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The public health perspective: Building the HIVe
Jonathan Elford
Digital Culture & Education , 2012,
Leadership in strategic information (LSI) building skilled public health capacity in Ethiopia
Italia V Rolle, Irum Zaidi, Jennifer Scharff, Donna Jones, Aynalem Firew, Fikre Enquselassie, Ashenafi Negash, Negussie Deyessa, Getnet Mitike, Nadine Sunderland, Peter Nsubuga
BMC Research Notes , 2011, DOI: 10.1186/1756-0500-4-292
Abstract: Trainees' skill sets increased in descriptive and analytic epidemiology, surveillance, and monitoring and evaluation (M and E). Data from the evaluation indicated that the course structure and the M and E module required revision in order to improve outcomes. Additionally, the first cohort had a high attrition rate. Overall, trainees and key stakeholders viewed LSI as important in building skilled capacity in public health in Ethiopia.The evaluation provided constructive insight in modifying the course to improve retention and better address trainees' learning needs. Subsequent course attrition rates decreased as a result of changes made based on evaluation findings.The United States (U.S.) President's Emergency Plan for AIDS Relief (PEPFAR), implemented in 2003, is a significant undertaking by the U.S. government to prevent and treat HIV-infected persons in developing countries [1]. Strategic Information (SI) is an essential element of PEPFAR that ensures quality data are used to guide programs supported by this initiative. Surveillance, monitoring and evaluation (M and E), health management information systems, planning, and reporting are the core components of SI [2]. As the second cycle of PEPFAR broadens its focus to health systems strengthening in addition to scaling up services for HIV care treatment and prevention (PEPFAR I), the effective use of SI is key for this venture to be successful. A recent review of PEPFAR I by the Institute of Medicine (IOM) supports the role of SI in HIV-related activities. The IOM report recommended that as PEPFAR goes forward there is a need for quality data to guide interventions, evidence-based decision making, and ongoing evaluations and research [2].The Centers for Disease Control and Prevention (CDC) has extensive experience in teaching the use of data for effective decision making using an applied approach that entails hands on practical training [3-5]. The use of data is central for evidence-based decisions as it leads t
Building the national health information infrastructure for personal health, health care services, public health, and research
Don E Detmer
BMC Medical Informatics and Decision Making , 2003, DOI: 10.1186/1472-6947-3-1
Abstract: A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries). The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security) framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges.A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors.If you cannot measure it, you cannot improve it. Lord KelvinBetter health in the 21st century – it is what we seek for our families, our patients, our neighbors, our communities, our nation, and indeed people all over the world. It is a matter of quality of life for individuals, stability and happiness within communities, productivity for industry, security for nations, and professional satisfaction for heath workers. Maintaining and improving health is not an abstract notion. We already know much about where and how we fall short in assuring health. We also know the potential to improve health grows daily as result of the steady flow of research advances.The health of individuals and the population depends on four major domains of our vast, complex, and disorganized health secto
Central African Field Epidemiology and Laboratory Training Program: building and strengthening regional workforce capacity in public health
Gervais Ondobo Andze, Abel Namsenmo, Benoit Kebella Illunga, Ditu Kazambu, Dieula Delissaint, Christopher Kuaban, Francois-Xavier Mbopi-Kéou, Wilfred Gabsa, Leopold Mulumba, Jean Pierre Bangamingo, John Ngulefac, Melissa Dahlke, David Mukanga, Peter Nsubuga
Pan African Medical Journal , 2011,
Abstract: The Central African Field Epidemiology and Laboratory Training Program (CAFELTP) is a 2-year public health leadership capacity building training program. It was established in October 2010 to enhance capacity for applied epidemiology and public health laboratory services in three countries: Cameroon, Central African Republic, and the Democratic Republic of Congo. The aim of the program is to develop a trained public health workforce to assure that acute public health events are detected, investigated, and responded to quickly and effectively. The program consists of 25% didactic and 75% practical training (field based activities). Although the program is still in its infancy, the residents have already responded to six outbreak investigations in the region, evaluated 18 public health surveillance systems and public health programs, and completed 18 management projects. Through these various activities, information is shared to understand similarities and differences in the region leading to new and innovative approaches in public health. The program provides opportunities for regional and international networking in field epidemiology and laboratory activities, and is particularly beneficial for countries that may not have the immediate resources to host an individual country program. Several of the trainees from the first cohort already hold leadership positions within the ministries of health and national laboratories, and will return to their assignments better equipped to face the public health challenges in the region. They bring with them knowledge, practical training, and experiences gained through the program to shape the future of the public health landscape in their countries. Pan African Medical Journal 2011; 10(Supp 1):4
The Ethiopian Field Epidemiology and Laboratory Training Program: strengthening public health systems and building human resource capacity
Daddi Jima, Getnet Mitike, Zegeye Hailemariam, Alemayehu Bekele, Adamu Addissie, Richard Luce, Peter Wasswa, Olivia Namusisi, Sheba Nakacubo Gitta, Monica Musenero, David Mukanga
Pan African Medical Journal , 2011,
Abstract: The Ethiopian Field Epidemiology and Laboratory Training Program (EFELTP) is a comprehensive two-year competency-based training and service program designed to build sustainable public health expertise and capacity. Established in 2009, the program is a partnership between the Ethiopian Federal Ministry of Health, the Ethiopian Health and Nutrition Research Institute, Addis Ababa University School of Public Health, the Ethiopian Public Health Association and the US Centers of Disease Control and Prevention. Residents of the program spend about 25% of their time undergoing didactic training and the 75% in the field working at program field bases established with the MOH and Regional Health Bureaus investigating disease outbreaks, improving disease surveillance, responding to public health emergencies, using health data to make recommendations and undertaking other field Epidemiology related activities on setting health policy. Residents from the first 2 cohorts of the program have conducted more than 42 outbreaks investigations, 27analyses of surveillance data, evaluations of 11 surveillance systems, had28oral and poster presentation abstracts accepted at 10 scientific conferences and submitted 8 manuscripts of which 2are already published. The EFELTP has provided valuable opportunities to improve epidemiology and laboratory capacity building in Ethiopia. While the program is relatively young, positive and significant impacts are assisting the country better detect and respond to epidemics and address diseases of major public health significance. Pan African Medical Journal 2011; 10 (Supp 1):5
Building capacity without disrupting health services: public health education for Africa through distance learning
Lucy Alexander, Ehi Igumbor, David Sanders
Human Resources for Health , 2009, DOI: 10.1186/1478-4491-7-28
Abstract: This brief paper describes the innovative aspects of the programme, offering some evaluative indications of its impact, and reviews how the delivery of text-led distance learning has facilitated the realization of the objectives of public health training. Strategies are proposed for scaling up such a programme to meet the growing need in this essential area of health human resource capacity development in Africa.The human resources crisis in Africa is especially acute in the public health field. Sadana and Petrakova [1] note the concentration of public health programmes in "high-income countries" while IJsselmuiden et al. [2] draw attention to the insufficient number of public health programmes in Africa and their limited coverage arising from their inadequate staffing allocation, among other factors.In 1993, when the University of the Western Cape (UWC) established its Public Health Programme (which became a School of Public Health in 2000), public health education in South Africa was concentrated in university medical faculties and did not cater for the broad range of allied health professionals working in the health services. Recognizing the need for "... an adequate supply of equitably distributed and competent personnel" [3], to address the country's public health challenges, the UWC undertook to:? provide an academic environment for appropriate education and training, research and service-oriented courses in the field of public health;? provide field training that is community-based and fosters community partnership;? create a centre for innovative ideas in public health education and research, and become a magnet for international health scholars;? provide a forum for discussion and debate about ethical issues in public health, and empower communities to participate in these debates;? cooperate with future schools of public health in South Africa, the African continent and internationally [Unpublished document: University of the Western Cape: Colloquium: The
Public Health Capacity Building in Times of Austerity: A Case Study From the University of East London
Carmen Aceijas,Nena Foster
Public Health Reviews , 2011,
Abstract: The University of East London (UEL) offers a BSc and MSc of Public Health (PH). The programmes are designed to build the workforce capacity by enabling access to higher education (HE) for future PH practitioners and specialists, and facilitating promotion possibilities within current employment. In 2009/10, the MSc and BSc programs had 143 and 70 students respectively, with 209 students undertaking PH combined degrees at the BSc level. This paper presents methods and outcomes of aligning the programs with the United Kingdom Public Health Skills and Career Framework (UK PHSCF). The realigned MSc programme is a 1.5 year (full-time), six module (180 credits) programme with strong emphasis on epidemiology and research. The BSc programme lasts three years (full-time) and consists of 36 modules (360 credits) providing an introductory overview of the core functions of PH. The programmes’ modules were mapped against the 9 UK PHSCF PH areas. Additional activities were built into the programs to enhance the learning experience and augment transferable skills.After the realignment, the UK Government published in 2010 the White Paper for PH and, in spite of this, announced budget cuts to HE funding along with increased tuition fees. The programme changes are likely to contribute to PH capacity building but in a time when political reform adversely impacts on the development of the PH workforce.
Share of Nations in 37 International Public Health Journals: An Equity and Diversity Perspective Towards Health Research Capacity Building
N Keshavarz Mohammadi,F Zaree,E de Leeuw,MM Emamjomeh
Iranian Journal of Public Health , 2011,
Abstract: Background: This paper contributes to further exploration of inequity in access to health research capacity development by examining the representation of different nations in international public health journals. It also aims to examine the degree of diversity that exists in these journals.Methods: This study is a descriptive survey. It was done with objective sampling on 37 ISI health journals on October of 2008.The number and nationality of people in different editorial positions of the journals was identified. The second analy-sis involved recalculating the numbers obtained for each nation to the population size of nations per million inhabitants. In order to better compare countries in terms of presence in editorial team of the journals, a ‘public health editor equity gap ratio' (PHEEGR) was developed.Results: Low income countries have occupied none of the leadership positions of chief editor or associate /assistant chief editors and middle income countries at maximum shared less than 5 percent. The PHEEGR gap in access to the different editorial positions between highest to the lowest representation of countries was 16/1 for chief editors, 12/1 for associate editors , 335/1 for editorial boards and 202/1 for associate editorial boards. However, after normalizing the data to the country's population, the gap increased significantly.Conclusion: There is an imbalance and possibly even inequity in the composition of editorial boards and offices of interna-tional health journals that should be paid significant attention. This can contribute to fill the equity gap exists between health in developing and developed countries.
Governance and Capacity Building in German and Austrian Public Health Since the 1950s
Horst Noack
Public Health Reviews , 2011,
Abstract: The German speaking countries (Germany and Austria) have a strong tradition of universal health insurance since the late 19th century. Germany was one of the leading countries in “social hygiene as health science”, an interdisciplinary field of academic work, health policy and practice, providing a comprehensive scientific basis both for professional education and training in the new academies for social hygiene, the schools of public health in the 1920s, and also for a rapidly growing network of municipal public health services. Public health in Austria at that time was less advanced. There was a rupture in the field of public health in these countries as the Nazi regime and World War II destroyed almost all of the human resources, the scientific basis and the institutional infrastructure required for advancement. In the postwar period Germany was divided with separate social and health systems in East and West Germany until reunification in 1990. Meanwhile, Austria became a democratic federal republic developing a social welfare policy on the basis of a successful economy. Whereas Germany set up national programmes to support the development of a new public health, Austria established a health promotion fund. As a result, there has been more growth in the public health community in Germany than in Austria. However, in both countries strong efforts to strengthen the educational base will be needed to address the complex issues facing public health in the 21st century. For example, health expenditures in Germany and Austria are among the highest in the European Union, but health systems indicators such as healthy life years show values below the European average. The challenge to renew the highly fragmented systems of health/disease care and improve the social determinants of population health underline the need for strengthening public health structures and national policy in the two German speaking countries. Development of the scientific community is underway but has not yet reached the levels of the outstanding achievements of the late 19th and early 20th centuries.
The Tanzania Field Epidemiology and Laboratory Training Program: building and transforming the public health workforce
Peter Mmbuji, David Mukanga, Janeth Mghamba, Mohamed Ahly, Fausta Mosha, Simba Azima, Sembuche Senga, Candida Moshiro, Innocent Semali, Italia Rolle, Stefan Wiktor, Suzzane McQueen, Peter McElroy, Peter Nsubuga
Pan African Medical Journal , 2011,
Abstract: The Tanzania Field Epidemiology and Laboratory Training Program (TFELTP) was established in 2008 as a partnership among the Ministry of Health and Social Welfare (MOHSW), Muhimbili University of Health and Allied Sciences, National Institute for Medical Research, and local and international partners. TFELTP was established to strengthen the capacity of MOHSW to conduct public health surveillance and response, manage national disease control and prevention programs, and to enhance public health laboratory support for surveillance, diagnosis, treatment and disease monitoring. TFELTP is a 2-year full-time training program with approximately 25% time spent in class, and 75% in the field. TFELTP offers two tracks leading to an MSc degree in either Applied Epidemiology or, Epidemiology and Laboratory Management. Since 2008, the program has enrolled a total of 33 trainees (23 males, 10 females). Of these, 11 were enrolled in 2008 and 100% graduated in 2010. All 11 graduates of cohort 1 are currently employed in public health positions within the country. Demand for the program as measured by the number of applicants has grown from 28 in 2008 to 56 in 2011. While training the public health leaders of the country, TFELTP has also provided essential service to the country in responding to high-profile disease outbreaks, and evaluating and improving its public health surveillance systems and diseases control programs. TFELTP was involved in the country assessment of the revised International Health Regulations (IHR) core capabilities, development of the Tanzania IHR plan, and incorporation of IHR into the revised Tanzania Integrated Disease Surveillance and Response (IDSR) guidelines. TFELTP is training a competent core group of public health leaders for Tanzania, as well as providing much needed service to the MOHSW in the areas of routine surveillance, outbreak detection and response, and disease program management. However, the immediate challenges that the program must address include development of a full range of in-country teaching capacity for the program, as well as a career path for graduates. Pan African Medical Journal 2011;10(Supp1):9
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