Health Services Administration Commons^™

A Sustainable Approach To Health Systems Strengthening In Developing Countries: Lessons From The Ebola Crisis, Prince Tarnah

Capstone Collection

The research paper started with emphasizing the importance of health security as an issue of global concern under the UNDP theory of human security. The research then proceeded with a focus on the approaches to health systems strengthening and a reflection on lessons learned from the Ebola virus outbreak to answer the question: How do we approach health systems strengthening (HSS) to achieve sustainable impact? Scholarly articles, and literature from other authoritative sources on health systems strengthening, like the World Health Organization (WHO) and the US Agency for International Development (USAID), were reviewed to determine a clear definition of HSS, …

(Video) Income-Related Inequalities In Utilization Of Health Services Among Private Health Insurance Beneficiaries In Brazil, Heitor Werneck

GW Research Days 2016 - 2020

Brazil’s 1988 health reform created the Unified Health System (SUS). SUS is a universal health system that emulates British National Health Service, featuring an open-ended benefit package and a major goal of health equity. An unforeseen consequence of the reform was that former beneficiaries of the social health insurance sought to sustain their privileged access to health services through private health insurance. Despite achievements in expanding healthcare access and improved health outcomes, recurring opinion polls suggest that Brazilians are skeptical about SUS’ capacity to delivery timely and quality health services, making private insurance a priority to most households. The literature …

Building Capacity In Implementation Science Research Training At The University Of Nairobi., George O Osanjo, Julius O Oyugi, Isaac O Kibwage, Walter O Mwanda, Elizabeth N Ngugi, Fredrick C Otieno, Wycliffe Ndege, Mara Child, Carey Farquhar, Jeremy Penner, Zohray Talib, James N Kiarie

Health Policy and Management Faculty Publications

BACKGROUND: Health care systems in sub-Saharan Africa, and globally, grapple with the problem of closing the gap between evidence-based health interventions and actual practice in health service settings. It is essential for health care systems, especially in low-resource settings, to increase capacity to implement evidence-based practices, by training professionals in implementation science. With support from the Medical Education Partnership Initiative, the University of Nairobi has developed a training program to build local capacity for implementation science.

METHODS: This paper describes how the University of Nairobi leveraged resources from the Medical Education Partnership to develop an institutional program that provides training …

Neoliberalism Redux: The Global Health Policy Agenda And The Politics Of Cooptation In Latin America And Beyond, Anne E Birn, Laura Nervi, Carlos Eduardo Siqueira

Gastón Institute Publications

This article explores the neoliberal cooptation of social justice-oriented global health policies over the last three decades, from primary health care and ‘health for all’ to various contemporary so-called ‘health equity’ initiatives, such as Universal Health Coverage and ‘health convergence’. The authors illustrate and contextualize the different periods and approaches with examples from a range of Latin American countries, drawing on diverse political experiences and social struggles in the health arena. The analysis concludes with reflections about the region’s experiences of resisting and challenging the neoliberal health agenda, in spite of domestic and global environments that have constrained these efforts, …

Maximizing The Impact Of Training Initiatives For Health Professionals In Low-Income Countries: Frameworks, Challenges, And Best Practices, Corrado Cancedda, Paul E. Farmer, Vanessa Kerry, Tej Nuthulaganti, Kirstin W. Scott, Eric Goosby, Agnes Binagwaho

Dartmouth Scholarship

Corrado Cancedda and colleagues outline a framework for health professional training initiatives in low-income countries.

Investigating Barriers To Early Cancer Detection For Rural Indian Women: A Qualitative Analysis Of Cancer Outreach In Dehradun, Uttarakhand, Blair Burnett

Independent Study Project (ISP) Collection

This study examines barriers to early detection for women’s specific cancers in rural India in and around Dehradun, Uttarakhand, within the framework of existing health outreach programs from tertiary hospitals in the state. The burden of cancer mortality within India is disproportionately affecting women living in rural populations considering the current health education and health care infrastructure in place. Barriers of knowledge, access to knowledge, economic condition, geography, and cultural norms are all examined within this study in the context of early cancer detection. National Indian health policy is currently framed to address the burden of cancer within India; however, …

Deconstructing Unmade Examining The Capacity Of Ayurveda To Address India’S Mental Health Crisis, Cassie Sutten Coats

Independent Study Project (ISP) Collection

Though India does not have a credible, widespread system in place to recognize and focus on issues of mental health, especially in allopathic treatments, it is imperative to evaluate the existing practices and approaches in regards to mental health alongside the impact that these approaches may have on Indian society. In contrast to Westernized systems of medicine, the traditional Indian system of Ayurveda inherently addresses issues in mental health due to the holistic approach through mind-body medicine. This study evaluates the enormous potential that exists within Ayurvedic philosophy to provide adequate, culturally congruent, treatments and care in mental health, and …

Burnout At The Frontline: The Effect Of A Reproductive Health Voucher Program On Health Workers In Uganda, Carinne M. Brody, John Micheal Irige, Ben Bellows

Background: Low job satisfaction among healthcare workers in developing countries can increase risk of burnout and have a negative effect on the quality of services. Novel financing strategies such as voucher programs, which aim to increase the utilization of services by the poor by offering physical vouchers for subsidized care, may unintentionally exacerbate burnout for health care workers by creating higher workloads.

Methods: A semi-structured survey that included both closed and open-ended questions as well as a locally-adapted job satisfaction scale was used to collect information on provider perceptions of changes in job satisfaction, workload, staffing and salaries …

Transforming Health Professions' Education Through In-Country Collaboration: Examining The Consortia Among African Medical Schools Catalyzed By The Medical Education Partnership Initiative., Zohray M. Talib, Elsie Kiguli-Malwadde, Hannah Wohltjen, Miliard Derbew, Yakub Mulla, David Olaleye, Nelson Sewankambo

Health Policy and Management Faculty Publications

BACKGROUND: African medical schools have historically turned to northern partners for technical assistance and resources to strengthen their education and research programmes. In 2010, this paradigm shifted when the United States Government brought forward unprecedented resources to support African medical schools. The grant, entitled the Medical Education Partnership Initiative (MEPI) triggered a number of south-south collaborations between medical schools in Africa. This paper examines the goals of these partnerships and their impact on medical education and health workforce planning.

METHODS: Semi-structured interviews were conducted with the Principal Investigators of the first four MEPI programmes that formed an in-country consortium. These …

Changes In Malaria Prevention And Incidence Due To Political Restructuring Of Mozambique And South Africa, Nirmala K. Shivakumar

Undergraduate Research Posters

The UN’s current Millennium Development Goal puts pressure on many countries to decrease malaria incidence by 2015, including Mozambique and South Africa. While Mozambique and South Africa have continually worked to decrease malaria incidence for the last five decades, neither country can claim elimination of disease by UN standards. This study analyzes the changes in political structure and the simultaneous changes in the malaria prevention programs of Mozambique and South Africa after the end of their respective civil wars in 1992 and 1994. This study analyzed public health, historical, and social science journal articles. This study examined political power distribution, …

Empowerment-Based Positive Youth Development: A New Understanding Of Healthy Development For African American Youth, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

A shift occurred in research about adolescents in the general population. Research is moving away from deficits toward a resilience paradigm and understanding trajectories of positive youth development. This shift has been less consistent in research and practice with African American youth. A gap also exists in understanding whether individual youth development dimensions generate potential in other dimensions. This study presents an empowerment-based positive youth development model. It builds upon existing research to present a new vision of healthy development for African American youth that is strengths-based, developmental, culture-bound, and action-oriented. It emphasizes the relationship between person and environment, the …

Humanitarian And Civic Assistance Health Care Training And Cultural Awareness Promoting Health Care Pluralism, Rose E. Facchini

Faculty and Staff - Articles & Papers

Integration between traditional and contemporary health care in a host nation can be beneficial to nation- and capacity-building and, subsequently, to the overall health of the society. Traditional health care in this sense refers to the indigenous health care system in the host nation, which includes characteristic religious or cultural practices, whereas contemporary health care is also known as conventional or Westernized; integration is a synchronization of these two health care forms. However, the choice of integration depends on the political and cultural situation of the nation in which the Department of Defense health care personnel are intervening. Thus, cultural …

The Impact Of The Chinese Rural Healthcare System On Infectious Disease: A Study Of The History And Reform Of Chinese Healthcare, And The Global Implications Of Infectious Disease Control In China, John Barbadoro

Independent Study Project (ISP) Collection

China’s healthcare system has gone through significant changes in the 20^th and 21^st centuries. These changes have mirrored not only the political focus of the time, but also the social issues facing China. The NRCMCS for rural residents is a cheap annual fee that covers a percentage of medical costs. There are two urban equivalents, the BMIUE and BMIUR for urban employees through their job, and residency respectively. Despite the focus on cheaper healthcare for rural residents, the problems of income inequality and mistrust in the medical system are major problems that affect the health of this large …

Las Multiplicidades De Salud Integral: Medicina Plural, Medicina Holística, Louise Highleyman

Independent Study Project (ISP) Collection

El Hospital Andino Alternativo de Chimborazo (H.A.A.CH.) es un hospital relativamente pequeño ubicado en la ciudad de Riobamba, la capital de la provincia de Chimborazo. Un proyecto de la Diócesis de Riobamba, lo que diferencia este hospital es la unión de tres áreas de medicina en el mismo lugar: medicina andina (o ancestral), medicina alternativa, y medicina alopática (o química).Los tres tipos de medicina “dan la libertad al paciente de elegir con qué tipo de medicina desea curarse.”[1] Aunque actualmente la mayoría de pacientes (70%, según la gerente) están transferidos por el Instituto Ecuatoriano de Seguridad Social (IESS) para …

Book Review: Dream Of Ding Village By Yan Lianke, Mike Frick

China Beat Blog: Archive 2008-2012

Unsurprisingly, the Chinese government levied a “three nos” ban—no sales, no distribution, and no promotion—against Dream of Ding Village after its publication in 2005. Though the storytelling relies heavily on dream sequences, Yan takes little poetic license when exposing the depth of the state’s culpability in spreading HIV among poor, medically-naïve farmers. He is just as uncompromising when detailing how officials denied responsibility for the ensuing AIDS epidemic, even as they profited from its human tragedy. No one in Ding Village receives medical care, mental health counseling, food assistance, or a chance to hold the blood heads legally accountable. Cast …

Conflict Situation For Health Care Workers: A Case Study Of The Occupational Challenges In Kasangati Health Centre Iv And Their Implications For Patient Care., Shannon Mcdowell

Independent Study Project (ISP) Collection

Many factors influence a country’s ability to provide quality health services for its people. Particularly, quality health care hinges upon the availability of properly trained and equipped health care workers (HCWs) to deliver effective care. Resource-strained countries committed to the Millennium Development Goals are confronting the reality that shortages and uneven distribution of HCWs threaten their capacities to encourage and establish healthy communities. A scarcity in HCWs is one challenge of public health initiatives and places stress on existing HCWs. Other challenges faced by HCWs severely affect performance, motivation, and overall care-giving ability.

This study aims to examine the particular …

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 …

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 …

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 …

Everything's Better In Moderation: Young Women's Gender Role Attitudes And Risky Sexual Behavior, Tamara Leech

Department of Public Health Scholarship and Creative Works

Purpose This study examines the association between gender role attitudes and risky sexual behavior among young women. Previous studies have posed seemingly contradictory arguments: that either traditional attitudes or egalitarian attitudes are associated with riskier behavior. Methods Data are based on the children of the National Longitudinal Survey of Youth, representing 520 sexually active 18–19-year-old women. Propensity radius matching was used to assess differences in rates of multiple sexual partners and sex outside of a committed relationship. Results Relative to moderate gender role attitudes, both egalitarian gender role attitudes and traditional gender role attitudes are associated with higher rates of …

Belize As A Classroom, Jordan Norris, Molly Calico

Impact Belize

During the week of January 7-14, 2010, Molly Calico and Jordan Norris participated in the Impact Belize program through the College of Health and Human Services. This program took place in Gales Point, a rural, underserved community in Belize. Impact students provided medical, dental and public health services to the community in an interdisciplinary service-learning format. As Master of Public Health students, Molly and Jordan directed health education initiatives and served on the Leadership Team for the program. Having participated in January of 2009 as well, Molly and Jordan were well prepared to conduct public health research and to assume …

A Cohort Study Of Reproductive And Hormonal Factors And Renal Cell Cancer Risk In Women, Gc Kabat, Stephanie A. Navarro Silvera, Ab Miller, Te Rohan

Department of Public Health Scholarship and Creative Works

We examined the association of reproductive and hormonal factors with renal cell cancer risk in a cohort study of 89 835 Canadian women. Compared with nulliparous women, parous women were at increased risk (hazard ratio (HR) 1.78, 95% confidence interval (CI) 1.02–3.09), and there was a significant gradient of risk with increasing levels of parity: relative to nulliparous women, women who had X5 pregnancies lasting 4 months or more had a 2.4-fold risk (HR 1⁄4 2.41, 95% CI 1⁄4 1.27–4.59, P for trend 0.01). Ever use of oral contraceptives was associated with a modest reduction in risk. No associations were …

Girls' Perception Of Physical Environmental Factors And Transportation: Reliability And Association With Physical Activity And Active Transport To School, Kelly R. Evenson, Amanda Birnbaum, Ariane L. Bedimo-Rung, James Sallis, Carolyn C. Voorhees, Kimberly Ring, John P. Elder

Department of Public Health Scholarship and Creative Works

Background

Preliminary evidence suggests that the physical environment and transportation are associated with youth physical activity levels. Only a few studies have examined the association of physical environmental factors on walking and bicycling to school. Therefore, the purpose of this study was (1) to examine the test-retest reliability of a survey designed for youth to assess perceptions of physical environmental factors (e.g. safety, aesthetics, facilities near the home) and transportation, and (2) to describe the associations of these perceptions with both physical activity and active transport to school.

Methods

Test and retest surveys, administered a median of 12 days later, …

Need For Cognition And Message Complexity In Motivating Fruit And Vegetable Intake Among Callers To The Cancer Information Service, Pamela Williams-Piehota, Judith Pizarro, Stephanie A. Navarro Silvera, Linda Mowad, Peter Salovey

Department of Public Health Scholarship and Creative Works

This field experiment examined the impact of an individual's need for cognition (NFC; the tendency to enjoy thinking deeply about issues), complex versus simple messages, and the interaction of NFC and message type on encouraging fruit and vegetable consumption. Callers to the Cancer Information Service of the National Cancer Institute (N = 517) were asked to participate in the experiment at the end of their call. Individual NFC was assessed, and participants were assigned randomly to receive a telephone message promoting fruit and vegetable consumption that was either complex and multifaceted or simple and straightforward. Similarly constructed brochures were mailed …

The Case Of South African And Chilean Health Systems: Comparison Of Financial, Economic And Health Indicators, Alberto Coustasse, Peter Hilsenrath, Patricio Silva Rojas

Management Faculty Research

The purpose of this study is to identify similarities and differences between healthcare systems of South Africa and Chile. The World Health Report 2000, the Human Development Index, and financial indicators were used for comparison. Chile showed better performance than South Africa in most of the measures used. Significant progress has been made in South Africa, bringing better education, healthcare and housing to the deprived black majority. However, the HIV/AIDS epidemic, weighs heavily on health indicators. Chile decentralized its health services and implemented economic reforms during the 1980's and has had steady improvement in its healthcare indicators. Finally, these counties …

Decreasing Barriers For Teens: Evaluation Of A New Teenage Pregnancy Prevention Strategy In School-Based Clinics, Abbey C. Sidebottom, Amanda Birnbaum, Sarah S. Nafstad

Department of Public Health Scholarship and Creative Works

Sidebottom et al seek to evaluate the effects of the change in distribution systems on students' receipt of requested contraceptives and demand for contraceptive school-based clinics (SBC). The result of the study reveals that the average number of requests per student was higher under the voucher system, possibly as a consequence of expires vouchers resulting in repeated requests. The findings also suggest that SBCs could go a step further in reducing adolescents' barriers to accessing contraceptives by adopting an on-site direct delivery system..