Public Health Commons^™

Frequency And Associated Factors For Care Giving Among Elderly Patients Visiting A Teaching Hospital In Karachi, Pakistan., Waris Qidwai Dr, Mohammad Uzair Abdul Rauf, Seema Sakina, Ayesha Hamid, Sidra Ishaque, Tabinda Ashfaq

Department of Family Medicine

Objective: To study frequency and associated factors for care giving among elderly Patients visiting a teaching hospital in Karachi, Pakistan.
Methodology: A cross sectional questionnaire-based study was conducted at the Community Health Centre (CHC), Aga Khan University Hospital (AKUH) Karachi, Pakistan from September to November 2009. All individuals, visiting the CHC and aged 65 years or above were interviewed after taking written informed consent.
Results: A total of 400 elderly completed the interview. Majority were females, 65-69 years age, More than half of the individuals ie: 227 (85%) had received Care Giver experience for assistance and among these 195(72%) had …

Disparities Research In Public Health Pbrns, Glen P. Mays

Health Management and Policy Presentations

Public health agencies are well positioned within the health system to play key roles in addressing oral health issues on a population-wide basis, However, current evidence reveals wide geographic variation in the delivery of public health interventions for oral health promotion. This session explores the factors contributing to this variation, and it highlights studies underway through the Public Health Practice-Based Research Networks (PBRNs) to produce more and better evidence about public health delivery and impact.

Economic Empowerment And Hiv Prevention Among Young Women And Girls In Kenya: Lessons From The Study Of Economic Empowerment Programs, Samantha Van Putten

Independent Study Project (ISP) Collection

One of the major issues facing Kenya is HIV/AIDS. With recognition by the global community that providing women with economic opportunities can help both those who are HIV positive, as well as in prevention for those who are not infected, programs combining microfinance and HIV education have started to emerge. While women in these programs 3 3 have shown preliminary signs of success, young girls did not respond as well in part due to lack of interest in the particular programs themselves. As such, this study examines two economic empowerment programs for girls and young mothers at the non-governmental organization …

Using Public Health Pbrn Research To Inform Policy & Practice, Public Health Practice-Based Research Networks

Health Management and Policy Reports

The Public Health Practice-Based Research Networks Program is a national program of the Robert Wood Johnson Foundation that supports research networks dedicated to producing new scientific knowledge on how best to organize, finance, and deliver public health strategies in realworld practice settings. This body of scientific inquiry, known as Public Health Services and Systems Research (PHSSR), is a rapidly developing area of scholarship within the larger fields of public health research and health services research. A public health practice-based research network (PBRN) brings multiple public health organizations into collaboration with an academic research center for the purposes of designing and …

Reproductive Health Education In The Kibera Slum: Developing A Slum-Specific Curriculum, Susanna Schneider Banks

Independent Study Project (ISP) Collection

The principal objective of this Independent Study Project is to make recommendations for a slum-specific reproductive health curriculum to be used in primary schools that serve the Kibera Slum in Nairobi, Kenya. In order to obtain data and form a credible basis for the recommendations, interviews were conducted with teachers, focus groups were facilitated with students, and questionnaires were distributed to parents. Additionally, observations were made about the current state of reproductive health education at each school. Data was collected at Kibera School for Girls, a private school in Kibera, and Olympic Primary School, a public school at the edge …

Effective, Efficient Health Care Reform The United States And Swiss Health Care Systems: A Comparative Analysis What Can The U.S. Learn From The Swiss Experience?, Rebecca Dittrich

Independent Study Project (ISP) Collection

Home to 45 million people without health insurance while still spending 17% of its GDP on health care expenses, the United States has been in need of a massive health care overhaul for quite some time. Some have speculated that the Swiss system may be an ideal model for health care reform, and in fact, many aspects of the newly instated Patient Protection and Affordable Care Act (ACA) do reflect areas of LAMal, Swiss health care law. This paper evaluates the Swiss and United States health care systems (under ACA), their similarities and differences, and the pros and cons of …

Cap Centre : L’Epicerie Sociale, Ana De Pina

Independent Study Project (ISP) Collection

Contrairement à autres study abroad programs, « The School of International Training (SIT) » donne les étudiants Américains une opportunité de découvrir la culture Française, d’apprendre la langue Française, et de s’intègre dans la société Française. Pendant notre séjour en France, nous avons fait de bénévolat dans une association que correspond à nos études aux États-Unis. Aux États-Unis j’étudie la sante publique. Je suis très intéressé pour l’administration des hôpitaux et autres institutions de santé et la relation entre la sécurité sociale et la bonne santé. Donc, pendant trois mois j’ai travaillé au CAP Centre, une épicerie sociale qui aide …

Understanding Social Marketing In A Not-For-Profit Ngo Setting: An Internship With Pace In Eastern Uganda, Veronica L. Tuerffs

Independent Study Project (ISP) Collection

The organization PACE (Programme for Accessible health, Communication and Education) focuses on generating a positive health impact throughout Uganda by the means of social marketing and other proven, evidence based techniques. An internship with the organization took place over the course of six weeks and was conducted under the A2L (Access to Life) program which is located in four of the country’s eastern districts. The focus of the health and sales communication internship was the implementation of PACE’s marketing scheme on their life-saving products and how the products and organization are perceived.

Any of the information gathered during this time …

Individual And Small-Group Market Health Insurance Rate Review And Disclosure: State And Federal Roles After Ppaca, Kathryn Linehan

National Health Policy Forum

Oversight of private insurance, including health insurance, is primarily a state responsibility. Each state establishes its own laws and regulations regarding insurer activities, including premium increases for the insurance products within its purview. The authority that state regulators have to review and deny requests for premium changes varies from state to state, as do the amount of resources available to state insurance departments for reviewing premium changes. In some markets where insurers have proposed or implemented steep increases, such changes have received considerable attention from the press, state regulators, and policymakers. The Patient Protection and Affordable Care Act (PPACA) requires …

High Burden Of Prevalent And Recently Acquired Hiv Among Female Sex Workers And Female Hiv Voluntary Testing Center Clients In Kigali, Rwanda, Sarah L. Braunstein, Chantal M. Ingabire, Eveline Geubbels, Joseph Vyankandondera, Marie-Michele Umulisa, Elysee Gahiro, Mireille Uwineza, Coosje J. Tuijn, Denis Nash, Janneke H. H. M. Va De Wijgert

Publications and Research

Methods: We conducted a cross-sectional survey of 800 FSW and 1,250 female VCT clients in Rwanda, which included interviewing and testing for HIV-1/2, HSV-2 and pregnancy, and BED-CEIA and Avidity Index (AI) to identify recent infections among HIV-infected women.

Results: Prevalence of HIV-1, HSV-2, and pregnancy were 24% (95% CI: 21.0–27.0), 59.8% (56.4–63.2), and 7.6% (5.8–9.5) among FSW, and 12.8% (10.9–14.6), 43.2% (40.4–46.0), and 11.4% (9.7–13.3) among VCT clients, respectively. Thirty-five percent of FSW and 25% of VCT clients had never been HIV tested. Per national guidelines, 33% of newly HIV-diagnosed FSW and 36% of VCT clients were already eligible …

Indigenous Beliefs About Biomedical And Bush Medicine Treatment Efficacy For Indigenous Cancer Patients: A Review Of The Literature, K. D. Schaik, S. C. Thompson

Aboriginal Policy Research Consortium International (APRCi)

Background: Australia’s Indigenous people suffer from higher cancer mortality than non-Indigenous Australians, a discrepancy partly caused by differences in beliefs about treatment efficacy between Indigenous patients and their non-Indigenous healthcare providers. This paper critically reviews the literature associated with Indigenous beliefs about cancer treatment, both ‘bush medicine’ and biomedical, in order to provide recommendations to healthcare providers about accommodating Indigenous beliefs when treating cancer.

Methods: A search was undertaken of peer-reviewed journal papers using electronic databases and citation snowballing. Papers were selected for inclusion based upon relevance to themes that addressed the research questions. Results: Literature suggests that Indigenous beliefs …

Building A Sustainable Public Health Pbrn: Tips For Securing Ongoing Research Funding, Public Health Practice-Based Research Networks

Health Management and Policy Reports

Diversify your network’s research funding base. The Public Health PBRN Program funding made available by the Robert Wood Johnson Foundation provides start-up resources and initial research support for networks, but networks will require larger and more sustainable sources of funding for public health research as they progress. The most ample sources can be found in federal funding agencies that operate competitive extramural research programs, include CDC, NIH, AHRQ, HRSA, USDA, and NSF. Public health research funding is also available from state and foundation sources, and even corporate sources (e.g. Pfizer’s Public Health Research Fellowship Program). For sustainability, networks should look …

Aligning Graduate Medical Education With Public Policy, Rob Cunningham

National Health Policy Forum

In late May–early June 2011, the Forum sponsored a site visit to Denver, Colorado, to observe innovative efforts to improve the health of Coloradans and reduce the cost of health care. The three-day agenda was designed to convey the breadth and interconnectedness of the efforts underway in Denver and to highlight both successes and challenges. The exploration concentrated on how three themes of national interest are unfolding in Denver: building and sustaining a robust and effective safety net in an evolving health care market; improving the health of people and their communities to prevent and reduce the need for health …

Public Health Pbrns: Generating Evidence For Policy & Practice, Public Health Practice-Based Research Networks Program

Health Management and Policy Reports

The Public Health Practice-Based Research Networks Program is a national program of the Robert Wood Johnson Foundation that supports the development of research networks for studying the comparative effectiveness, efficiency and equity of public health strategies deployed in real-world practice settings. A practice-based research network (PBRN) brings multiple public health agencies together with research partners to design and implement studies of population-based strategies that prevent disease and injury and promote health. Participating practitioners and researchers collaborate to identify pressing research questions of interest, design rigorous and relevant studies, execute research effectively, and translate findings rapidly into practice. As such, PBRNs …

Access To Essential Medicines: In Pakistan Identifying Policy Research And Concerns, Shehla Zaidi, Noureen Nishtar

Community Health Sciences

The fundamental importance of ensuring access to medicines, particularly for the poor, is reflected in MDG 8 however remains poor in many low and middle income countries (LMICs). Country specific evidence on access to medicines is weak in LMICs and research has rarely been from an integrated health systems perspective. This study used an evidence based approach to identify key priority concerns and emerging research questions related to access to medicines in Pakistan. WHO’s Access to Medicine Framework was used as the conceptual basis for data collection on rational usage, affordability, financing and health systems. Methods involved a systematic desk …

Influenza Vaccination Of The Healthcare Workforce: Developing A Model State Law, Alexandra M. Stewart, Marisa A Cox

Health Policy and Management Faculty Publications

No abstract provided.

Disclosure Of Medical Error, Kiran Shaikh, Sharifa Bashir Lalani

School of Nursing & Midwifery

With the advancement of medical sciences, lives are being prolonged and practice of medicine is considered an art and no longer as science. ‘To Err is Human Report’ has been released and gives data of medical errors in United States which opened people’s eyes but there is grieving need that health professional in Pakistan also report the medical errors. Medical errors are common, costly, and often preventable. This could only happen when health professional are trained and made aware to report the errors. Evidences shows that full and honest disclosure of error and restitution are factors that may lead to …

Rocky Mountain Highs And Lows: Efforts To Improve Health And Reduce Costs In Denver, Michele J. Orza, Jessamyn Taylor

National Health Policy Forum

In late May–early June 2011, the Forum sponsored a site visit to Denver, Colorado, to observe innovative efforts to improve the health of Coloradans and reduce the cost of health care. The three-day agenda was designed to convey the breadth and interconnectedness of the efforts underway in Denver and to highlight both successes and challenges. The exploration concentrated on how three themes of national interest are unfolding in Denver: building and sustaining a robust and effective safety net in an evolving health care market; improving the health of people and their communities to prevent and reduce the need for health …

Home, But Not Alone: Evidence-Based Maternal, Infant, And Early Childhood Home Visitation, Eileen Salinsky

National Health Policy Forum

Home visitation services for young and expectant families have the potential to improve child and parent outcomes in a broad variety of ways, but the effectiveness of home visits may depend on the nature, frequency, and duration of these services. The Patient Protection and Affordable Care Act of 2010 (PPACA) created a new federal funding stream to promote the development and implementation of evidence-based home visiting programs. This issue brief provides an overview of the newly established Maternal, Infant, and Early Childhood Home Visiting program, describes existing approaches to home visitation, and discusses the implications of federal funding for state …

Making Sense Of Health Care Planning In Ireland; The Street Level Public Organization (Slpo)., Vivienne Byers

Conference Papers

One of the central mechanisms of the Strategic Management Initiative (SMI) (Government of Ireland 1996) is the devolution of accountability and responsibility from the centre to executive agencies. Service planning was introduced in the Irish health care sector as part of this strategic planning ethos. This paper reports on a study that examined both the intent and the consequences of implementing legislatively mandated planning in the Irish health services, in the context of significant organizational change. In an effort to draw broader lessons, a comparison is drawn with the Canadian experience of service planning.

The choice was made to study …

Local Health Departments’ Governance: A Visual Display Using Lhd Shape Files, Gulzar H. Shah Dr., Carolyn J. Leep, Reba Novich

Health Policy & Management: Faculty Presentations (2008-2022)

Analyses conducted for public health systems and services research (PHSSR) frequently include a variable that represents the relationship between state and local health departments (i.e., a governance category) in their analyses, either as an explanatory variable or a control variable. A number of organizations and researchers has categorized states according to governance, but the categorizations have been inconsistent across studies. This lack of agreement regarding governance category has been problematic for PHSSR.

The Association of State and Territorial Health Officials (ASTHO) in conjunction with NORC at the University of Chicago and with input from the National Association of County and …

Influenza Vaccination Of The Health Care Workforce: A Literature Review, Alexandra M. Stewart, Marisa A. Cox, Mallory O'Connor

Health Policy and Management Faculty Publications

Since 1981, the Centers for Disease Control and Prevention (CDC) has recommended that all health care workers (HCWs) receive an annual influenza vaccination. The Healthy People objectives aimed for 60% coverage of HCW influenza vaccination by 2010 and 90% coverage by 2020. Although influenza vaccine uptake among HCWs has trended upward over the past several years, the percentage of immunized HCWs has remained approximately 40% between 2004 and 2008.

In order to complete the literature review, researchers identified and analyzed peer reviewed literature, news articles, professional organization position statements, and institutional policies published between 1991 and 2011. In the absence …

The Hospitalist: Better Value In Inpatient Care?, Lisa Sprague

National Health Policy Forum

From perhaps a few hundred practitioners in 1996 to an estimated 30,000 today, the discipline called hospital medicine has shown remarkably rapid growth. It represents a fundamental separation of the inpatient and outpatient components of internal and family medicine. The split has implications for the quality and efficiency of care delivery, the outlook for the physician workforce, and the development of new models such as accountable care organizations (ACOs).

Medicare's Bundling Pilot: Including Post-Acute Care Services, Laura A. Dummit

National Health Policy Forum

Fee-for-service Medicare, in which a separate payment is made for each service, rewards health care providers for delivering more services, but not necessarily coordinating those services over time or across settings. To help address these concerns, the Patient Protection and Affordable Care Act of 2010 requires Medicare to experiment with making a bundled payment for a hospitalization plus post-acute care, that is, the recuperative or rehabilitative care following a hospital discharge. This bundled payment approach is intended to promote more efficient care across the acute/post-acute episode because the entity that receives the payment has financial incentives to keep episode costs …

Substance Abuse In Georgia, The Burruss Institute Of Public Service And Research

Georgia Journal of Public Policy

In order to create a snapshot of substance use and abuse in Georgia, the Burruss Institute of Public Service and Research requested access to data from the National Survey on Drug Use and Health conducted on behalf of the Substance Abuse and Mental Health Services Administration (SAMHSA), a unit of the Department of Health and Human Services (HHS).  SAMHSA would not provide access to the raw data; instead, the Institute was given a series of tables with estimates of the average annual number of users of various substances among Georgians ages 12 and older between the years 2002 and 2008. …

Evaluation Of A Quality Management Initiative And Hiv Ambulatory Services Performance In Thailand, Meemon Natthani

Electronic Theses and Dissertations

The accomplishment of pilot implementation of the HIVQUAL-T model, an innovative HIV care quality management tool, has led to an authoritative decision to scale up the use of the model nationwide in Thailand. However, the level of implementing this model varies across target hospitals. Some hospitals have fully adopted the model by conducting quality improvement (QI) activities following performance measurement (PM) results while others have partially adopted only PM or have not used this model at all. The differential level of implementation could be a contributing factor accounting for discrepancies in the quality of care across different HIV ambulatory care …

Increasing Organ Donation In Ireland : Social Marketing And Infrastructural Improvements., Ronan O'Sullivan

Theses

There were over 600 patients on the organ waiting list in Ireland in November 2010. This is a substantial increase on the 414 patients on the waiting list in 2008. Ireland also witnessed a dramatic decline in the number of donors from 90 donors in 2009 to 58 donors in 2010. This thesis focuses on investigating the current state of organ donation in the Republic of Ireland, with the eventual goal of recommending alterations to improve the system. In depth- interviews were conducted with eleven leading personnel from the fields of organ donation and social marketing in Ireland as well …

Local Public Health System Partnerships: A Mixed Methods Multi-State Study, Priscilla A. Barnes

Dissertations

The purpose of this three-paper dissertation was to conduct a mixed methods multi-state examination of specific partnership-related activities among local public health systems (LPHSs) as well as to explore perceptions of LPHS practitioners regarding partnership practices.

In the first paper, secondary data analysis of questions from the National Public Health Performance Standards Program (NPHPSP, n = 110) was used to determine the frequency that partnership activities were conducted optimally (> 75% of the time) and whether any associations existed between three different partnership capacities. Activities were matched with relational, organizational, and programmatic capacities from the Collaborative Capacity Framework. Overall, 86% …

Self-Insurance And The Potential Effects Of Health Reform On The Small-Group Market, Kathryn Linehan

National Health Policy Forum

The Patient Protection and Affordable Care Act (PPACA) as amended by the Health Care Education Reconciliation Act of 2010 makes landmark changes to health insurance markets. Individual and small-group insurance plans and markets will see the biggest changes, but PPACA also affects large employer and self-insured plans by imposing rules for benefit design and health plan practices. Over half of workers—most often those in very large firms—are covered by self-insured health plans in which employers (or employee groups) bear all or some of the risk of providing insurance coverage to a defined population of workers and their dependents. As PPACA …

The Elder Justice Act: Addressing Elder Abuse, Neglect, And Exploitation, Carol O'Shaughnessy

National Health Policy Forum

Elder abuse, neglect, and exploitation is a social problem that affects older people across all socioeconomic groups and care settings. Although national data on the full extent of the problem are elusive, one study found that 11 percent of older people living in community settings had experienced physical, emotional, or sexual abuse, or potential neglect during one year. Abuse and neglect of residents of nursing facilities and other institutions have been a continuing concern of policymakers and advocates for many years. The Elder Justice Act (EJA), enacted as part of the Patient Protection and Affordable Care Act (PPACA) on March …