuasive…

  20. Public Health Nursing for People with AIDS.

    ERIC Educational Resources Information Center

    Dickinson, Dena; And Others

    Individuals with Acquired Immune Deficiency Syndrome (AIDS) or AIDS-related conditions (ARC) need continual care and support, at a level which can severely tax the health resources of a community. Public health nursing should have a central role in the effective and efficient response to this devastating problem. Since the early stages of the AIDS…

  1. Challenges in Sustaining Public Health Interventions

    ERIC Educational Resources Information Center

    Altman, David G.

    2009-01-01

    Sustainability remains a key challenge in public health. The perspective article by Fagen and Flay adds to our understanding of technical factors associated with sustaining health interventions in schools. In this commentary, the Fagen and Flay article (2009) is considered within the broader literature on sustainability. By taking a broad view,…

  2. Nuclear Education in Public Health and Nursing.

    ERIC Educational Resources Information Center

    Winder, Alvin E.; Stanitis, Mary Anne

    1988-01-01

    A survey of 20 public health schools and 240 university schools of nursing found that nuclear war related content was most likely to be appear in disaster nursing and in environmental health courses. Innovative curricula included political action projects for nuclear war prevention. (FMW)

  3. 'Doing' public health and 'making' public health practitioners: putting policy into practice in 'Starting Well'.

    PubMed

    Mackenzie, Mhairi

    2008-09-01

    Public health policy has arguably taken a new direction in the UK since 1997. This is typified by a review of the public health workforce. A key profession within this workforce is that of health visiting. Starting Well, a Scottish National Health Demonstration Project is one attempt to develop the public health role of health visitors. The project aimed to improve child health by providing intensive home visiting to families in Glasgow. This paper reports on a process study focused on whether Starting Well, an intervention exemplifying contemporary public health policy, could be operationalised through health visiting practice. Semi-structured interviews were conducted with a purposive sample of 44 staff responsible for developing and implementing the programme. Whilst greater contact with families allowed health visitors to develop their understanding of the life circumstances of their case-load families, the evaluation raised issues about the feasibility of systematically changing practice and demonstrated the difficulties of implementing an approach that relied as much on individual values and organisational context as formal guidelines and standardised tools. Furthermore, the ability of the systems and structures within which practitioners were operating to facilitate a broad public health approach was limited. The policy context for public health demands that increasing numbers of health workers are familiar with its principles and modus operandi. It remains, however, a contested area of work and its implementation requires change at a number of levels. This has implications for current policy assumptions about improving population health.

  4. Environmental health impacts of dispersed mineralisation in South Africa

    NASA Astrophysics Data System (ADS)

    Davies, T. C.; Mundalamo, H. R.

    2010-11-01

    The crust of South Africa has undergone various episodes and styles of mineralisation, dating as far back as the Archaean. The suite of minerals produced is diverse and includes metals, non-metals and industrial minerals. Since the Pleistocene, substantial quantities of elements, both nutritional and toxic, that were involved in ore forming processes, have been remobilised and redistributed by surficial processes of intense tropical weathering, leaching, eluviation, podsolisation and gleying; and more recently, by mining and related processes, as well as by other urban and industrial activities. As a result of this "dispersion" it is not uncommon to find large tracts of the country containing anomalous trace element contents or deficiencies in essential micro-nutrient elements. Through water and food crops, extremes in trace element variation in soils are transmitted into the food chain, with often undesirable consequences for human and animal health. But the known variations are not as yet adequately documented. Nor is there sufficient knowledge on the implications of these variations for the health of the environment and its ecosystems. Nutrient deficient soils may be the principal causative factor in the devastating endemic osteoarthritic disease that afflicts two-thirds of the women in Maputaland, for instance. The generally low Se status of agricultural soils could represent an important co-factor in the relatively high diffusion rates of HIV-AIDS in the country. The impact of geology on animal health also remains an area of critical concern to both farmers and managers of the hugely important wildlife game reserves. This paper discusses a few known relationships between trace element excess/deficiency stemming originally from mineralisation processes, and the local and regional distribution of diseases in man and animals in South Africa. It is submitted that the challenge for future research in medical geology would lie in an organised effort aimed at

  5. From apartheid to neoliberalism: health equity in post-apartheid South Africa.

    PubMed

    Baker, Peter A

    2010-01-01

    In 1994, the African National Congress (ANC) won South Africa's first ever democratic election. It inherited a health service that was indelibly marked with the inequities of the apartheid era, highly privatized and distorted toward the hospital needs of urban Whites. The ANC's manifesto promised major improvements, but this study finds only two significant health equity improvements: (1) primary care had funding increased by 83 percent and was better staffed; and (2) health care workers became significantly more race-representative of the population. These improvements, however, were outweighed by equity losses in the deteriorating public-private mix. Policy analysis of the elite actors attributes this failure to the dominance of the Treasury's neoliberal macroeconomic policy (GEAR), which severely limited any increases in public spending. The ANC's nationalist ideology underpinned GEAR and many of the health equity decisions. It united the ANC, international capital, African elites, and White capital in a desire for an African economic renaissance. And it swept the population along with it, becoming the new hegemonic ideology. As this study finds, the successful policies were those that could be made a part of this active hegemonic reformation, symbolically celebrating African nationalism, and did not challenge the interests of the major actors.

  6. Public Health 101 Nanocourse: A Condensed Educational Tool for Non–Public Health Professionals

    PubMed Central

    Gajdos, Zofia K. Z.; Kreatsoulas, Catherine; Afeiche, Myriam C.; Asgarzadeh, Morteza; Nelson, Candace C.; Kanjee, Usheer; Caban-Martinez, Alberto J.

    2015-01-01

    Graduate students and postdoctoral fellows—including those at the Harvard School of Public Health (HSPH)—have somewhat limited opportunities outside of traditional coursework to learn holistically about public health. Because this lack of familiarity could be a barrier to fruitful collaboration across disciplines, HSPH postdocs sought to address this challenge. In response, the Public Health 101 Nanocourse was developed to provide an overview of five core areas of public health (biostatistics, environmental health sciences, epidemiology, health policy and management, and social and behavioral sciences) in a two half-day course format. We present our experiences with developing and launching this novel approach to acquainting wider multidisciplinary audiences with the field of public health. PMID:25706019

  7. Public health 101 nanocourse: a condensed educational tool for non-public health professionals.

    PubMed

    Ramirez, Cherie L; Gajdos, Zofia K Z; Kreatsoulas, Catherine; Afeiche, Myriam C; Asgarzadeh, Morteza; Nelson, Candace C; Kanjee, Usheer; Caban-Martinez, Alberto J

    2015-03-01

    Graduate students and postdoctoral fellows-including those at the Harvard School of Public Health (HSPH)-have somewhat limited opportunities outside of traditional coursework to learn holistically about public health. Because this lack of familiarity could be a barrier to fruitful collaboration across disciplines, HSPH postdocs sought to address this challenge. In response, the Public Health 101 Nanocourse was developed to provide an overview of five core areas of public health (biostatistics, environmental health sciences, epidemiology, health policy and management, and social and behavioral sciences) in a two half-day course format. We present our experiences with developing and launching this novel approach to acquainting wider multidisciplinary audiences with the field of public health.

  8. Algal blooms and public health

    SciTech Connect

    Epstein, P.R. . Harvard Medical School)

    1993-06-01

    Alterations in coastal ecology are expanding the geographic extent, frequency, magnitude, and species complexity'' of algal blooms throughout the world, increasing the threat of fish and shellfish poisonings, anoxia in marine nurseries, and of cholera. The World Health Organization and members of the medical profession have described the potential health effects of global climate change. They warn of the consequences of increased ultraviolet-B (UV-B) rays and of warming: the possible damage to agriculture and nutrition, and the impact on habitats which may alter the distribution of vector-borne and water-based infectious diseases. Algal growth due to increased nitrogen (N) and phosphorus (P) and warming are already affecting marine microflora and aquatic plants; and there is now clear evidence that marine organisms are a reservoir for enteric pathogens. The pattern of cholera in the Western Hemisphere suggests that environmental changes have already begun to influence the epidemiology of this infectious disease. 106 refs.

  9. Psychology and health after apartheid: Or, Why there is no health psychology in South Africa.

    PubMed

    Yen, Jeffery

    2016-05-01

    As part of a growing literature on the histories of psychology in the Global South, this article outlines some historical developments in South African psychologists' engagement with the problem of "health." Alongside movements to formalize and professionalize a U.S.-style "health psychology" in the 1990s, there arose a parallel, eclectic, and more or less critical psychology that contested the meaning and determinants of health, transgressed disciplinary boundaries, and opposed the responsibilization of illness implicit in much health psychological theorizing and neoliberal discourse. This disciplinary bifurcation characterized South African work well into the postapartheid era, but ideological distinctions have receded in recent years under a new regime of knowledge production in thrall to the demands of the global market. The article outlines some of the historical-political roots of key trends in psychologists' work on health in South Africa, examining the conditions that have impinged on its directions and priorities. It raises questions about the future trajectories of psychological research on health after 20 years of democracy, and argues that there currently is no "health psychology" in South Africa, and that the discipline is the better for it.

  10. PUBLIC HEALTH IN EASTERN MACEDONIA

    PubMed Central

    White, Paul Dudley

    1920-01-01

    In Macedonia a band of devoted, associated physicians fought the plagues of the nearer Orient, a splendid example of cosmopolitan coöperation. Here is the story as viewed by American eyes of a work which is fundemental in the removal of a very serious menace to the health of the world. Imagesp15-ap15-bp16-ap17-ap17-bp18-ap19-ap20-a PMID:18010227

  11. [Water fluoridation and public health].

    PubMed

    Barak, Shlomo

    2003-11-01

    Fluoridation in Israel was first mooted in 1973 and finally incorporated into law in November 2002 obligating the Ministry of Health to add fluoride to the nation's water supply. Epidemiology studies in the USA have shown that the addition of one part per million of fluoride to the drinking water reduced the caries rate of children's teeth by 50% to 60% with no side effects. Both the WHO in 1994 and the American Surgeon General's report of 2000 declared that fluoridation of drinking water was the safest and most efficient way of preventing dental caries in all age groups and populations. Opposition to fluoridation has arisen from "antifluoridation" groups who object to the "pollution" of drinking water by the addition of chemicals and mass medication in violation of the "Patient's Rights" law and the Basic Law of Human Dignity and Liberty. A higher prevalence of hip fractures in elderly osteoporotic women and osteosarcoma in teenagers has been reported in areas where excess fluoride exists in the drinking water. However, none of the many independent professional committees reviewing the negative aspects of fluoridation have found any scientific evidence associating fluoridation with any ill-effects or health problems. In Israel, where dental treatment is not included in the basket of Health Services, fluoridation is the most efficient and cheapest way of reducing dental disease, especially for the poorer members of the population.

  12. Remote Sensing, Air Quality, and Public Health

    NASA Technical Reports Server (NTRS)

    Quattrochi, Dale A.; Rickman, Douglas; Mohammad, Al-Hamdan; Crosson, William; Estes, Maurice, Jr.; Limaye, Ashutosh; Qualters, Judith

    2008-01-01

    HELIX-Atlanta was developed to support current and future state and local EPHT programs to implement data linking demonstratio'n projects which could be part of the EPHT Network. HELIX-Atlanta is a pilot linking project in Atlanta for CDC to learn about the challenges the states will encounter. NASA/MSFC and the CDC are partners in linking environmental and health data to enhance public health surveillance. The use of NASA technology creates value - added geospatial products from existing environmental data sources to facilitate public health linkages. Proving the feasibility of the approach is the main objective

  13. Integrating Social Theory Into Public Health Practice

    PubMed Central

    Potvin, Louise; Gendron, Sylvie; Bilodeau, Angèle; Chabot, Patrick

    2005-01-01

    The innovative practice that resulted from the Ottawa Charter challenges public health knowledge about programming and evaluation. Specifically, there is a need to formulate program theory that embraces social determinants of health and local actors’ mobilization for social change. Likewise, it is imperative to develop a theory of evaluation that fosters reflexive understanding of public health programs engaged in social change. We believe advances in contemporary social theory that are founded on a critique of modernity and that articulate a coherent theory of practice should be considered when addressing these critical challenges. PMID:15798114

  14. The public health impact of tsunami disasters.

    PubMed

    Keim, Mark E

    2011-01-01

    Tsunamis have the potential to cause an enormous impact on the health of millions of people. During the last half of the twentieth century, more people were killed by tsunamis than by earthquakes. Most recently, a major emergency response operation has been underway in northeast Japan following a devastating tsunami triggered by the biggest earthquake on record in Japan. This natural disaster has been described as the most expensive in world history. There are few resources in the public health literature that describe the characteristics and epidemiology of tsunami-related disasters, as a whole. This article reviews the phenomenology and impact of tsunamis as a significant public health hazard.

  15. Public engagement on global health challenges

    PubMed Central

    Cohen, Emma RM; Masum, Hassan; Berndtson, Kathryn; Saunders, Vicki; Hadfield, Tom; Panjwani, Dilzayn; Persad, Deepa L; Minhas, Gunjeet S; Daar, Abdallah S; Singh, Jerome A; Singer, Peter A

    2008-01-01

    Background Experience with public engagement activities regarding the risks and benefits of science and technology (S&T) is growing, especially in the industrialized world. However, public engagement in the developing world regarding S&T risks and benefits to explore health issues has not been widely explored. Methods This paper gives an overview about public engagement and related concepts, with a particular focus on challenges and benefits in the developing world. We then describe an Internet-based platform, which seeks to both inform and engage youth and the broader public on global water issues and their health impacts. Finally, we outline a possible course for future action to scale up this and similar online public engagement platforms. Results The benefits of public engagement include creating an informed citizenry, generating new ideas from the public, increasing the chances of research being adopted, increasing public trust, and answering ethical research questions. Public engagement also fosters global communication, enables shared experiences and methodology, standardizes strategy, and generates global viewpoints. This is especially pertinent to the developing world, as it encourages previously marginalized populations to participate on a global stage. One of the core issues at stake in public engagement is global governance of science and technology. Also, beyond benefiting society at large, public engagement in science offers benefits to the scientific enterprise itself. Conclusion Successful public engagement with developing world stakeholders will be a critical part of implementing new services and technologies. Interactive engagement platforms, such as the Internet, have the potential to unite people globally around relevant health issues. PMID:18492256

  16. Public Health Action Model for Cancer Survivorship

    PubMed Central

    Moore, Angela R.; Buchanan, Natasha D.; Fairley, Temeika L.; Smith, Judith Lee

    2016-01-01

    Long-term objectives associated with cancer survivors have been suggested by Healthy People 2020, including increasing the proportion of survivors living beyond 5 years after diagnosis and improving survivors’ mental and physical health-related quality of life. Prior to reaching these objectives, several intermediate steps must be taken to improve the physical, social, emotional, and financial well-being of cancer survivors. Public health has a role in developing strategic, actionable, and measurable approaches to facilitate change at multiple levels to improve the lives of survivors and their families. The social ecological model has been used by the public health community as the foundation of multilevel intervention design and implementation, encouraging researchers and practitioners to explore methods that promote internal and external changes at the individual, interpersonal, organizational, community, and policy levels. The survivorship community, including public health professionals, providers, policymakers, survivors, advocates, and caregivers, must work collaboratively to identify, develop, and implement interventions that benefit cancer survivors. The National Action Plan for Cancer Survivorship highlights public health domains and associated strategies that can be the impetus for collaboration between and among the levels in the social ecological model and are integral to improving survivor outcomes. This paper describes the Public Health Action Model for Cancer Survivorship, an integrative framework that combines the National Action Plan for Cancer Survivorship with the social ecological model to demonstrate how interaction among the various levels may promote better outcomes for survivors. PMID:26590641

  17. Patterns in PARTNERing across Public Health Collaboratives

    PubMed Central

    Bevc, Christine A.; Retrum, Jessica H.; Varda, Danielle M.

    2015-01-01

    Inter-organizational networks represent one of the most promising practice-based approaches in public health as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically public health networks (n = 162), to better understand the structured relationships and interactions among public health organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of public health collaboratives in a series of Exponential Random Graph (ERG) models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen public health practice partnerships. PMID:26445053

  18. Risk communication for public health emergencies.

    PubMed

    Glik, Deborah C

    2007-01-01

    This review defines crisis risk communication, traces its origins to a number of applied fields, and then shows how basic principles have become incorporated into emergency preparedness and risk communication for public health. Literature from four different disciplines that inform crisis risk communications are reviewed. These are (a) environmental risk communication, (b) disaster management, (c) health promotion and communication, and (d) media and communication studies. Current curricula and training materials are briefly reviewed. Although this literature review suggests much progress has been made to incorporate and disseminate crisis risk communication principles into public health practice, and case studies suggest that public health workers have gained skills and experience, this emerging field still lacks in-depth evaluation of the effectiveness of event-specific crisis risk communication efforts.

  19. The politics of public health policy.

    PubMed

    Oliver, Thomas R

    2006-01-01

    Politics, for better or worse, plays a critical role in health affairs. The purpose of this article is to articulate a role for political analysis of public health issues, ranging from injury and disease prevention to health care reform. It begins by examining how health problems make it onto the policy agenda. Perceptions regarding the severity of the problem, responsibility for the problem, and affected populations all influence governmental responses. Next, it considers how bounded rationality, fragmented political institutions, resistance from concentrated interests, and fiscal constraints usually lead political leaders to adopt incremental policy changes rather than comprehensive reforms even when faced with serious public health problems. It then identifies conditions under which larger-scale transformation of health policy can occur, focusing on critical junctures in policy development and the role of policy entrepreneurs in seizing opportunities for innovation. Finally, it reviews the challenges confronting officials and agencies who are responsible for implementing and administering health policies. Public health professionals who understand the political dimensions of health policy can conduct more realistic research and evaluation, better anticipate opportunities as well as constraints on governmental action, and design more effective policies and programs.

  20. Community health workers and the response to HIV/AIDS in South Africa: tensions and prospects.

    PubMed

    Schneider, Helen; Hlophe, Hlengiwe; van Rensburg, Dingie

    2008-05-01

    After a decline in enthusiasm for national community health worker (CHW) programmes in the 1980s, these have re-emerged globally, particularly in the context of HIV. This paper examines the case of South Africa, where there has been rapid growth of a range of lay workers (home-based carers, lay counsellors, DOT supporters etc.) principally in response to an expansion in budgets and programmes for HIV, most recently the rollout of antiretroviral therapy (ART). In 2004, the term community health worker was introduced as the umbrella concept for all the community/lay workers in the health sector, and a national CHW Policy Framework was adopted. We summarize the key features of the emerging national CHW programme in South Africa, which include amongst others, their integration into a national public works programme and the use of non-governmental organizations as intermediaries. We then report on experiences in one Province, Free State. Over a period of 2 years (2004--06), we made serial visits on three occasions to the first 16 primary health care facilities in this Province providing comprehensive HIV services, including ART. At each of these visits, we did inventories of CHW numbers and training, and on two occasions conducted facility-based group interviews with CHWs (involving a total of 231 and 182 participants, respectively). We also interviewed clinic nurses tasked with supervising CHWs. From this evaluation we concluded that there is a significant CHW presence in the South African health system. This infrastructure, however, shares many of the managerial challenges (stability, recognition, volunteer vs. worker, relationships with professionals) associated with previous national CHW programmes, and we discuss prospects for sustainability in the light of the new policy context.

  1. Building on Experience: A Formative Evaluation of a Peer Education Sexual Health Project in South Africa

    ERIC Educational Resources Information Center

    Warwick, Ian; Aggleton, Peter

    2004-01-01

    In South Africa, as elsewhere in the world, the promise of peer education as a means of promoting sexual health has contributed to its increasing popularity. While structural and organisational constraints can compromise the success of peer education, many of those involved in modest local programmes in South Africa are able to address the sexual…

  2. International trends in health science librarianship part 14: East Africa (Kenya, Uganda, Rwanda).

    PubMed

    Gathoni, Nasra; Kamau, Nancy; Nannozi, Judith; Singirankabo, Marcel

    2015-06-01

    This is the 14th in a series of articles exploring international trends in health science librarianship in the 21st century. This is the second of four articles pertaining to different regions in the African continent. The present issue focuses on countries in East Africa (Kenya, Uganda and Rwanda). The next feature column will investigate trends in West Africa. JM.

  3. Rural Africana. Current Research in the Social Sciences -- No. 17, Rural Health in Africa.

    ERIC Educational Resources Information Center

    Messing, Simon D., Ed.; And Others

    The document is one in a series devoted to current research in the social sciences, exploring the problems of social and economic development in rural Africa south of the Sahara. Each issue focuses on a specific problem. This document covers rural health in Africa. The 13 papers are divided into 4 sections: (1) cultural, economic, and political…

  4. Health policy: Reducing rheumatic heart disease in Africa -- time for action.

    PubMed

    Beaton, Andrea; Sable, Craig

    2016-04-01

    Rheumatic heart disease (RHD) key opinion leaders, health ministers, clinicians, and industry representatives gathered in Ethiopia in February 2015. The question: how to eradicate RHD in Africa. The response: the Addis Ababa communiqué, a practical document outlining seven major barriers to RHD control in Africa and seven strategies to address them.

  5. Epidemiology, Etiology, and Public Health

    SciTech Connect

    Weller, Richard E.

    2000-02-23

    Veterinary oncology has seen tremendous growth since the first textbook devoted to the subject in the late 1970s. Cancer is usually at the top of the list when owners ask about health concerns for their pets (and it remains the leading cause of death among dogs and cats). The volume, Veterinary Oncology Secrets, joins others in the series by presenting in question and answer format the type of information so important to veterinary students, interns and residents, general practitioners, and specialists in a number of clinical fields.

  6. The invisibilization of health promotion in Australian public health initiatives.

    PubMed

    O'Hara, Lily; Taylor, Jane; Barnes, Margaret

    2016-07-19

    The field of health promotion has arguably shifted over the past thirty years from being socially proactive to biomedically defensive. In many countries this has been accompanied by a gradual decline, or in some cases the almost complete removal of health promotion designated positions within Government health departments. The language or discourse used to describe the practice and discipline of health promotion is reflective of such changes. In this study, critical discourse analysis was used to determine the representation of health promotion as a practice and a discipline within 10 Australian Government weight-related public health initiatives. The analysis revealed the invisibilization of critical health promotion in favour of an agenda described as 'preventive health'. This was achieved primarily through the textual practices of overlexicalization and lexical suppression. Excluding document titles, there were 437 uses of the terms health promotion, illness prevention, disease prevention, preventive health, preventative health in the documents analysed. The term 'health promotion' was used sparingly (16% of total terms), and in many instances was coupled with the term 'illness prevention'. Conversely, the terms 'preventive health' and 'preventative health' were used extensively, and primarily used alone. The progressive invisibilization of critical health promotion has implications for the perceptions and practice of those identifying as health promotion professionals and for people with whom we work to address the social and structural determinants of health and wellbeing. Language matters, and the language and intent of critical health promotion will struggle to survive if its speakers are professionally unidentifiable or invisible.

  7. Soils and public health: the vital nexus

    NASA Astrophysics Data System (ADS)

    Pachepsky, Yakov

    2015-04-01

    Soils sustain life. They affect human health via quantity, quality, and safety of available food and water, and via direct exposure of individuals to soils. Throughout the history of civilization, soil-health relationships have inspired spiritual movements, philosophical systems, cultural exchanges, and interdisciplinary interactions, and provided medicinal substances of paramount impact. Given the climate, resource, and population pressures, understanding and managing the soil-health interactions becomes a modern imperative. We are witnessing a paradigm shift from recognizing and yet disregarding the 'soil-health' nexus complexity to parameterizing this complexity and identifying reliable controls. This becomes possible with the advent of modern research tools as a source of 'big data' on multivariate nonlinear soil systems and the multiplicity of health metrics. The phenomenon of suppression of human pathogens in soils and plants presents a recent example of these developments. Evidence is growing about the dependence of pathogen suppression on the soil microbial community structure which, in turn, is affected by the soil-plant system management. Soil eutrophication appears to create favorable conditions for pathogen survival. Another example of promising information-rich research considers links and feedbacks between the soil microbial community structure and structure of soil physical pore space. The two structures are intertwined and involved in the intricate self-organization that controls soil services to public health. This, in particular, affects functioning of soils as a powerful water filter and the capacity of this filter with respect to emerging contaminants in both 'green' and 'blue' waters. To evaluate effects of soil services to public health, upscaling procedures are needed for relating the fine-scale mechanistic knowledge to available coarse-scale information on soil properties and management. More needs to be learned about health effects of soils

  8. Blurring personal health and public priorities: an analysis of celebrity health narratives in the public sphere.

    PubMed

    Beck, Christina S; Aubuchon, Stellina M; McKenna, Timothy P; Ruhl, Stephanie; Simmons, Nathaniel

    2014-01-01

    This article explores the functions of personal celebrity health narratives in the public sphere. This study examines data about 157 celebrities, including athletes, actors, musicians, and politicians, who have shared private information regarding a personal health situation (or that of a loved one) with others in the public domain. Part of a larger project on celebrity health narratives, this article highlights three key functions that celebrity health narratives perform--education, inspiration, and activism--and discusses the implications for celebrities and for public conversations about health-related issues.

  9. Mental health training for health workers in Africa: a systematic review.

    PubMed

    Liu, Germaine; Jack, Helen; Piette, Angharad; Mangezi, Walter; Machando, Debra; Rwafa, Chido; Goldenberg, Matthew; Abas, Melanie

    2016-01-01

    Commitment to building mental health treatment capacity in Africa is increasing but little agreement exists on strategies to train health workers on mental health or evaluation of training efforts. We systematically reviewed published literature on interventions to train health-care workers in Africa on mental health. 37 studies met our inclusion criteria. Training outcomes focused on changes in knowledge and attitude, with few studies evaluating skill and practice and only two studies measuring clinical outcomes. Quality of study methodology was generally not high, with scarce follow-up data and use of control cohorts. Existing studies provide examples of many training and evaluation strategies, but evidence to draw conclusions about the efficacy of different training techniques is inadequate. Key knowledge gaps include development and testing of innovative educational strategies; development of standardised, competency-based learning objectives and outcome measures; and training that facilitates implementation of integrated mental health systems. African institutions need to be empowered to do research in these areas to encourage the development of best practices for the continent.

  10. Association of Schools and Programs of Public Health

    MedlinePlus

    ... Search Find an Academic Program Discover Discover Overview Public health protects and improves the health of individuals, families, ... Services and Natural Disasters Health Disparities Profiles in Public Health Study Study Overview Graduates of CEPH-accredited schools ...

  11. Activism: working to reduce maternal mortality through civil society and health professional alliances in sub-Saharan Africa.

    PubMed

    Ray, Sunanda; Madzimbamuto, Farai; Fonn, Sharon

    2012-06-01

    Partnerships between civil society groups campaigning for reproductive and human rights, health professionals and others could contribute more to the strengthening of health systems needed to bring about declines in maternal deaths in Africa. The success of the HIV treatment literacy model developed by the Treatment Action Campaign in South Africa provides useful lessons for activism on maternal mortality, especially the combination of a right-to-health approach with learning and capacity building, community networking, popular mobilisation and legal action. This paper provides examples of these from South Africa, Botswana, Kenya and Uganda. Confidential enquiries into maternal deaths can be powerful instruments for change if pressure to act on their recommendations is brought to bear. Shadow reports presented during UN human rights country assessments can be used in a similar way. Public protests and demonstrations over avoidable deaths have succeeded in drawing attention to under-resourced services, shortages of supplies, including blood for transfusion, poor morale among staff, and lack of training and supervision. Activists could play a bigger role in holding health services, governments, and policy-makers accountable for poor maternity services, developing user-friendly information materials for women and their families, and motivating appropriate human resources strategies. Training and support for patients' groups, in how to use health facility complaints procedures is also a valuable strategy.

  12. The new frontier of public health education.

    PubMed

    Birnbaum, David; Gretsinger, Kathryn; Ellis, Ursula

    2017-02-06

    Purpose The aim of this paper is to describe the experience and educational benefits of a course that has several unique educational design features. Design/methodology/approach This includes narrative description of faculty and student experience from participants in a flipped-instructional-design inter-professional education course. Findings "Improving Public Health - An Interprofessional Approach to Designing and Implementing Effective Interventions" is an undergraduate public health course open to students regardless of background. Its student activities mirror the real-life tasks and challenges of working in a public health agency, including team-building and leadership; problem and project definition and prioritization; evidence-finding and critical appraisal; written and oral presentation; and press interviews. Students successfully developed project proposals to address real problems in a wide range of communities and settings and refined those proposals through interaction with professionals from population and public health, journalism and library sciences. Practical implications Undergraduate public health education is a relatively new endeavor, and experience with this new approach may be of value to other educators. Originality/value Students in this course, journalism graduate students who conducted mock interviews with them and instructors who oversaw the course all describe unique aspects and related personal benefit from this novel approach.

  13. Xenotransplantation: consent, public health and charter issues.

    PubMed

    Caulfield, T A; Robertson, G B

    2001-01-01

    There is a growing body of literature and commentary analyzing the ethical and public policy concerns associated with xenotransplantation. While this technology holds great promise to provide an almost limitless supply of organs for transplantation, there remains grave concern about possible public health ramifications. As a result, it has been recommended that patients who undergo xenotransplantations will need to agree, inter alia, to a lifetime of close health monitoring, participation in an international database and autopsy upon death. It has been suggested that this agreement would transform the nature of informed consent into a "binding contract." Though such draconian measures are understandable given the magnitude of the risks involved, would existing common law and legislation allow their implementation? This paper analyzes relevant Canadian consent and public health law in the context of the xenotransplantation. Canada is a country with a particularly rich body of informed consent jurisprudence--jurisprudence firmly rooted (rightly or not) in the ethical principle of autonomy. In this climate, many of the suggested monitoring strategies would find little support from Canadian law. Before xenotransplantations proceed, policy makers must be sensitive to the legal barriers which exist to the implementation [of] effective public health measures. Effective surveillance programs will require novel approaches to consent and the enactment of specific public health laws.

  14. Challenging urban health: towards an improved local government response to migration, informal settlements, and HIV in Johannesburg, South Africa.

    PubMed

    Vearey, Joanna

    2011-01-01

    This article is a review of the PhD thesis undertaken by Joanna Vearey that explores local government responses to the urban health challenges of migration, informal settlements, and HIV in Johannesburg, South Africa. Urbanisation in South Africa is a result of natural urban growth and (to a lesser extent) in-migration from within the country and across borders. This has led to the development of informal settlements within and on the periphery of urban areas. The highest HIV prevalence nationally is found within urban informal settlements. South African local government has a 'developmental mandate' that calls for government to work with citizens to develop sustainable interventions to address their social, economic, and material needs. Through a mixed-methods approach, four studies were undertaken within inner-city Johannesburg and a peripheral urban informal settlement. Two cross-sectional surveys - one at a household level and one with migrant antiretroviral clients - were supplemented with semi-structured interviews with multiple stakeholders involved with urban health and HIV in Johannesburg, and participatory photography and film projects undertaken with urban migrant communities. The findings show that local government requires support in developing and implementing appropriate intersectoral responses to address urban health. Existing urban health frameworks do not deal adequately with the complex health and development challenges identified; it is essential that urban public health practitioners and other development professionals in South Africa engage with the complexities of the urban environment. A revised, participatory approach to urban health - 'concept mapping' - is suggested which requires a recommitment to intersectoral action, 'healthy urban governance' and public health advocacy.

  15. History of health, a valuable tool in public health

    PubMed Central

    Perdiguero, E; Bernabeu, J; Huertas, R; Rodriguez-Ocana, E

    2001-01-01

    The aim of this article is to highlight the importance of the history of public health for public health research and practice itself. After summarily reviewing the current great vitality of the history of collective health oriented initiatives, we explain three particular features of the historical vantage point in public health, namely the importance of the context, the relevance of a diachronic attitude and the critical perspective. In order to illustrate those three topics, we bring up examples taken from three centuries of fight against malaria, the so called "re-emerging diseases" and the 1918 influenza epidemic. The historical approach enriches our critical perception of the social effects of initiatives undertaken in the name of public health, shows the shortcomings of public health interventions based on single factors and asks for a wider time scope in the assessment of current problems. The use of a historical perspective to examine the plurality of determinants in any particular health condition will help to solve the longlasting debate on the primacy of individual versus population factors, which has been particularly intense in recent times.


Keywords: history PMID:11511647

  16. Health impact assessment as an accountability mechanism for the International Monetary Fund: the case of sub-Saharan Africa.

    PubMed

    O'Keefe, Eileen; Scott-Samuel, Alex

    2010-01-01

    Health impact assessment (HIA) is both an effective tool for promoting healthy public policies and one that has the potential to help hold accountable for their actions those who create unhealthy public policies. This article identifies some of the issues that arise in considering the application of HIA to the operation of the International Monetary Fund (IMF), especially in the context of sub-Saharan Africa. The authors do this in the belief that the IMF's lending conditionalities and macroeconomic policies constitute an important social determinant of health. The recent report of the Commission on Social Determinants of Health has created helpful and timely policy space for the development of a health equity- and human rights-oriented accountability framework for the IMF.

  17. Supplementing Public Health Inspection via Social Media.

    PubMed

    Schomberg, John P; Haimson, Oliver L; Hayes, Gillian R; Anton-Culver, Hoda

    2016-01-01

    Foodborne illness is prevented by inspection and surveillance conducted by health departments across America. Appropriate restaurant behavior is enforced and monitored via public health inspections. However, surveillance coverage provided by state and local health departments is insufficient in preventing the rising number of foodborne illness outbreaks. To address this need for improved surveillance coverage we conducted a supplementary form of public health surveillance using social media data: Yelp.com restaurant reviews in the city of San Francisco. Yelp is a social media site where users post reviews and rate restaurants they have personally visited. Presence of keywords related to health code regulations and foodborne illness symptoms, number of restaurant reviews, number of Yelp stars, and restaurant price range were included in a model predicting a restaurant's likelihood of health code violation measured by the assigned San Francisco public health code rating. For a list of major health code violations see (S1 Table). We built the predictive model using 71,360 Yelp reviews of restaurants in the San Francisco Bay Area. The predictive model was able to predict health code violations in 78% of the restaurants receiving serious citations in our pilot study of 440 restaurants. Training and validation data sets each pulled data from 220 restaurants in San Francisco. Keyword analysis of free text within Yelp not only improved detection of high-risk restaurants, but it also served to identify specific risk factors related to health code violation. To further validate our model we applied the model generated in our pilot study to Yelp data from 1,542 restaurants in San Francisco. The model achieved 91% sensitivity 74% specificity, area under the receiver operator curve of 98%, and positive predictive value of 29% (given a substandard health code rating prevalence of 10%). When our model was applied to restaurant reviews in New York City we achieved 74% sensitivity

  18. Supplementing Public Health Inspection via Social Media

    PubMed Central

    Schomberg, John P.; Haimson, Oliver L.; Hayes, Gillian R.; Anton-Culver, Hoda

    2016-01-01

    Foodborne illness is prevented by inspection and surveillance conducted by health departments across America. Appropriate restaurant behavior is enforced and monitored via public health inspections. However, surveillance coverage provided by state and local health departments is insufficient in preventing the rising number of foodborne illness outbreaks. To address this need for improved surveillance coverage we conducted a supplementary form of public health surveillance using social media data: Yelp.com restaurant reviews in the city of San Francisco. Yelp is a social media site where users post reviews and rate restaurants they have personally visited. Presence of keywords related to health code regulations and foodborne illness symptoms, number of restaurant reviews, number of Yelp stars, and restaurant price range were included in a model predicting a restaurant’s likelihood of health code violation measured by the assigned San Francisco public health code rating. For a list of major health code violations see (S1 Table). We built the predictive model using 71,360 Yelp reviews of restaurants in the San Francisco Bay Area. The predictive model was able to predict health code violations in 78% of the restaurants receiving serious citations in our pilot study of 440 restaurants. Training and validation data sets each pulled data from 220 restaurants in San Francisco. Keyword analysis of free text within Yelp not only improved detection of high-risk restaurants, but it also served to identify specific risk factors related to health code violation. To further validate our model we applied the model generated in our pilot study to Yelp data from 1,542 restaurants in San Francisco. The model achieved 91% sensitivity 74% specificity, area under the receiver operator curve of 98%, and positive predictive value of 29% (given a substandard health code rating prevalence of 10%). When our model was applied to restaurant reviews in New York City we achieved 74

  19. Social marketing: its place in public health.

    PubMed

    Ling, J C; Franklin, B A; Lindsteadt, J F; Gearon, S A

    1992-01-01

    This review of the public health role of social marketing begins by tracing the history of social marketing and noting that social marketing adopts the traditional marketing framework of product, price, place, and promotion and embraces several methods of commercial marketing as well as consumer research. However, no universally acknowledged definition exists. A review of the literature is divided into three time periods representing early theoretical development, the evaluation of experiences, and increasing acceptance. Concerns about social marketing are discussed in terms of ethics, disempowerment, and the commercialization of health information. Examples of social marketing are then provided from developing countries and are analyzed in groupings defined as tangible products, sustained health practices, and service utilization. Practitioners' views and concerns are also reviewed. The strengths of social marketing include knowledge of the audience, systematic use of qualitative methods, use of incentives, closer monitoring, strategic use of the mass media, realistic expectations, aspiring to high standards, and recognition of price. Weaknesses of social marketing include its time, money, and human requirements; the fact that marketing elements are missing (public health lacks the flexibility to adjust products and services to clients' interests and preferences); and the potential serious impact on the future of Public Service Announcements, which may die out because social marketers pay for air time. After placing social marketing in context with other practices designed to achieve social change, the review ends with the prediction that the public health role of social marketing is likely to increase. The World Health Organization's recent call for health promotion and the UN Children's Fund's social mobilization actions are provided as examples of this increased role. It is noted, however, that social marketing alone cannot solve public health problems.

  20. Expert knowledge sourcing for public health surveillance: national tsetse mapping in Uganda.

    PubMed

    Berrang-Ford, Lea; Garton, Kelly

    2013-08-01

    In much of sub-Saharan Africa, availability of standardized and reliable public health data is poor or negligible. Despite continued calls for the prioritization of improved health datasets in poor regions, public health surveillance remains a significant global health challenge. Alternate approaches to surveillance and collection of public health data have thus garnered increasing interest, though there remains relatively limited research evaluating these approaches for public health. Herein, we present a case study applying and evaluating the use of expert knowledge sources for public health dataset development, using the case of vector distributions of Human African Trypanosomiasis (HAT) in Uganda. Specific objectives include: 1) Review the use of expert knowledge sourcing methods for public health surveillance, 2) Review current knowledge on tsetse vector distributions of public health importance in Uganda and the methods used for tsetse mapping in Africa; 3) Quantify confidence of the presence or absence of tsetse flies in Uganda based on expert informant reports, and 4) Assess the reliability and potential utility of expert knowledge sourcing as an alternative or complimentary method for public health surveillance in general and tsetse mapping in particular. Information on tsetse presence or absence, and associated confidence, was collected through interviews with District Entomologist and Veterinary Officers to develop a database of tsetse distributions for 952 sub-counties in Uganda. Results show high consistency with existing maps, indicating potential reliability of modeling approaches, though failing to provide evidence for successful tsetse control in past decades. Expert-sourcing methods provide a novel, low-cost and rapid complimentary approach for triangulating data from prediction modeling where field-based validation is not feasible. Data quality is dependent, however, on the level of expertise and documentation to support confidence levels for

  1. Health Security Intelligence: Assessing the Nascent Public Health Capability

    DTIC Science & Technology

    2012-03-01

    Information Sharing System MOU Memorandum of Understanding NBIC National Biosurveillance Integration Center NCMI National Center for...definition, have come to the fore in the literature, biosurveillance and health security. Biosurveillance , as a term, is too limited to provide the...purposes. The Government Accountability Office (GAO) in a 2006 report on public health infrastructure described biosurveillance as, “…automated

  2. Health of Children in Day Care: Public Health Profiles.

    ERIC Educational Resources Information Center

    Kansas State Dept. of Health and Environment, Topeka.

    Profiles are provided for innovative public health activities that focus on the health of children in day care. All are considered to be models worthy of replication. Profiles depict (1) child care in Arizona; (2) child day care licensing in Connecticut; (3) safeguarding children in day care in Kansas; (4) paired state and local inspection in…

  3. Rapid assessment response (RAR) study: drug use and health risk - Pretoria, South Africa

    PubMed Central

    2011-01-01

    Background Within a ten year period South Africa has developed a substantial illicit drug market. Data on HIV risk among drug using populations clearly indicate high levels of HIV risk behaviour due to the sharing of injecting equipment and/or drug-related unprotected sex. While there is international evidence on and experience with adequate responses, limited responses addressing drug use and drug-use-related HIV and other health risks are witnessed in South Africa. This study aimed to explore the emerging problem of drug-related HIV transmission and to stimulate the development of adequate health services for the drug users, by linking international expertise and local research. Methods A Rapid Assessment and Response (RAR) methodology was adopted for the study. For individual and focus group interviews a semi-structured questionnaire was utilised that addressed key issues. Interviews were conducted with a total of 84 key informant (KI) participants, 63 drug user KI participants (49 males, 14 females) and 21 KI service providers (8 male, 13 female). Results and Discussion Adverse living conditions and poor education levels were cited as making access to treatment harder, especially for those living in disadvantaged areas. Heroin was found to be the substance most available and used in a problematic way within the Pretoria area. Participants were not fully aware of the concrete health risks involved in drug use, and the vague ideas held appear not to allow for concrete measures to protect themselves. Knowledge with regards to substance related HIV/AIDS transmission is not yet widespread, with some information sources disseminating incorrect or unspecific information. Conclusions The implementation of pragmatic harm-reduction and other evidence-based public health care policies that are designed to reduce the harmful consequences associated with substance use and HIV/AIDS should be considered. HIV testing and treatment services also need to be made available in

  4. Sanctions and the struggle for health in South Africa.

    PubMed Central

    Coovadia, H M

    1999-01-01

    This commentary describes the role of a major antiapartheid health organization, the National Medical and Dental Association (NAMDA), in reinforcing and maintaining international pressure on the racist South African government. NAMDA was a constituent of the Mass Democratic Movement (MDM), which was at the forefront in the struggle for freedom in South Africa. NAMDA endorsed the programs of the banned African National Congress (ANC), which included a range of sanctions. Debates within NAMDA on enlarging sanctions into an academic boycott are summarized. The development of a policy of selective academic support, which approved academic exchanges in accord with the aims of the MDM, is explained. Indirect evidence shows that international pressures created by specific types of economic sanctions and the forms of academic boycott decided on by NAMDA achieved their objectives. I have highlighted the tension between these strategies, which resulted in the isolation of the apartheid regime, as well as the responsibility to protect the most vulnerable from the burdens that resulted from these policies. PMID:10511831

  5. Ancestor reverence and mental health in South Africa.

    PubMed

    Berg, Astrid

    2003-06-01

    The great majority of South Africa's people consult traditional healers. The deeper meaning of much traditional healing centres on ancestor reverence. This belief system and its accompanying rituals may positively influence the mental health of the individual and the community. Among traditional Xhosa-speaking peoples, the relationship with the ancestors is given expression in life cycle rituals that have much in common with Western psychotherapeutic principles and practices. The common thread that underpins many rituals is that of making links via concrete, literal means. Examples include the participation of the community in the healing of the individual; the linking of body and mind through dancing and drumming. Dreams form an essential connection between conscious life and the unconscious. Understanding the psychological depth of these practices is important so that a respectful relationship between Western-trained professionals and traditional healers can develop. Analytical psychology, with its notion of the collective unconscious has a particular contribution to make to cross-cultural understanding. The ancestors may be understood as archetypal representations of the collective unconscious.

  6. Building a Nation: Religion and Values in the Public Schools of the USA, Australia, and South Africa

    ERIC Educational Resources Information Center

    Mawdsley, Ralph D.; Cumming, Jacqueline Joy; de Waal, Elda

    2008-01-01

    Although the systems of public schools differ among Australia, South Africa and the USA, all three countries recognize that religion plays a significant role in determining values. All three countries have written constitutions but only South Africa and the USA have a Bill of Rights that protects persons' exercise of religious beliefs. In…

  7. Existing public health surveillance systems for mental health in China.

    PubMed

    Zhou, Wei; Xiao, Shuiyuan

    2015-01-01

    Mental health is a challenging public health issue worldwide and surveillance is crucial for it. However, mental health surveillance has not been developed until recently in certain developed countries; many other countries, especially developing countries, have poor or even no health information systems. This paper presents surveillance related to mental health in China, a developing country with a large population of patients with mental disorders. Detailed information of seven relevant surveillance systems is introduced respectively. From the perspective of utilization, problems including accessibility, comprehensiveness and data quality are discussed. Suggestions for future development are proposed.

  8. China-Africa Health Development Initiatives: Benefits and Implications for Shaping Innovative and Evidence-informed National Health Policies and Programs in Sub-saharan African Countries

    PubMed Central

    Tambo, Ernest; Ugwu, Chidiebere E.; Guan, Yayi; Wei, Ding; Xiao-Ning; Xiao-Nong, Zhou

    2016-01-01

    Background and Introduction: This review paper examines the growing implications of China’s engagement in shaping innovative national initiatives against infectious diseases and poverty control and elimination in African countries. It seeks to understand the factors and enhancers that can promote mutual and innovative health development initiatives, and those that are necessary in generating reliable and quality data for evidence-based contextual policy, priorities and programs. Methods: We examined the China-Africa health cooperation in supporting global health agenda on infectious diseases such as malaria, schistosomiasis, Ebola, TB, HIV/AIDS, neglected tropical diseases (NTDs) prevention, control and elimination spanning a period of 10 years. We reviewed referenced publications, global support data, and extensive sources related to and other emerging epidemics and infectious diseases of poverty, programs and interventions, health systems development issues, challenges, opportunities and investments. Published literature in PubMed, Scopus, Google Scholar, Books and web-based peer-reviewed journal articles, government annual reports were assessed from the first Forum on China-Africa Cooperation (FOCAC) in November 2006 to December 2015 Third Ministerial conferences. Results: Our findings highlight current shared public health challenges and emphasize the need to nurture, develop and establish effective, functional and sustainable health systems capacity to detect and respond to all public health threats and epidemic burdens, evidence-based programs and quality care outcomes. China’s significant health diplomacy emphasizes the importance of health financing in establishing health development commitment and investment in improving the gains and opportunities, importantly efficiency and value health priorities and planning. Conclusions and Global Health Implications: Strengthening China-Africa health development agenda towards collective commitment and investment

  9. The skills gap in hospital management in the South African public health sector.

    PubMed

    Pillay, Rubin

    2008-01-01

    A lack of management capacity has been identified as the key stumbling block to the transformation and reconceptualization of the public sector in South Africa into a more effective, efficient, and responsive system of health delivery. As part of the overall management development process, this research aimed to identify the skills important for public sector health management and to evaluate managers' self-assessed proficiency in each of these skills. A cross-sectional survey using a self-administered questionnaire was conducted among hospital managers in the South African public health sector. Respondents were asked to rate the level of importance that each proposed competency had in their job and to indicate their proficiency in each skill. Self-assessment of levels of competency showed that managers felt most competent in strategic planning, people management, and self-management, and relatively less competent in the task-related skills and their ability to deliver healthcare. People management, self-management, and task-related skills were rated as being most important, followed by strategic management and health delivery skills, respectively. The largest differences between mean importance rating and mean skill rating were for people management skills, task-related and self-management skills. These findings reflect the reality of the local health service environment and the needs of health managers and will be useful in the conceptualization, design, and delivery of health management programs aimed at enhancing current and future management and leadership capacity in the public health sector in South Africa.

  10. Arsenic and human health: epidemiologic progress and public health implications.

    PubMed

    Argos, Maria; Ahsan, Habibul; Graziano, Joseph H

    2012-09-10

    Elevated concentrations of arsenic in groundwater pose a public health threat to millions of people worldwide, including severely affected populations in South and Southeast Asia. Although arsenic is an established human carcinogen and has been associated with a multitude of health outcomes in epidemiologic studies, a mode of action has yet to be determined for some aspects of arsenic toxicity. Herein, we emphasize the role of recent genetic and molecular epidemiologic investigations of arsenic toxicity. Additionally, we discuss considerations for the public health impacts of arsenic exposure through drinking water with respect to primary and secondary prevention efforts.

  11. The Changing Political Undercurrents in Health Services Delivery in Sub-Saharan Africa.

    PubMed

    Ichoku, H E; Ifelunini, A I

    2016-08-03

    This article reviews the changing political undercurrent in health service delivery in Sub-Saharan Africa, chronicling the ideological shift in orientation toward neoliberalism in the health sector, an ideology crafted and introduced into Sub-Saharan Africa by the International Monetary Fund and the World Bank. The article examines the implication of this neoliberal reform on the efficiency in health care provision and on the quality and accessibility of health services by the poor and vulnerable. Drawing inference from countries like Nigeria, the authors argue that the ascendency of neoliberalism in the health systems of Sub-Saharan Africa has engendered unethical practices and introduced elements of moral hazard in the health sector, reducing the incentive for governments to develop effective service delivery over the long term. The authors therefore advocate for a rejection of neoliberal ideology in favor of a universal coverage principle if an inclusive health system is to be developed.

  12. [Financing the public health services. 1967].

    PubMed

    Mascarenhas, Rodolfo Dos Santos

    2006-08-01

    Federal statistic figures show that the Brazilian States altogether have, in their respective territories, a collection of taxes which is higher than the Union one. The highest collection of the Central Government which is shown at the official statistics is due to the excess of collection of the federal taxes over the ones of the States; this usually happens in five or six states, of which, in 1964 Guanabara and São Paulo were responsible for 91% of this difference. One can not change the present system of competence in Public Health Services in the three levels--central, regional and local--without modifying at the same time the present Brazilian tributary system, where the municipal governments received back in 1962 only 5.6 of the general collection of taxes. Figures from 1955 show that the per capita cost of Public Health Services in Brazil, comprising the three levels, was Cr 123 Cr dollars dollars ( 1.82 US dollars), and in 1962, Cr 827 (US 2.30 US dollars). These three levels of government reserved in 1955, 5.6% of the money spent in its total expenditure for Public Health activities; this percentage declined to 4.5% in 1962. In relation to the sum invested on Public Health government activities, the Union spent in 1962, 36.4% of the total expenses, the States 59.3% and the counties only 5.5%. There is a great disproportion in the distribution of Public Health expenditure among the various Brazilian States, ranging from a minimal percentage over the total public expenses such as the case of Goiás (1.6% in 1964) up to a maximum of 17.2% in Pará in the same year. There is also a considerable variation from one state to another and in 1964 it ranged from the lowest limit of 70 Cr dollars in Maranhão up to 5.217 in Guanabara. If we analyze the per capita expenses of each state with Public Health activities, using 1964 and 1954 figures represented in 1964 monetary values, we can verify that the expenditure of 20 states dropped of 17.2%. One can not know

  13. Public Health, Ethics, and Autonomous Vehicles.

    PubMed

    Fleetwood, Janet

    2017-04-01

    With the potential to save nearly 30 000 lives per year in the United States, autonomous vehicles portend the most significant advance in auto safety history by shifting the focus from minimization of postcrash injury to collision prevention. I have delineated the important public health implications of autonomous vehicles and provided a brief analysis of a critically important ethical issue inherent in autonomous vehicle design. The broad expertise, ethical principles, and values of public health should be brought to bear on a wide range of issues pertaining to autonomous vehicles.

  14. Public Health, Ethics, and Autonomous Vehicles

    PubMed Central

    2017-01-01

    With the potential to save nearly 30 000 lives per year in the United States, autonomous vehicles portend the most significant advance in auto safety history by shifting the focus from minimization of postcrash injury to collision prevention. I have delineated the important public health implications of autonomous vehicles and provided a brief analysis of a critically important ethical issue inherent in autonomous vehicle design. The broad expertise, ethical principles, and values of public health should be brought to bear on a wide range of issues pertaining to autonomous vehicles. PMID:28207327

  15. What does social justice require for the public's health? Public health ethics and policy imperatives.

    PubMed

    Gostin, Lawrence O; Powers, Madison

    2006-01-01

    Justice is so central to the mission of public health that it has been described as the field's core value. This account of justice stresses the fair disbursement of common advantages and the sharing of common burdens. It captures the twin moral impulses that animate public health: to advance human well-being by improving health and to do so particularly by focusing on the needs of the most disadvantaged. This Commentary explores how social justice sheds light on major ongoing controversies in the field, and it provides examples of the kinds of policies that public health agencies, guided by a robust conception of justice, would adopt.

  16. [Status report on public health in Mauritius in 2009].

    PubMed

    D'Aoust, L; Munbodh, P; Sookram, C; Paratian, U; Gaüzère, B A; Aubry, P

    2010-06-01

    Mauritius is an island nation off the coast of Africa in the southwestern Indian Ocean. Improved socio-sanitation conditions over the past years have dramatically decreased the incidence of tropical diseases to levels comparable with those observed in developed countries. Some tropical illnesses including malaria, schistosomiasis, cysticercosis and lymphatic filariasis have been eradicated. Others such as amibiasis, typhoid fever and leprosy have become rare. However, because of the island's geographical proximity to countries with uncontrolled and suboptimal socio-sanitation conditions and its humid subtropical climate, there is a continued risk for certain vector transmitted tropical diseases such as Chikungunya and dengue. In addition, the incidence of HIV infection and AIDS has been rising rapidly since 2004 and tuberculosis remains a public health problem. Better living conditions have also been accompanied by an increase in cardiovascular and metabolic diseases that, along with cancer, are now the main causes of morbidity and mortality.

  17. Developing integrated multistate environmental public health surveillance.

    PubMed

    Wartenberg, Daniel; Thompson, W Douglas; Fitzgerald, Edward F; Gross, Hillary J; Condon, Suzanne K; Kim, Nancy; Goun, Barbara D; Opiekun, Richard E

    2008-01-01

    Environmental exposures cause substantial morbidity and mortality in the United States. A major goal of Centers for Disease Control and Prevention Environmental Public Health Tracking program is the development of a national network of health and environmental data with analytic tools for rapid evaluation of specific national or regional environmental health concerns. A six-state collaborative project in the northeast United States was established to assess the feasibility of such a system, assessing the possible association between ambient air quality and adverse birth outcomes. For this regional surveillance project, issues were discussed surrounding the design of a mutually acceptable protocol, obtaining human subjects' protection approvals, obtaining and organizing both the exposure and outcome data, analyzing the data both locally and regionally, and planning subsequent interventions to address identified public health concerns.

  18. Gender equality as a means to improve maternal and child health in Africa.

    PubMed

    Singh, Kavita; Bloom, Shelah; Brodish, Paul

    2015-01-01

    In this article we examine whether measures of gender equality, household decision making, and attitudes toward gender-based violence are associated with maternal and child health outcomes in Africa. We pooled Demographic and Health Surveys data from eight African countries and used multilevel logistic regression on two maternal health outcomes (low body mass index and facility delivery) and two child health outcomes (immunization status and treatment for an acute respiratory infection). We found protective associations between the gender equality measures and the outcomes studied, indicating that gender equality is a potential strategy to improve maternal and child health in Africa.

  19. Developing an academia-based public health observatory: the new global public health observatory with emphasis on urban health at Johns Hopkins Bloomberg School of Public Health.

    PubMed

    Castillo-Salgado, Carlos

    2015-11-01

    Health observatories may differ according to their mission, institutional setting, topical emphasis or geographic coverage. This paper discusses the development of a new urban-focused health observatory, and its operational research and training infrastructure under the academic umbrella of the Department of Epidemiology and the Institute of Urban Health at the Johns Hopkins Bloomberg School of Public Health (BSPH) in Baltimore, USA. Recognizing the higher education mission of the BSPH, the development of a new professional training in public health was an important first step for the development of this observatory. This new academia-based observatory is an innovative public health research and training platform offering faculty, investigators, professional epidemiology students and research partners a physical and methodological infrastructure for their operational research and training activities with both a local urban focus and a global reach. The concept of a public health observatory and its role in addressing social health inequalities in local urban settings is discussed.

  20. "How I Floated on Gentle Webs of Being": Psychiatrists Stories About the Mental Health Treatment Gap in Africa.

    PubMed

    Cooper, Sara

    2016-09-01

    A strong movement has emerged recently which is highlighting the high levels of untreated mental illness in Africa and making proposals for reducing this 'gap' in mental health care. This movement has been criticised for insufficiently attending to the epistemologies embedded in its recommendations, and inadequately considering the views of practitioners 'on the ground'. Employing a narrative-based approach, I accessed the stories about the mental health 'treatment gap' of 28 psychiatrists all working clinically in public mental health care settings in South Africa, Uganda, Nigeria or Ethiopia. Rather than focusing on the content of these stories, I was more interested in their underpinning meaning-codes and epistemological politics. Dominant thinking about the 'treatment gap' was heavily informed by a biomedical paradigm, and associated epistemological order of European Colonial Modernity. There were, however, cracks in this master narrative, which crystalised in the stories that were told by three particular psychiatrists. Their narratives operated within an alternative paradigm, one which appears to be informed by the tradition of phenomenology, and in particular the ideas associated with French philosopher Merleau-Ponty. This more marginalised thinking may offer important insights into reducing the mental health 'treatment gap' in Africa in ways very different from those created by current seats of power.

  1. Carrying guns in public: legal and public health implications.

    PubMed

    Vernick, Jon S

    2013-03-01

    In District of Columbia v. Heller, the U.S. Supreme Court ruled that the Second Amendment protects an individual's right to own handguns in the home for protection, invalidating a Washington, D.C. law banning most handgun possession. The Heller decision, however, provided lower courts with little guidance regarding how to judge the constitutionality of gun laws other than handgun bans. Nevertheless, lower courts have upheld the vast majority of federal, state, and local gun laws challenged since Heller. One area in which some lower courts have disagreed has been the constitutionality of laws regulating the ability to carry firearms in public. This issue may be the next to be addressed by the Supreme Court under its evolving Second Amendment jurisprudence. Courts should carefully consider the negative public health and safety implications of gun carrying in public as they weigh the constitutionality of these laws.

  2. Public health impact of large airports.

    PubMed

    Passchier, W; Knottnerus, A; Albering, H; Walda, I

    2000-01-01

    Large airports with the related infrastructure, businesses and industrial activities affect the health of the population living, travelling and working in the surroundings of or at the airport. The employment and contributions to economy from the airport and related operations are expected to have a beneficial effect, which, however, is difficult to quantify. More pertinent data are available on the, largely negative, health effects of environmental factors, such as air and soil pollution, noise, accident risk, and landscape changes. Information on the concurrent and cumulative impact of these factors is lacking, but is of primary relevance for public health policy. A committee of the Health Council of The Netherlands recently reviewed the data on the health impact of large airports. It was concluded that, generally, integrated health assessments are not available. Such assessments, as part of sustainable mobility policy, should accompany the further development of the global aviation system.

  3. Academic health sciences librarians' publication patterns.

    PubMed Central

    Mularski, C A; Bradigan, P S

    1991-01-01

    This study examines the publication patterns of U.S. academic health sciences librarians. A survey was sent to a random sample of Medical Library Association (MLA) members who work in academic settings. Some survey results are consistent with other research while others vary from the findings of previous studies. Faculty status requiring publication may be an incentive to publish; however, a large percentage of librarians in this study published despite the lack of a requirement. Academic health sciences librarians without advanced degrees other than a master's in library science produced about three quarters of the publications, whereas their colleagues with advanced degrees published slightly more than 25% of the publications. Results concerning professional maturity, position, and geographic location reflect findings of earlier studies of academic librarians' publication patterns. Publication productivity generally increased with professional maturity, most authors held administrative or supervisory positions, and many lived in the Northeast and Midwest regions of the United States. The differences in rates of publication between males and females was not statistically significant after controlling for respondents' professional maturity and position. Recommendations for future research are discussed. PMID:2039902

  4. Climate Services to Improve Public Health

    PubMed Central

    Jancloes, Michel; Thomson, Madeleine; Costa, María Máñez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary

    2014-01-01

    A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4–6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers. PMID:24776719

  5. Climate services to improve public health.

    PubMed

    Jancloes, Michel; Thomson, Madeleine; Costa, María Mánez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary

    2014-04-25

    A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4-6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers.

  6. Understanding the public's health problems: applications of symbolic interaction to public health.

    PubMed

    Maycock, Bruce

    2015-01-01

    Public health has typically investigated health issues using methods from the positivistic paradigm. Yet these approaches, although they are able to quantify the problem, may not be able to explain the social reasons of why the problem exists or the impact on those affected. This article will provide a brief overview of a sociological theory that provides methods and a theoretical framework that has proven useful in understanding public health problems and developing interventions.

  7. Building Public Health Ontario: experience in developing a new public health agency.

    PubMed

    Goel, Vivek

    2012-06-05

    The history and development of Ontario's new public health agency, Public Health Ontario, is explored. The governance model and organizational structure are identified along with an overview of the relationship with the Ontario Ministry of Health and Long-Term Care. The strategic mission and vision are described as are the key functions. The building of the organization through new investments and divestments is explained. The paper concludes with an overview of the challenges encountered and the opportunities ahead.

  8. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 2 2012-07-01 2012-07-01 false Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...

  9. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...

  10. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...

  11. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...

  12. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 2 2013-07-01 2012-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...

  13. Beyond the Golden Era of public health: charting a path from sanitarianism to ecological public health.

    PubMed

    Lang, Tim; Rayner, Geof

    2015-10-01

    The paper considers the long-term trajectory of public health and whether a 'Golden Era' in Public Health might be coming to an end. While successful elements of the 20th century policy approach need still to be applied in the developing world, two significant flaws are now apparent within its core thinking. It assumes that continuing economic growth will generate sufficient wealth to pay for the public health infrastructure and improvement needed in the 21st century when, in reality, externalised costs are spiralling. Secondly, there is evidence of growing mismatch between ecosystems and human progress. While 20th century development has undeniably improved public health, it has also undermined the capacity to maintain life on a sustainable basis and has generated other more negative health consequences. For these and other reasons a rethink about the role, purpose and direction of public health is needed. While health has to be at the heart of any viable notion of progress the dominant policy path offers new versions of the 'health follows wealth' position. The paper posits ecological public health as a radical project to reshape the conditions of existence. Both of these broad paths require different functions and purposes from their institutions, professions and politicians. The paper suggests that eco-systems pressures, including climate change, are already adding to pressure for a change of course.

  14. Intercultural Competency in Public Health: A Call for Action to Incorporate Training into Public Health Education.

    PubMed

    Fleckman, Julia M; Dal Corso, Mark; Ramirez, Shokufeh; Begalieva, Maya; Johnson, Carolyn C

    2015-01-01

    Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Although these programs share common goals for improving clinical care for patients and reducing health disparities, there is little standardization across programs. Furthermore, little progress has been made to translate cultural competency training from the clinical setting into the public health setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant public health programming and culturally sensitive public health research is more critical than ever. Awareness of differing cultures needs to be included in all processes of planning, implementation and evaluation. By focusing on community-based health program planning and research, cultural competence implies that it is possible for public health professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Public health professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness, and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt, and strengthen intercultural competence education in public health educational institutions.

  15. The impact of pensions on health and wellbeing in rural South Africa: Does gender matter?

    PubMed Central

    Schatz, Enid; Gómez-Olivé, Xavier; Ralston, Margaret; Menken, Jane; Tollman, Stephen

    2012-01-01

    Unique to Africa, a means-tested non-contributory pension is available to South Africans. In 2006, women over 60 and men over 65 were pension-eligible. To explore the effect of the pension for health and wellbeing indicators of rural South African men and women, we analyze data from the WHO-INDEPTH Study of Global Ageing and Adult Health Survey, carried out in the Agincourt sub-district by the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) in 2006. Because pension receipt was not measured directly, our findings represent intent-to-treat (ITT) rather than treatment-on-the-treated (TOT) effects using age as an indicator for intent-to-treat. Overall, women report poorer wellbeing compared to men. However, women have a “honeymoon” period at ages 60–64, the first years of pension-eligibility, in which they report lower levels of worry and sadness, and higher overall happiness, life satisfaction, and quality of life as compared to younger and older women. For men, in contrast, reports of wellbeing worsen in the pre-pension years, followed by a similar but not as prominent pattern of favorable reports in the five years following pension-eligibility, and a decline in the next five-year period. Thus, while pensions continue to enhance financial wellbeing, our results suggest that their effect on social wellbeing may be gendered and transitory. Further research is needed to improve understanding of these dynamics. PMID:22884944

  16. Public health nutrition: results and research.

    PubMed

    Binns, C W; Leong, J F

    2000-01-01

    Public health nutrition is focused on the prevention of diet-related diseases and the attainment of good health, through policy, education and health promotion. It involves many sectors of the community, cooperating to improve the health and wellbeing of the population with emphasis on prevention, equity, wellbeing and improved quality of life. In the majority of western countries, an epidemic of coronary heart disease (CHD) began after World War One, reaching its peak in the 1970's. In Asia, the epidemic began after WW2 with the rapid economic development of the region. In western countries, of which Australia is a typical example, health promotion activities and improved hospital treatment have been effective in reducing the impact of the CHD epidemic. The life expectancy of the population has steadily grown to 75.6 years for males and 81.3 years for females. Despite major advances in the prevention and treatment of cardiovascular disease, it is still the leading cause of premature mortality and morbidity in Australia. Furthermore, cardiovascular disease shares common risk factors with other leading causes of death, including lifestyle behaviours (diet, physical inactivity, alcohol consumption, smoking), physiological states (obesity, hypertension, high blood cholesterol) and socioeconomic factors. For Asia, the challenge is to implement public health policies that will tackle the epidemic of chronic disease before it reaches its peak. Health Promotion policies will be important for all countries. The use of the disability adjusted life years (DALY) methodology to measure the association between the cause of disease and relate its occurrence to health outcomes will be an important public health planning tool.

  17. Public health and business: a partnership that makes cents.

    PubMed

    Simon, Paul A; Fielding, Jonathan E

    2006-01-01

    Historically, public health agencies have had relatively few formal partnerships with private business. However, both groups share an interest in ensuring a healthy population. Businesses have a financial interest in supporting organized public health efforts; in turn, business partnerships can increase the reach and effectiveness of public health. This paper makes the case for the business sector's participation in the broad public health system and its support of governmental public health agencies. Examples of past and current partnerships exemplify how public health efforts benefit business and suggest opportunities for future collaboration to improve the public's health.

  18. [Suggestions for the upcoming public health law in Spain].

    PubMed

    Urbanos, Rosa

    2010-01-01

    The upcoming public health law must serve as the basis for public health reform. The text of the law should allow public health structures to be modernized and adapted to the country's new needs. A broader concept of public health and a redefinition of its functions and basic services are required. Some of the main suggestions for the upcoming law are the establishment of a Spanish Agency for Public Health and a Public Health Council, the design of a Spanish Strategy of Public Health, and reform of professional training.

  19. Use of indicators in achieving 'Health for All' in South Africa, 1987.

    PubMed

    Yach, D; Klopper, J M; Taylor, S P

    1987-12-05

    This review evaluates South Africa's performance in achieving health when measured against the World Health Organization's global indicators designed to achieve 'Health for All' by the year 2000. As this programme has not been implemented in South Africa, a need exists for this country to announce indicators and targets. South Africa meets the World Health Organization's targets in terms of health expenditure but available information on many of the other indicators suggest that a large segment of the population falls outside the targets set. Lack of immunisation and poor nutrition are reflected in unacceptably high infant mortality rates and relatively low life expectancies. As accurate data are needed for planning at both national and local levels a national health survey should be conducted.

  20. Keeping the “Public” in Schools of Public Health

    PubMed Central

    Klitzman, Susan; Diamond, Catherine; El-Mohandes, Ayman

    2015-01-01

    In this article, we compared the characteristics of public and private accredited public health training programs. We analyzed the distinct opportunities and challenges that publicly funded schools of public health face in preparing the nation’s public health workforce. Using our experience in creating a new, collaborative public school of public health in the nation’s largest urban public university system, we described efforts to use our public status and mission to develop new approaches to educating a workforce that meets the health needs of our region and contributes to the goal of reducing health inequalities. Finally, we considered policies that could protect and strengthen the distinct contributions that public schools of public health make to improving population health and reducing health inequalities. PMID:25706006

  1. Health-related services provided by public health educators.

    PubMed

    Johnson, Hans H; Becker, Craig M

    2011-09-01

    This study identifies the health-related services provided by public health educators. The investigators, with the help of practicing public health educators, created the list of health-related services. Respondents received questionnaires in 2001 and 2007. Thus, this study determined the changes in health-related services provided over a 6-year period. Respondents ranked up to five health-related services by the amount of time spent delivering each health-related service. The list of health-related services presented in a 2001 survey and a 2007 survey were identical. As in 2001, this list in the 2007 survey captured the breadth of health-related services provided, with one exception. In 2007, several participants wrote-in "emergency preparedness/bioterrorism." The types of health-related services provided did not change over the 6-year period; however, the ranking of these services did change. Most notably, nutrition education and involvement with physical activity moved up in the ranking in 2007.

  2. Health care quality improvement publication trends.

    PubMed

    Sun, Gordon H; MacEachern, Mark P; Perla, Rocco J; Gaines, Jean M; Davis, Matthew M; Shrank, William H

    2014-01-01

    To analyze the extent of academic interest in quality improvement (QI) initiatives in medical practice, annual publication trends for the most well-known QI methodologies being used in health care settings were analyzed. A total of 10 key medical- and business-oriented library databases were examined: PubMed, Ovid MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, Scopus, the Cochrane Central Register of Controlled Trials, ABI/INFORM, and Business Source Complete. A total of 13 057 articles were identified that discuss at least 1 of 10 well-known QI concepts used in health care contexts, 8645 (66.2%) of which were classified as original research. "Total quality management" was the only methodology to demonstrate a significant decline in publication over time. "Continuous quality improvement" was the most common topic of study across all publication years, whereas articles discussing Lean methodology demonstrated the largest growth in publication volume over the past 2 decades. Health care QI publication volume increased substantially beginning in 1991.

  3. Remote sensing and urban public health

    NASA Technical Reports Server (NTRS)

    Rush, M.; Vernon, S.

    1975-01-01

    The applicability of remote sensing in the form of aerial photography to urban public health problems is examined. Environmental characteristics are analyzed to determine if health differences among areas could be predicted from the visual expression of remote sensing data. The analysis is carried out on a socioeconomic cross-sectional sample of census block groups. Six morbidity and mortality rates are the independent variables while environmental measures from aerial photographs and from the census constitute the two independent variable sets. It is found that environmental data collected by remote sensing are as good as census data in evaluating rates of health outcomes.

  4. Law, public health, and the diabetes epidemic.

    PubMed

    Moulton, Anthony D; Albright, Ann L; Gregg, Edward W; Goodman, Richard A

    2013-10-01

    The prevalence of new cases of diabetes continues to increase, and the health burden for those with diabetes remains high. This is attributable, in part, to low adoption of evidence-based interventions for diabetes prevention and control. Law is a critical tool for health improvement, yet assessments reported in this paper indicate that federal, state, and local laws give only partial support to guidelines and evidence-based interventions relevant to diabetes prevention and control. Public health practitioners and policymakers who are concerned with the human, fiscal, and economic costs of the epidemic can explore new ways to translate the evidence base for diabetes prevention and control into effective laws and policies.

  5. Public health policy for preventing violence.

    PubMed

    Mercy, J A; Rosenberg, M L; Powell, K E; Broome, C V; Roper, W L

    1993-01-01

    The current epidemic of violence in America threatens not only our physical health but also the integrity of basic social institutions such as the family, the communities in which we live, and our health care system. Public health brings a new vision of how Americans can work together to prevent violence. This new vision places emphasis on preventing violence before it occurs, making science integral to identifying effective policies and programs, and integrating the efforts of diverse scientific disciplines, organizations, and communities. A sustained effort at all levels of society will be required to successfully address this complex and deeply rooted problem.

  6. Media, racism and public health psychology.

    PubMed

    Nairn, Raymond; Pega, Frank; McCreanor, Tim; Rankine, Jenny; Barnes, Angela

    2006-03-01

    International literature has established that racism contributes to ill-health of migrants, ethnic minorities and indigenous peoples. Racism generally negates wellbeing, adversely affecting physical and psychological health. Numerous studies have shown that media contribute marginalizing particular ethnic and cultural groups depicting them primarily as problems for and threats to the dominant. This articles frames media representations of, and their effect on, the indigenous Maori of Aotearoa, New Zealand within the ongoing processes of colonization. We argue that reflects the media contribution to maintenance and naturalisation of colonial relationships and seek to include critical media scholarship in a critical public health psychology.

  7. Commercial Pesticides Applicator Manual: Public Health.

    ERIC Educational Resources Information Center

    Fitzwater, William D.; Reed, Leonard G., Jr.

    This training manual provides information needed to meet the minimum EPA standards for certification as a commercial applicator of pesticides in the public health pest control category. The text discusses pests such as roaches, bedbugs, bees, mosquitoes, gnats, flies, and rodents with possible control measures provided. (CS)

  8. Patient Activation: Public Libraries and Health Literacy

    ERIC Educational Resources Information Center

    Malachowski, Margot

    2011-01-01

    Patient activation is a new term for a perennial problem. People know what they need to do for their health: exercise, eat right, and get enough rest--but how are they motivated to actually do these things? This is what patient activation is. From this author's vantage point as a medical librarian, public libraries are well-placed to be part of…

  9. Applying Nutrition Science to the Public's Health

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is a bewildering array of nutrition information available to the public and to professionals. Nutrition messages are often conflicting, confusing, and often simply rhetoric. More consumer research is needed to understand more fully the best way to communicate health messages, recommendations, ...

  10. Five Critical Challenges for Public Health

    ERIC Educational Resources Information Center

    Kumanyika, Shiriki K.

    2014-01-01

    This article presents comments and observations given by Dr. Shiriki K. Kumanyika as the Lautenberg Award Lecture at the commencement of the University of Medicine and Dentistry of New Jersey-Rutgers School of Public Health, May 20, 2013. The award is named after Senator Frank Lautenberg, who served as a U.S. Senator from New Jersey during 1982 to…

  11. Public Health Pest Control Category Manual.

    ERIC Educational Resources Information Center

    Bowman, James S.; Turmel, Jon P.

    This manual provides information needed to meet the standards for pesticide applicator certification. It presents pest control guidelines for those organisms of public health significance. Fact sheets with line drawings discuss pests such as cockroaches, bedbugs, lice, ants, beetles, bats, birds, and rodents. (CS)

  12. [The interface between public health and cyberculture].

    PubMed

    Honorato, Eduardo Jorge Sant Ana

    2014-02-01

    This is an opinion piece that proposes a reflection on the current status of the interface between cyberculture and public health and its use as a means for research, not as a mere tool. Cyberculture thus represents a new form of interface between people. And it is precisely "through" and "by means of" social relations that individuals acquire skills and communication techniques. The forms and the means of the relationship alters, but the ends remain unchanged, namely to be in contact with other humans. In recent decades, with the advent of computers, the Internet and all the technological apparatus, human relationships are dependent on them, which is the modern so-called cyberculture. This now affects all areas of activity, and public health cannot be left behind, taking advantage of it and its benefits for its development. It is necessary to keep abreast of these changes and raise them from the theoretical to the practical plane, not only implementing public health policies but also taking the socio-virtual aspects into consideration. It is also necessary for the professionals involved to be updated on new forms of communication, interaction, research methodology, preparation of instruments, sampling approaches and all other phenomena arising from cyberculture that will work in partnership with public health.

  13. [Challenges and perspectives of veterinary public health].

    PubMed

    Villamil Jiménez, Luis C; Romero, Jaime R

    2003-01-01

    This article presents the conceptual basis for veterinary public health-VPH, including historical aspects of its constitution and development, its fields of action, and its current challenges. It also presents a reflection on VPH within the frame of the veterinary services and it finally proposes that education plays a fundamental role in order to face the challenges of a new era.

  14. Public Health Pest Control. Bulletin 755.

    ERIC Educational Resources Information Center

    Evans, Burton R.

    This manual gives general control principles and specific information on control of mosquitoes, flies, bedbugs, fleas, lice, cockroaches, venomous arthropods, ticks and chiggers, and rodents. The specific information includes life-cycles and habitats, public health importance, non-chemical control, and control with pesticides. (BB)

  15. The invisibility of informal interpreting in mental health care in South Africa: notes towards a contextual understanding.

    PubMed

    Swartz, Leslie; Kilian, Sanja

    2014-12-01

    Despite South Africa's constitutional commitment to equality, represented by 11 official languages and the promotion of South African Sign Language, many users of the public health system receive treatment from people who cannot speak their language, and there are no formal interpreting services. This is a legacy of service provision from the apartheid era, and interpreting is currently undertaken by nurses, cleaners, security guards, and family members of patients, amongst others. We provide a preliminary outline of proximal and distal issues which may bear upon this situation. Changing understandings of the nature of careers in the health field, international trends in mental health theory and practice toward crude biologism, and ongoing patterns of social exclusion and stigma all contribute not only to a continuing state of compromised linguistic access to mental health care, but also to processes of rendering invisible the actual work of care in the mental health field.

  16. The impact of community health workers (CHWs) on Buruli ulcer in sub-Saharan Africa: a systematic review

    PubMed Central

    Vouking, Marius Zambou; Tamo, Violette Claire; Mbuagbaw, Lawrence

    2013-01-01

    Buruli ulcer (BU) is a cutaneous neglected tropical disease caused by Mycobacterium ulcerans. Participation of Community Health Workers (CHWs) is an integral part of the management of BU, yet their impact has not been systematically evaluated in sub-Saharan Africa. METHODS: Our objectives were to summarize the evidence on the impact of CHWs on the control of BU in sub-Saharan Africa by looking at their recruitment, training, non-governmental support and performance. We searched the following electronic databases from January 1998 to July 2012: Medline, EMBASE (Excerpta Medica Database), The Cochrane Library, Google Scholar, CINAHL (Cumulative Index to Nursing and Allied Health Literature), WHOLIS (World Health Organization Library Database), LILACS (Latin American and Caribbean Literature on Health Sciences) and contacted experts in the field. There were no restrictions to language or publication status. All study designs that could provide the information we sought were eligible, provided the studies were conducted in sub-Saharan Africa. Critical appraisal of all identified citations was done independently by two authors to establish the possible relevance of the articles for inclusion in the review. Of 195 hits, 17 papers met the inclusion criteria. For the management of Buruli Ulcer, CHWs are often recruited from the communities they will serve. Communities play a role in CHW selection. Larger numbers of CHWs are needed in order to improve the detection and management of cases. One of the major obstacles to the control of BU is inadequate and poorly- equipped health facilities in the affected areas. Evidence from this review suggests that CHW programmes can have large impacts on the control of BU in sub-Saharan Africa. Large-scale rigorous studies, including RCTs, are needed to assess whether the CHWs programs promote equity and access. PMID:24009795

  17. Modelling Medications for Public Health Research

    PubMed Central

    van Gaans, D.; Ahmed, S.; D’Onise, K.; Moyon, J.; Caughey, G.; McDermott, R.

    2016-01-01

    Most patients with chronic disease are prescribed multiple medications, which are recorded in their personal health records. This is rich information for clinical public health researchers but also a challenge to analyse. This paper describes the method that was undertaken within the Public Health Research Data Management System (PHReDMS) to map medication data retrieved from individual patient health records for population health researcher’s use. The PHReDMS manages clinical, health service, community and survey research data within a secure web environment that allows for data sharing amongst researchers. The PHReDMS is currently used by researchers to answer a broad range of questions, including monitoring of prescription patterns in different population groups and geographic areas with high incidence/prevalence of chronic renal, cardiovascular, metabolic and mental health issues. In this paper, we present the general notion of abstraction network, a higher level network that sits above a terminology and offers compact and more easily understandable view of its content. We demonstrate the utilisation of abstraction network methodology to examine medication data from electronic medical records to allow a compact and more easily understandable view of its content. PMID:28149446

  18. A public health training center experience: professional continuing education at schools of public health.

    PubMed

    Potter, Margaret A; Fertman, Carl I; Eggleston, Molly M; Holtzhauer, Frank; Pearsol, Joanne

    2008-01-01

    The Public Health Training Center (PHTC) national program was first established at accredited schools of public health in 2000. The PHTC program used the US Health Resources and Services Administration's grants to build workforce development programs, attracting schools as training providers and the workforce as training clients. This article is a reflection on the experience of two schools, whose partnership supported one of the PHTCs, for the purpose of opening a conversation about the future of continuing education throughout schools and degree programs of public health. This partnership, the Pennsylvania & Ohio Public Health Training Center (POPHTC), concentrated its funding on more intensive training of public healthcare workers through a relatively narrow inventory of courses that were delivered typically in-person rather than by distance-learning technologies. This approach responded to the assessed needs and preferences of the POPHTC's workforce population. POPHTC's experience may not be typical among the PHTCs nationally, but the collective experience of all PHTCs is instructive to schools of public health as they work to meet an increasing demand for continuing education from the public health workforce.

  19. Regional Projections of Extreme Apparent Temperature Days in Africa and the Related Potential Risk to Human Health

    PubMed Central

    Garland, Rebecca M.; Matooane, Mamopeli; Engelbrecht, Francois A.; Bopape, Mary-Jane M.; Landman, Willem A.; Naidoo, Mogesh; van der Merwe, Jacobus; Wright, Caradee Y.

    2015-01-01

    Regional climate modelling was used to produce high resolution climate projections for Africa, under a “business as usual scenario”, that were translated into potential health impacts utilizing a heat index that relates apparent temperature to health impacts. The continent is projected to see increases in the number of days when health may be adversely affected by increasing maximum apparent temperatures (AT) due to climate change. Additionally, climate projections indicate that the increases in AT results in a moving of days from the less severe to the more severe Symptom Bands. The analysis of the rate of increasing temperatures assisted in identifying areas, such as the East African highlands, where health may be at increasing risk due to both large increases in the absolute number of hot days, and due to the high rate of increase. The projections described here can be used by health stakeholders in Africa to assist in the development of appropriate public health interventions to mitigate the potential health impacts from climate change. PMID:26473895

  20. Regional Projections of Extreme Apparent Temperature Days in Africa and the Related Potential Risk to Human Health.

    PubMed

    Garland, Rebecca M; Matooane, Mamopeli; Engelbrecht, Francois A; Bopape, Mary-Jane M; Landman, Willem A; Naidoo, Mogesh; Merwe, Jacobus van der; Wright, Caradee Y

    2015-10-12

    Regional climate modelling was used to produce high resolution climate projections for Africa, under a "business as usual scenario", that were translated into potential health impacts utilizing a heat index that relates apparent temperature to health impacts. The continent is projected to see increases in the number of days when health may be adversely affected by increasing maximum apparent temperatures (AT) due to climate change. Additionally, climate projections indicate that the increases in AT results in a moving of days from the less severe to the more severe Symptom Bands. The analysis of the rate of increasing temperatures assisted in identifying areas, such as the East African highlands, where health may be at increasing risk due to both large increases in the absolute number of hot days, and due to the high rate of increase. The projections described here can be used by health stakeholders in Africa to assist in the development of appropriate public health interventions to mitigate the potential health impacts from climate change.

  1. Developing public sociology through health impact assessment.

    PubMed

    Elliott, Eva; Williams, Gareth

    2008-11-01

    The renewed interest in 'public sociology' has sparked debate and discussion about forms of sociological work and their relationship to the State and civil society. Medical sociologists are accustomed to engaging with a range of publics and audiences inside and outside universities and are in a position to make an informed contribution to this debate. This paper describes how some of the debates about sociological work are played out through a 'health impact assessment' of a proposed housing renewal in a former coal mining community. We explore the dynamics of the health impact assessment process and relate it to wider debates, current in the social sciences, on the 'new knowledge spaces' within which contentious public issues are now being discussed, and the nature of different forms of expertise. The role of the 'public sociologist' in mediating the relationships between the accounts and interpretations of lay participants and the published 'evidence' is described as a process of mutual learning between publics, professionals and social scientists. It is argued that the continued existence and development of any meaningful 'professional sociology' requires an openness to a 'public sociology' which recognises and responds to new spaces of knowledge production.

  2. Deaths Rates in Public Hospitals of Eastern Cape Province of South Africa

    PubMed Central

    Buso, DL; Longo-Mbenza, B; Bovet, P; van den Borne, B; Okwe, A Nge; Mzingelwa, M

    2012-01-01

    Background: South Africa (SA) is experiencing a rapid epidemiologic transition as a consequence of political, economic and social changes. In this study we described, based on hospital data, the mortality patterns of Non communicable Diseases (NCD), Communicable Diseases (CD), the NCD/CD ratios, and the trends of deaths. Methods: We conducted a cross-sectional survey of all deaths occurring in several public hospitals in the Eastern Cape Province of SA between 2002 and 2006. Causes of deaths were coded according to the ICD 10 Edition. Results: A total of 107380 admissions responded to the inclusion criteria between 2002 and 2006. The crude death rate was 4.3% (n=4566) with a mean age of 46±21 years and a sex ratio of 3.1 men (n=3453): 1 woman (n=1113). Out of all deaths, there were 62.9% NCD (n=2872) vs. 37.1% CD (n=1694) with NCD/CD ratio of 1.7. The ratio NCD/CD deaths in men was 1.3 (n=1951/1502) vs. NCD/CD deaths in women of 1.9 (n=735/378). The peak of deaths was observed in winter season. The majority of NCD deaths were at age of 30–64 years, whereas the highest rate of CD deaths was at age< 30 years. The trend of deaths including the majority of NCD, increased from 2002 to 2006. There was a tendency of increase in tuberculosis deaths, but a tendency of decrease in HIV/AIDS deaths was from 2002 to 2006. Conclusion: Non-communicable diseases are the leading causes of deaths in rural Eastern Cape province of SA facing Post-epidemiologic transition stages. We recommend overarching priority actions for the response to the Non-communicable Diseases: policy change, prevention, treatment, international cooperation, research, monitoring, accountability, and re-orientation of health systems. PMID:23641386

  3. A survey of dental public health specialists on current dental public health competencies.

    PubMed

    Mascarenhas, Ana Karina; Altman, Donald

    2016-09-01

    In preparation to update the Dental Public Health specialty competencies, the Expert Panel determined that a needs assessment be conducted. A nine item open and close ended survey developed by the Expert Panel was used to collect data on the Diplomates current work environment, the utility of the current set of Dental Public Health competencies, and to identify any gaps in the current competencies. In 2015, the survey was administered to all active Diplomates of the American Board of Dental Public Health. One hundred and nine Diplomates responded. Diplomates overwhelmingly reported that each of the ten current competencies were still relevant for Dental Public Health specialists in the 21(st) Century, but needed to be updated to be more contemporary. Domains suggested to achieve this were interprofessional care, cultural competency, health literacy, and evidence-based dentistry.

  4. Smoking, Mental Illness, and Public Health.

    PubMed

    Prochaska, Judith J; Das, Smita; Young-Wolff, Kelly C

    2016-12-16

    Tobacco remains the leading preventable cause of death worldwide. In particular, people with mental illness are disproportionately affected with high smoking prevalence; they account for more than 200,000 of the 520,000 tobacco-attributable deaths in the United States annually and die on average 25 years prematurely. Our review aims to provide an update on smoking in the mentally ill. We review the determinants of tobacco use among smokers with mental illness, presented with regard to the public health HAVE framework of "the host" (e.g., tobacco user characteristics), the "agent" (e.g., nicotine product characteristics), the "vector" (e.g., tobacco industry), and the "environment" (e.g., smoking policies). Furthermore, we identify the significant health harms incurred and opportunities for prevention and intervention within a health care systems and larger health policy perspective. A comprehensive effort is warranted to achieve equity toward the 2025 Healthy People goal of reducing US adult tobacco use to 12%, with attention to all subgroups, including smokers with mental illness. Expected final online publication date for the Annual Review of Public Health Volume 38 is March 20, 2017. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

  5. Health Resources Statistics; Health Manpower and Health Facilities, 1968. Public Health Service Publication No. 1509.

    ERIC Educational Resources Information Center

    National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.

    This report is a part of the program of the National Center for Health Statistics to provide current statistics as baseline data for the evaluation, planning, and administration of health programs. Part I presents data concerning the occupational fields: (1) administration, (2) anthropology and sociology, (3) data processing, (4) basic sciences,…

  6. The Growing Public Health Impact of Wildfire Smoke Emissions Webinar

    EPA Pesticide Factsheets

    This is a brief discussion of wildfire smoke and its health effects along with tools available to provide public health guidance during wildfire events, including the Wildfire Smoke Guide for Public Health Officials

  7. Harmful Algal Blooms and Public Health

    PubMed Central

    Grattan, Lynn M.; Holobaugh, Sailor; Morris, J. Glenn

    2015-01-01

    The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and public health risks. To accomplish this, close communication and collaboration is needed among HAB scientists, public health researchers and local, state and tribal health departments at academic, community outreach, and policy levels. PMID:27616971

  8. Harmful Algal Blooms and Public Health.

    PubMed

    Grattan, Lynn M; Holobaugh, Sailor; Morris, J Glenn

    2016-07-01

    The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and public health risks. To accomplish this, close communication and collaboration is needed among HAB scientists, public health researchers and local, state and tribal health departments at academic, community outreach, and policy levels.

  9. Epigenetics: Relevance and Implications for Public Health

    PubMed Central

    Rozek, Laura S.; Dolinoy, Dana C.; Sartor, Maureen A.; Omenn, Gilbert S.

    2015-01-01

    Improved understanding of the multilayer regulation of the human genome has led to a greater appreciation of environmental, nutritional, and epigenetic risk factors for human disease. Chromatin remodeling, histone tail modifications, and DNA methylation are dynamic epigenetic changes responsive to external stimuli. Careful interpretation can provide insights for actionable public health through collaboration between population and basic scientists and through integration of multiple data sources. We review key findings in environmental epigenetics both in human population studies and in animal models, and discuss the implications of these results for risk assessment and public health protection. To ultimately succeed in identifying epigenetic mechanisms leading to complex phenotypes and disease, researchers must integrate the various animal models, human clinical approaches, and human population approaches while paying attention to life-stage sensitivity, to generate effective prescriptions for human health evaluation and disease prevention. PMID:24641556

  10. Globalisation and global health governance: implications for public health.

    PubMed

    Kruk, Margaret E

    2012-01-01

    Globalisation is a defining economic and social trend of the past several decades. Globalisation affects health directly and indirectly and creates economic and health disparities within and across countries. The political response to address these disparities, exemplified by the Millennium Development Goals, has put pressure on the global community to redress massive inequities in health and other determinants of human capability across countries. This, in turn, has accelerated a transformation in the architecture of global health governance. The entrance of new actors, such as private foundations and multi-stakeholder initiatives, contributed to a doubling of funds for global health between 2000 and 2010. Today the governance of public health is in flux, with diminished leadership from multilateral institutions, such as the WHO, and poor coherence in policy and programming that undermines the potential for sustainable health gains. These trends pose new challenges and opportunities for global public health, which is centrally concerned with identifying and addressing threats to the health of vulnerable populations worldwide.

  11. Moving from ideas to action - developing health financing systems towards universal coverage in Africa

    PubMed Central

    2012-01-01

    Background Accelerating progress towards universal coverage in African countries calls for concrete actions that reinforce social health protection through establishment of sustainable health financing mechanisms. In order to explore possible pathways for moving past the existing obstacles, panel discussions were organized on health financing bringing together Ministers of health and Ministers of finance with the objective of creating a discussion space where the different perspectives on key issues and needed actions could meet. This article presents a synthesis of panel discussions focusing on the identified challenges and the possible solutions. The overview of this paper is based on the objectives and proceedings of the panel discussions and relies on the observation and study of the interaction between the panelists and on the discourse used. Summary The discussion highlighted that a large proportion of the African population has no access to needed health services with significant reliance on direct out of pocket payments. There are multiple obstacles in making prepayment and pooling mechanisms operational. The relatively strong political commitment to health has not always translated into more public spending for health. Donor investment in health in low income countries still falls below commitments. There is need to explore innovative domestic revenue collection mechanisms. Although inadequate funding for health is a fundamental problem, inefficient use of resources is of great concern. There is need to generate robust evidence focusing on issues of importance to ministry of finance. The current unsatisfactory state of health financing was mainly attributed to lack of clear vision; evidence based plans and costed strategies. Discussion Based on the analysis of discussion made, there are points of convergence and divergence in the discourse and positions of the two ministries. The current blockage points holding back budget allocations for health can be

  12. Poor health kills small business: illness and microenterprises in South Africa.

    PubMed

    Chao, Li-Wei; Pauly, Mark; Szrek, Helena; Pereira, Nuno Sousa; Bundred, Frances; Cross, Catherine; Gow, Jeff

    2007-01-01

    Small businesses contribute almost 50 percent of total employment and 30 percent of gross domestic product in South Africa, but the impact of poor health and AIDS on these businesses is poorly documented. Using three waves of longitudinal data from predominantly African neighborhoods in peri-urban Durban, South Africa, this project investigates the connections between the health of the owner of a micro- and small enterprise (MSE) and the MSE's growth, survival, or exit. The results show that poor baseline health and declines in health over time are both significantly associated with subsequent business closure.

  13. Gambling and the Health of the Public: Adopting a Public Health Perspective.

    PubMed

    Korn, David A.; Shaffer, Howard J.

    1999-01-01

    During the last decade there has been an unprecedented expansion of legalized gambling throughout North America. Three primary forces appear to be motivating this growth: (1) the desire of governments to identify new sources of revenue without invoking new or higher taxes; (2) tourism entrepreneurs developing new destinations for entertainment and leisure; and (3) the rise of new technologies and forms of gambling (e.g., video lottery terminals, powerball mega-lotteries, and computer offshore gambling). Associated with this phenomenon, there has been an increase in the prevalence of problem and pathological gambling among the general adult population, as well as a sustained high level of gambling-related problems among youth. To date there has been little dialogue within the public health sector in particular, or among health care practitioners in general, about the potential health impact of gambling or gambling-related problems. This article encourages the adoption of a public health perspective towards gambling. More specifically, this discussion has four primary objectives:1. Create awareness among health professionals about gambling, its rapid expansion and its relationship with the health care system;2. Place gambling within a public health framework by examining it from several perspectives, including population health, human ecology and addictive behaviors;3. Outline the major public health issues about how gambling can affect individuals, families and communities;4. Propose an agenda for strengthening policy, prevention and treatment practices through greater public health involvement, using the framework of The Ottawa Charter for Health Promotion as a guide.By understanding gambling and its potential impacts on the public's health, policy makers and health practitioners can minimize gambling's negative impacts and appreciate its potential benefits.

  14. Public and private donor financing for health in developing countries.

    PubMed

    Howard, L M

    1991-06-01

    Among the many variables that influence the outcome of national health status in both developed and developing countries, the availability and efficiency of financing is critical. For 148 developing countries, annual public and private expenditures from domestic sources (1983) were estimated to be approximately $100 billion. For the United States alone, annual public and private costs for medical care are almost five times larger ($478 billion, 1988). In contrast to domestic expenditures, the total flow of donor assistance for health in 1986 was estimated to be $4 billion, approximately 5% of total current domestic expenditures by developing countries. Direct donor assistance for development purposes by the United States Government approximates 0.5% of the US federal budget (1988). Approximately 10% of all United States development assistance is allocated for health, nutrition, and population planning purposes. While the total health sector contribution is on the order of $500 million annually, the US contribution represents about 13% of health contributions by all external donors. In sub-Saharan Africa, all donor health allocations only reach 3.4% of total development assistance. While available data suggest that private and voluntary organizations contribute approximately 20% of total global health assistance, data reporting methods from private agencies are not sufficiently specific to provide accurate global estimates. Clearly, developing countries as a whole are dependent on the efficient use of their own resources because external financing remains a small fraction of total domestic financing. Nevertheless, improvement in health sector performance often depends on the sharing of western experience and technology, services available through external donor cooperation. In this effort, the available supply of donor financing for health is not restricted entirely by donor policy, but also by the official demand for external financing as submitted by developing

  15. Status report on hypertension in Africa--consultative review for the 6th Session of the African Union Conference of Ministers of Health on NCD's.

    PubMed

    van de Vijver, Steven; Akinyi, Hilda; Oti, Samuel; Olajide, Ademola; Agyemang, Charles; Aboderin, Isabella; Kyobutungi, Catherine

    2013-01-01

    Hypertension has always been regarded as a disease of affluence but this has changed drastically in the last two decades with average blood pressures now higher in Africa than in Europe and USA and the prevalence increasing among poor sections of society. We have conducted a literature search on PubMed on a broad range of topics regarding hypertension in Africa, including data collection from related documents from World Health Organization and other relevant organizations that are available in this field. We have shared the initial results and drafts with international specialists in the context of hypertension in Africa and incorporated their feedback. Hypertension is the number one risk factor for CVD in Africa. Consequently, cardiovascular disease (CVD) has taken over as number one cause of death in Africa and the total numbers will further increase in the next decades reflecting on the growing urbanization and related lifestyle changes. The new epidemic of hypertension and CVD is not only an important public health problem, but it will also have a big economic impact as a significant proportion of the productive population becomes chronically ill or die, leaving their families in poverty. It is essential to develop and share best practices for affordable and effective community-based programs in screening and treatment of hypertension. In order to prevent and control hypertension in the population, Africa needs policies developed and implemented through a multi-sectoral approach involving the Ministries of Health and other sectors including education, agriculture, transport, finance among others.

  16. Status report on hypertension in Africa - Consultative review for the 6th Session of the African Union Conference of Ministers of Health on NCD's

    PubMed Central

    van de Vijver, Steven; Akinyi, Hilda; Oti, Samuel; Olajide, Ademola; Agyemang, Charles; Aboderin, Isabella; Kyobutungi, Catherine

    2013-01-01

    Hypertension has always been regarded as a disease of affluence but this has changed drastically in the last two decades with average blood pressures now higher in Africa than in Europe and USA and the prevalence increasing among poor sections of society. We have conducted a literature search on PubMed on a broad range of topics regarding hypertension in Africa, including data collection from related documents from World Health Organization and other relevant organizations that are available in this field. We have shared the initial results and drafts with international specialists in the context of hypertension in Africa and incorporated their feedback. Hypertension is the number one risk factor for CVD in Africa. Consequently, cardiovascular disease (CVD) has taken over as number one cause of death in Africa and the total numbers will further increase in the next decades reflecting on the growing urbanization and related lifestyle changes. The new epidemic of hypertension and CVD is not only an important public health problem, but it will also have a big economic impact as a significant proportion of the productive population becomes chronically ill or die, leaving their families in poverty. It is essential to develop and share best practices for affordable and effective community-based programs in screening and treatment of hypertension. In order to prevent and control hypertension in the population, Africa needs policies developed and implemented through a multi-sectoral approach involving the Ministries of Health and other sectors including education, agriculture, transport, finance among others. PMID:24570798

  17. A Review and Critique of Teledermatology in the South African Public Health Sector.

    PubMed

    Walters, Laticha E M; Mars, Maurice; Scott, Richard E

    2016-01-01

    Nearly 80% of the world's population live in developing countries in Asia, Africa, and Latin America. Many of these countries must face a triple or quadruple burden of disease with severely limited resources and health systems. South Africa (SA) is one such country, and recognises the potential for e-health to moderate these limitations. Dermatological issues remain a concern in SA and globally. Indeed, the World Health Organisation (WHO) has recognised that a number of diseases are most likely to manifest themselves through a dermatological problem before becoming full-blown. However, there is an acute shortage of dermatologists in SA. Teledermatology has promise as a service delivery intervention. This study reports on the current status of teledermatology services in the public health sector of SA.

  18. The public health leadership certificate: a public health and primary care interprofessional training opportunity.

    PubMed

    Matson, Christine C; Lake, Jeffrey L; Bradshaw, R Dana; Matson, David O

    2014-03-01

    This article describes a public health leadership certificate curriculum developed by the Commonwealth Public Health Training Center for employees in public health and medical trainees in primary care to share didactic and experiential learning. As part of the program, trainees are involved in improving the health of their communities and thus gain a blended perspective on the effectiveness of interprofessional teams in improving population health. The certificate curriculum includes eight one-credit-hour didactic courses offered through an MPH program and a two-credit-hour, community-based participatory research project conducted by teams of trainees under the mentorship of health district directors. Fiscal sustainability is achieved by sharing didactic courses with MPH degree students, thereby enabling trainees to take advantage of a reduced, continuing education tuition rate. Public health employee and primary care trainees jointly learn knowledge and skills required for community health improvement in interprofessional teams and gain an integrated perspective through opportunities to question assumptions and broaden disciplinary approaches. At the same time, the required community projects have benefited public health in Virginia.

  19. Private medicine and the privatisation of health care in South Africa.

    PubMed

    Naylor, C D

    1988-01-01

    Health services in the Republic of South Africa (RSA) are provided by a mixture of public and private providers and institutions. Estimates of total health-related expenditure for 1985 range between 5.3% and 5.9% of gross national product (GNP), divided on approximately a 55:45 basis between public and private sectors. Basic preventive and curative services are provided by a hospital- and clinic-based public system. The public system does not adequately serve the rural areas and African tribal bantustans, and racial discrimination and/or segregation are obvious in its organisation and funding. The public sector's strength is the provision of state-subsidised care to many citizens who are unable to afford private medicine. The vast majority of hospitals are operated on a non-profit basis by government, industries, and voluntary agencies. Excluding hospitals that receive state subsidies, private investor-owned hospitals control about 10% of all hospital beds in the RSA. One-third of these investor-owned beds are held by state-dependent contractors providing long-term care. Two-thirds are wholly independent. Growth has been rapid in the independent hospital sector, and major corporations have entered the market. In 1985, over 85% of the white population was privately insured by a variety of prepayment programmes, including those organised through parastatal corporations and government departments. Despite major enrollment growth in the preceding decade, only 8% of blacks held private insurance by 1985; their coverage also tended to be less comprehensive. Faced with deficit financing, a sluggish economy, complaints from its white constituency about taxation levels, and pressure from private sector interest groups, the Nationalist government has endorsed the concept of privatisation of health care. Exponents of privatisation claim that it will permit differentiation by income to supplant discrimination by race. However, the direct links between disposable income and

  20. Women's Health. Report of the Public Health Service Task Force on Women's Health Issues. Volume II.

    ERIC Educational Resources Information Center

    Public Health Service (DHHS), Rockville, MD.

    This report identifies a broad spectrum of issues affecting women's health and is divided into four sections: (1) social factors affecting women's health; (2) women's physical health and well-being; (3) health concerns of older women; and (4) issues related to alcohol, drug use and abuse, and the mental health of women. The Public Health Service…