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1 – 10 of over 1000Describes the process which Yorkshire Regional Health Authority haschosen to adopt to ensure that a comprehensive, co‐ordinated,region‐wide system has been implemented. The system…
Abstract
Describes the process which Yorkshire Regional Health Authority has chosen to adopt to ensure that a comprehensive, co‐ordinated, region‐wide system has been implemented. The system comprises staffing, training, policy and guidance development, food hygiene monitoring, communication, collaboration, networking and support. Discusses lessons to be learned and future actions.
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Twenty-first century has dawned with substantial achievements in population health outcome indicators in India. However, very little is known on patterns in causes of death in…
Abstract
Purpose
Twenty-first century has dawned with substantial achievements in population health outcome indicators in India. However, very little is known on patterns in causes of death in India. The paper aims to discuss this issue.
Design/methodology/approach
In this paper, data was drawn from two sources namely, National Family Health Survey (NFHS-1, 1992-1993 and NFHS-2, 1998-1999) and published reports of Survey of Cause of Death (Rural). Three-years moving average causes-of-death estimates were calculated based on World Health Organization classification of causes of death. Negative binomial regression models were fitted to capture the effect of socio-demographic and behavioural determinants of patterns in causes of death.
Findings
The leading causes of death were heart diseases, tuberculosis, asthma, paralysis, prematurity and cancer. Three-fifth of the deaths to children under the age of ten was from communicable, maternal, perinatal and nutritional conditions. On the other hand, about two-third persons aged 45 years and above were dying from non-communicable diseases. Female were at greater risk of dying from non-communicable diseases (IRR: 1.22, 95 per cent CI: 1.11-1.34, p < 0.001).
Research limitations/implications
The epidemiologic transition in India has produced a shift in mortality from communicable, maternal, perinatal and nutritional conditions to non-communicable diseases, with little or no role played by injuries regardless of the level of all-cause mortality. Coupled with the effects of population age structures, other factors were also responsible for the bulk of the inter-regional disparities. These factors include differences in the populations’ health risks associated with the natural or built environments, prevalence of behavioural risk factors, or gaps in the capacities of health systems to respond to specific disease challenges, social stratification and others.
Originality/value
This paper described the trends, patterns and geographic variability in India’s causes-of-death profile in terms of communicable diseases, non-communicable diseases and injuries, and socio-economic and demographic determinants of patterns in the profile.
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Richard A.E. North, Jim P. Duguid and Michael A. Sheard
Describes a study to measure the quality of service provided by food‐poisoning surveillance agencies in England and Wales in terms of the requirements of a representative consumer…
Abstract
Describes a study to measure the quality of service provided by food‐poisoning surveillance agencies in England and Wales in terms of the requirements of a representative consumer ‐ the egg producing industry ‐ adopting “egg associated” outbreak investigation reports as the reference output. Defines and makes use of four primary performance indicators: accessibility of information; completeness of evidence supplied in food‐poisoning outbreak investigation reports as to the sources of infection in “egg‐associated” outbreaks; timeliness of information published; and utility of information and advice aimed at preventing or controlling food poisoning. Finds that quality expectations in each parameter measured are not met. Examines reasons why surveillance agencies have not delivered the quality demanded. Makes use of detailed case studies to illustrate inadequacies of current practice. Attributes failure to deliver “accessibility” to a lack of recognition on the status or nature of “consumers”, combined with a self‐maintenance motivation of the part of the surveillance agencies. Finds that failures to deliver “completeness” and “utility” may result from the same defects which give rise to the lack of “accessibility” in that, failing to recognize the consumers of a public service for what they are, the agencies feel no need to provide them with the data they require. The research indicates that self‐maintenance by scientific epidemiologists may introduce biases which when combined with a politically inspired need to transfer responsibility for food‐poisoning outbreaks, skew the conduct of investigations and their conclusions. Contends that this is compounded by serious and multiple inadequacies in the conduct of investigations, arising at least in part from the lack of training and relative inexperience of investigators, the whole conditioned by interdisciplinary rivalry between the professional groups staffing the different agencies. Finds that in addition failures to exploit or develop epidemiological technologies has affected the ability of investigators to resolve the uncertainties identified. Makes recommendations directed at improving the performance of the surveillance agencies which, if adopted will substantially enhance food poisoning control efforts.
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Seyed Mohammad Alavinia, Koorosh Etemad, Alireza Mahdavi, Maryam Omidvar, Sara Imanpour, Rudmilla Rahman, Muhiuddin Haider and Jared Frank
The purpose of this paper is to examine the non‐communicable disease (NCD) known as gestational diabetes mellitus (GDM). Specifically, this paper aims to examine the influence of…
Abstract
Purpose
The purpose of this paper is to examine the non‐communicable disease (NCD) known as gestational diabetes mellitus (GDM). Specifically, this paper aims to examine the influence of NCDs on health outcomes both worldwide and throughout the Islamic Republic of Iran, to discuss the current issues surrounding GDM and its impact on pregnant women and their children, and to present a new multi‐faceted approach for preventing future occurrences of GDM.
Design/methodology/approach
The paper examines the current issues surrounding NCDs and GDM, in terms of its prevalence and risk factors, and the efforts taken by the Iranian government to address the growing problem of GDM, through a comprehensive literature review. Further, this paper presents the basis for a new multi‐faceted approach for addressing and preventing GDM.
Findings
GDM is an NCD that can damage the health of both mothers and children. The disease has been linked to macrosomia, congenital cardiac and central nervous system abnormalities, and skeletal muscle deformities among neonates. Pregnant women who develop GDM are more likely to have induced labor, require caesarean section, and develop type 2 diabetes later in life. In the most severe cases, GDM can even result in fetal and maternal mortality. Worldwide prevalence of GDM varies by country, but Iranian women are a particularly high‐risk population. In fact, approximately one of every 20 pregnancies in Iran will be affected by complications and outcomes related to GDM.
Originality/value
In response to growing concerns surrounding the current prevalence of GDM both worldwide and within the Islamic Republic of Iran, along with the associated impact of GDM on health outcomes, the paper presents a multi‐faceted approach for addressing this NCD. This approach will involve a consolidated program of prevention and control with a focus on health‐care solutions which promote both awareness and education.
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The 2003 global outbreak of Severe Acute Respiratory Syndrome (SARS) was an abrupt reminder that infectious diseases pose a continuing threat to human health. In 1967, U.S…
Abstract
The 2003 global outbreak of Severe Acute Respiratory Syndrome (SARS) was an abrupt reminder that infectious diseases pose a continuing threat to human health. In 1967, U.S. Surgeon General William H. Stewart declared “it was time to close the book on infectious diseases” (Garrett, 1994, citing W.H. Stewart, “A Mandate for State Action,” presented at the Association of State and Territorial Health Officers, Washington, DC, December 4, 1967). In the latter half of the twentieth century, many shared this bold view that medical science had vanquished infectious disease. As a result, public health struggled to remain relevant in the face of advances in pharmaceuticals, surgery, genetics and other areas that were becoming increasingly dominant in the quest to extend and enhance human life. SARS forced many to rethink the significance of public health and the crisis, though relatively short-lived, (for commentary on the disparities between the responses to HIV and SARS, see e.g. Altman (2003)) underscored the need to rebuild public health capacity that had been allowed to slip down the health system priority list.
Leila Vali, Fatemeh Ataollahi, Mohammadreza Amiresmaili, Nouzar Nakhaee and Maryam Okhovati
One of the priorities of the health system is community health promotion. In this regards, proper development of programs and plans is needed to create a responsive system which…
Abstract
Purpose
One of the priorities of the health system is community health promotion. In this regards, proper development of programs and plans is needed to create a responsive system which leads to health promotion. The aim of this study was to identify the requirements for developing non-communicable disease (NCDs) programs based on CIPP (context, input, process and product) model.
Design/methodology/approach
This is a qualitative study. Data were collected through semi-structured interviews with 40 experienced informants in the field of NCDs. The interviewees were selected bases on pre-determined criteria which then were completed by snowball sampling. Analysis was carried out using a content analysis approach that led to identifying program development requirements in four dimensions of context, input, process and product.
Findings
Twenty-nine requirements of developing program were categorized in four domains of context, input, process and product. These requirements comprised of pilot studies, the existence of appropriate needs assessment, evidence-based programs, promoting organizational culture, adequacy of resources, identification of stakeholders and comprehensive cooperation and existence of an appropriate evaluation system.
Research limitations/implications
Since this study was performed through a qualitative method, it is possible, some prerequisites of program development may not be encountered. But the extreme effort has been made to perceive diversity and different aspects.
Originality/value
The first study was in the field of appropriate requirements for program development in the context of a centralized health system in a developing country.
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Manuel M. Dayrit and Ronald Umali Mendoza
The control of particularly virulent communicable diseases such as COVID-19 can be considered a global public good. Unabated contagion, both within and across borders, can result…
Abstract
Purpose
The control of particularly virulent communicable diseases such as COVID-19 can be considered a global public good. Unabated contagion, both within and across borders, can result in a global public bad. More effective control – such as by flattening the epidemiological curve – could prevent severe social and economic disruption by allowing domestic health and social protection systems to more adequately respond to the health crisis. This article elaborates on some of the main elements of counter COVID-19 responses, drawing on emerging international good practices. While a full evaluation of policy effectiveness is still forthcoming, it is critical to review and synthesize the emerging lessons and evidence even this early.
Design/methodology/approach
This article reviews the international good practices in counter COVID-19 responses across countries.
Findings
Concerted efforts across borders, such as by sharing data and collaborating in research and by coordinating international support for countercyclical economic and health responses at the national level, are some of the options for countering COVID-19 at the international level. Within countries, more inclusive social protection and health systems, combined with countercyclical economic policies, and concerted behavioral changes tend to produce more effective collective action against the spread of the disease.
Research limitations/implications
This study is based on a review of emerging responses to the health crisis.
Practical implications
The policies and practices reviewed in this paper could feed into better-informed crisis responses to COVID-19 and other types of health shocks.
Originality/value
This study is among the first general reviews of policy responses to the COVID-19 health crisis.
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Siriyaporn Sittisarn, Pilasinee Wongnuch, Pussadee Laor, Chadaporn Inta and Tawatchai Apidechkul
Hand foot mouth disease (HFMD) is an emerging disease caused by Enterovirus. HFMD usually occurs in South-East Asian countries including Thailand. Thailand has been indicated as…
Abstract
Purpose
Hand foot mouth disease (HFMD) is an emerging disease caused by Enterovirus. HFMD usually occurs in South-East Asian countries including Thailand. Thailand has been indicated as one of the countries having high epidemic rate in children less than five years of age, particularly in the northern regions. The paper aims to discuss this issue.
Design/methodology/approach
A qualitative method was used to extract information from 48 informants from two different areas; high and low epidemic areas of HFMD. Question guidelines were developed from literature review and viewed by three external experts in the field before use. Interviews took place in a private and confidential room. Each interview lasted approximately 50 minutes.
Findings
There are no policies regarding HFMD control in both high and low epidemic areas of HFMD. The staff at sub-district local government level did not have the necessary qualifications for HFMD control. Additionally, staff were not stable, and there was a lack of a disease control team. Antiseptics for cleaning day care centers (DCC) were not effective for disease control; most DCC use Dettol®, soap, dishwashing liquid, detergent and water for cleaning the environment. These antiseptics do not include chlorine making it ineffective in destroying the virus.
Originality/value
The sub-district local government should be concerned about HFMD control; the staff should have the necessary qualifications suitable for disease control. Standard and practical HFMD control guideline should be set up and used in DCC.
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Pauline Allen, Bronwyn Croxson, Jennifer Roberts, Shirley Crawshaw, Kate Archibald and Lynda Taylor
This paper reports a national study which investigated the involvement of infection control professionals in (and their views about) the formal processes of contracting for health…
Abstract
This paper reports a national study which investigated the involvement of infection control professionals in (and their views about) the formal processes of contracting for health care in the NHS internal market. Health care professionals needed to be involved contracting, if it was to be effective. The study found that many infection control professionals were not, in fact, involved in contracting, while the importance of both contracts and informal professional networks were recognised. But respondents did not think that their professional networks entirely compensated for their lack of involvement in contracting. As formal agreements continue to be central to achieving quality of care in the post‐internal market NHS, infection control professionals need to be involved in specification and implementation of these arrangements.
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Russell Harpring, Amin Maghsoudi, Christian Fikar, Wojciech D. Piotrowicz and Graham Heaslip
This study aims to describe the compounding factors in a complex emergency, which exacerbate a cholera epidemic among vulnerable populations due to supply chain disruptions. Basic…
Abstract
Purpose
This study aims to describe the compounding factors in a complex emergency, which exacerbate a cholera epidemic among vulnerable populations due to supply chain disruptions. Basic needs such as food, medicine, water, sanitation and hygiene commodities are critical to reduce the incidence rate of cholera and control the spread of infection. Conflicts cause damage to infrastructure, displace vulnerable populations and restrict the flow of goods from both commercial and humanitarian organizations. This study assesses the underlying internal and external factors that either aggravate or mitigate the risk of a cholera outbreak in such settings, using Yemen as a case study.
Design/methodology/approach
This study adopts a system dynamics methodology to analyze factors that influence cholera outbreaks in the context of the Yemeni Civil War. A causal loop diagram with multiple components was constructed to represent the complexities of humanitarian situations that require critical decision-making. The model was built using data from humanitarian organizations, non-governmental organizations and practitioners, along with literature from academic sources. Variables in the model were confirmed through semi-structured interviews with a field expert.
Findings
Compounding factors that influenced the cholera outbreak in Yemen are visualized in a causal loop diagram, which can improve the understanding of relationships where numerous uncertainties exist. A strong link exists between humanitarian response and the level of infrastructure development in a country. Supply chains are affected by constraints deriving from the Yemeni conflict, further inhibiting the use of infrastructure, which limits access to basic goods and services. Aligning long-term development objectives with short-term humanitarian response efforts can create more flexible modes of assistance to prevent and control future outbreaks.
Research limitations/implications
The model focuses on the qualitative aspects of system dynamics to visualize the logistics and supply chain-related constraints that impact cholera prevention, treatment and control through humanitarian interventions. The resulting causal loop diagram is bounded by the Yemen context; thus, an extension of the model adapted for other contexts is recommended for further study.
Practical implications
This study presents a systematic view of dynamic factors existing in complex emergencies that have cause-and-effect relationships. Several models of cholera outbreaks have been used in previous studies, primarily focusing on the modes and mechanisms of transmission throughout a population. However, such models typically do not include other internal and external factors that influence the population and context at the site of an outbreak. This model incorporates those factors from a logistics perspective to address the distribution of in-kind goods and cash and voucher assistance.
Social implications
This study has been aligned with six of the United Nations Sustainable Development Goals (SDGs), using their associated targets in the model as variables that influence the cholera incidence rate. Recognizing that the SDGs are interlinked, as are the dynamic factors in complex humanitarian emergencies, the authors have chosen to take an interdisciplinary approach to consider social, economic and environmental factors that may be impacted by this research.
Originality/value
This paper provides an insight into the underlying inter-relations of internal and external factors present in the context of a cholera outbreak in a complex crisis. Supply chains for food; water, sanitation and hygiene; and health products are crucial to help prevent, control and treat an outbreak. The model exposes vulnerabilities in the supply chain, which may offer guidance for decision makers to improve resilience, reduce disruptions and decrease the severity of cholera outbreaks.
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