bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prioritizing Health Information in Europe – What do we want and need to know?
Authors: Fehr A , Ombrellaro K J , Achterberg P , Bogaert P , Carle F , Palmieri L , Tijhuis M J , Lyons R , Zelviene A , Ziese T 
Published: November 2019

Abstract

Background
Prioritization of Health information (HI) involves the establishment of methodological standards, and the development of political momentum to reliably track health status and health determinants. This is important in order to strengthen the evidence base for public health policies and facilitate effective delivery of healthcare services. In support of the establishment of a sustainable EU-wide Health information system, this consortium explores how HI is prioritized in EU and associated countries.

Methods
The Robert Koch Institute is conducting an online Policy Delphi survey among InfAct project partners, stakeholders from EU-Member States and associated countries. The Delphi methodology allows for rankings and priority-setting among a group of experts. The Policy Delphi facilitates the analysis of the impact and acceptability of a proposed policy option. The survey targets experts in national public health institutes and agencies, ministries of health and research. Participants are invited to provide information regarding their national HI prioritization processes, and to rank prioritization strategies and criteria, according to their degree of “desirability”, “feasibility”, “importance” and “confidence”.

Results
The Delphi survey will compile and assess processes and methods used to prioritize health information at national level in the EU and associated countries. The expected outcome is a list of good-practices in health information development and prioritization within countries, which could be further integrated to a health information prioritization strategy at the European level.

Conclusions
Prioritizing health information ensures that the right data is collected, is used to support ongoing public health policy action, and to capture emerging public health issues. This overview of prioritization strategies and methods aims to promote evidence-based public health by structuring exchanges about national HI prioritization in Europe.
Analysis of the free caesarean section initiative at the Nabil Choucair Health Center
Authors: Leye M M M , Mbengue E T , Tal Dia A 
Published: November 2019

Abstract

Introduction
The initiative for free caesareans was officially launched in December 2004. Our study, with The overall objective of contributing to an evaluation of the impact of this initiative on the operation of the Nabil Choucair Health Center (NCHC) will strengthen its implementation.

Methods
This is an analytical, cross-sectional, quantitative and qualitative study conducted from September 1 to October 31, 2017 at NCHC. It focused on four target populations: providers, beneficiaries, members of health and co-management committees, and those responsible for maternity and the laboratory. Data entry and analysis were performed with the Excel software and EPI Info version 3.3.2.

Results
The survey involved a total of 135 beneficiaries, 55 providers, 11 co-management committee members, 2 health committee members, the manager, the laboratory manager, and the chief medical officer of the community. maternity. The average age of the beneficiaries was 29.31 years. The media represented the main source of information with 52%. Despite the free cost of drug expenditure was 40039 FCFA. The average waiting time was 5 hours. The most frequently mentioned problems were: delay in repayment, influx, debt of the structure, abuse of benefits, breakage of reagents and / or drugs. At NCHC 33% of deliveries are by caesarean section. The rate of caesarean section in population has increased from 4% to 8% with free delivery.

Conclusions
It seems appropriate to make recommendations for the referral of providers on free caesarean section, for the management of cesarean section, for reorganization of services and for the improvement of the quality of reception.

Key messages
Caesarean. Universal health coverage.
Understanding place-based public health to reduce inequalities in the context of austerity
Authors: Lhussier M , Forster N 
Published: November 2019

Abstract

Background
Ageing populations and increased prevalence of long-term conditions, combined with reduced public funding following the financial crisis mean health needs often outstrip provision. Furthermore, austerity policies across Europe have been associated with a steep rise in health inequalities.

Methods
A comparative case study design, drawing on realist evaluation, examines the place-based strategies used by five UK Local Authorities (LAs) to maximise resources and reduce health inequalities. LAs were selected based on their implementation of innovative interventions and/or their experience of better or worse than expected trends in reducing health inequalities. Initial programme theories (IPTs) were developed through stakeholder consultation and literature searches, which will be tested and refined using case study data. Data collection methods are tailored to each case study context, but include: documentary analysis; system mapping exercises; and interviews with stakeholders and community members.

Preliminary Results
Initial programme theories were developed detailing the place-based strategies that are most effective in maximising resources and improving health outcomes, depending on contextual conditions. These theories cover strategies such as income generation schemes to supplement taxation; the introduction of ’disruptive’ voices into decision processes; outsourcing and widening skill-sets; reviewing and streamlining resources; and the development of tightly defined targets.

Conclusions
There is currently a lack of guidance on the optimal allocation of limited resources and effective delivery of services and interventions in contexts of reduced spending. Employing a realist approach has enabled us to move beyond the particularities of local contexts and strategies to produce pragmatic and transferable solutions which can inform the funding decisions of local government.

Key messages
LAs have to innovate to balance growing needs with shrinking resources. Pragmatic lessons are drawn to inform decision making applicable beyond local contextual specificities.
Factors influencing use of natural environments among immigrant women in Norway
Authors: Lorentzen C , Viken B 
Published: November 2019

Abstract

Background
Due to a high burden of health challenges among immigrants in Norway, and the documented health benefits of interaction with nature, Norwegian authorities have prioritized the promotion of outdoor recreation among immigrants. Success in this part of public health work presupposes knowledge about factors influencing immigrants` use of nature, which to date is scarce. The present study explores these conditions in a group of immigrant women in Norway.

Methods
We performed individual interviews with 14 first generation immigrant women aged 27-70 years from Iran (2), Poland (2), Palestine, Afghanistan, Congo, Kenya, Thailand, Russia, Portugal, Latvia, Colombia and Bulgaria. Data were analyzed by qualitative content analysis.

Results
Multiple and interrelated factors at the individual, relational, cultural/religious, and structural level influenced the interviewees` use of nature. Individual-level conditions included the interviewees` attitudes towards nature and their perceived control over making use of nature. Previous experiences with nature and role model influences shaped attitudes, and knowledge about outdoor life opportunities and appropriate clothing/equipment, and perceived security shaped perceived control. A major relational level barrier was the lack of access to companions for nature outings. A barrier at the cultural/religious level included the discomfort of wearing hijab/all-covering dresses in nature. Main structural level premises for use of nature included available time and economy and access to natural sites.

Conclusions
This study highlights multiple conditions influencing immigrant women in Norway`s use of nature. Public health actors should be aware of and take into account this knowledge.

Key messages
Factors influencing immigrant women in Norway`s use of nature are to be found at different levels of influence. Strategies for increasing immigrants` use of nature should be based on existing knowledge about influencing factors.
Advocating migrant and minority health in Bulgaria through an innovative education subject
Authors: Kamburova M 
Published: November 2019

Abstract

Introduction
Migrants and ethnic minorities often face serious inequities concerning their access to good quality health services. The Statement by the European Public Health Association on migration, ethnicity and health addresses the need of supporting public health policy makers by providing education courses.
The objectives of the teaching course “Migrant and minority health”, established in Medical University-Pleven in Bulgaria as optional additional subject, is to extend the specific knowledge of students (bachelors and masters of public health) and to develop competencies and skills of future public health practitioners and policy makers.

Results
The unique for Bulgaria course consists of 15 academic hours of the curriculum and ends with an electronically based test. Teaching methods include lectures, seminars and individual practical assignment and stresses on practice rather than theory. The training advocates migrant and minority health by presenting: the most important migrant’s social and health problems; impact of migrants’ health status on public health; the organization of healthcare in the recipient countries of migrants. The lecture course provides information for the main challenges facing healthcare professionals and the health system regarding the health of the migrants and main minorities groups, in particular the Roma as a predominantly ethnic minority in Bulgaria and Europe. The result of exam until now is good in 42.8% of students, very good in 14.2% and excellent in 42.8%. The curse enable public health professionals to acquire knowledge regarding to the international situation, critical assessment skills and the ability to implement appropriate strategies to address specific health problems.

Conclusions
The training meets the needs of in-depth knowledge of public health specialists in relation to the medical and social problems of migrants and minorities in Bulgaria. The positive experience gives ground to include it as part of basic curricula.

Key messages
The subject “Migrant and minority health” enhances student’s competencies as public health practitioners. Knowledge and skills are relevant to the EUPHA Statement on migration, ethnicity and health. By the subject “Migrant and minority health” public health practitioners may work to establish friendly health system with good quality of health services for migrants and Roma population in Bulgaria.
Adequate utilisation of emergency services in Germany: a differential by migration background?
Authors: Sauzet O , David M , Naghavi B , Borde T , Sehouli J , Razum O 
Published: November 2019

Abstract

Background
The role of emergency services (ES) is to provide a round-the-clock acute care. In recent years, inadequate use of emergency services has been internationally thematised because of overcrowding and the cost associated. There is only limited evidence regarding the pattern of utilisation of ES by populations with a migration background.

Methods
Consecutive patients visiting three ES in Berlin from July 2017 to July 2018, and who fulfilled inclusion criteria such as being conscious, were recruited into the study. A questionnaire covered medical conditions, reasons to visit the ES, and socio-economic factors. A criterion for the adequacy of utilisation was developed using a sub-sample of patients with information provided by physicians. Differences between migrants (1st generation), their offspring (2nd generation), and non-migrants were evaluated using logistic regression.

Results
2 327 patients were included, 901 had a migration background. The utilisation was adequate if the patient was admitted to hospital and/or if all three following criterion were fulfilled: reported to have been advised by a physician to visit the ES; reported strong pain; and reported a high perceived urgency (both ≥7 on a scale from 0 to 10). Adjusting for gender, age, condition and number of recent visits to ES, 1st generation migrants had a significantly higher chance than non-migrants to have an inadequate utilisation of services (OR 1.30; 95% CI [1.01; 1.68]). For 2nd generation persons, this was not statistically significant.

Conclusions
First generation migrants have a higher chance of inadequate ES use compared to non-migrants. A similar study 20 years ago had similar findings. This implies that existing information leaflets on ES addressing specific population groups are not sufficient to improve adequacy of use. Structural changes in the healthcare system as well as improved methods of communication respecting the needs of diverse subgroups of patients need to be considered.

Key messages
Existing information leaflets on emergency services addressing specific population groups are not sufficient to improve adequacy of use. Structural changes in the healthcare system as well as improved methods of communication respecting the needs of diverse subgroups of patients need to be considered.
Non-communicable diseases among refugees claimants in Greek refugee camps—are their care needs met?
Authors: Jervelund S S , Nordheim O , Stathopoulou T , Eikemo T A 
Published: November 2019

Abstract

Background
Little is known about the prevalence of non-communicable diseases (NCDs) among newly arrived refugees in Europe and whether their medical needs are met. The objective of this study was to investigate patterns of NCDs as refugee claimants migrate, whether refugee claimants experience unmet healthcare needs before, during and after flight when living in Greek refugee camps and to elucidate sociodemographic determinants for unmet medical care needs in the Greek refugee camps.

Methods
Survey data collected in 2016 among 267 newly arrived adult asylum-seekers staying at six refugee camps in Greece was used. The survey was available in English, Arabic and Farsi. We inspected frequency distributions of NCDs and unmet medical care needs, and using multiple logistic regression analysis, we estimated determinants for unmet medical needs in Greece.

Results
The majority had a good or fair self-reported health; yet, 17.1% suffered from 1 NCD, while 42.1% suffered from 2 or more NCDs. The most prevalent reported NCDs in Greece were: back or neck pain (26.6%) and severe headache (24.7%). The prevalence of most NCDs in the migration phases followed a U- or J-shaped pattern: decreased during migration and increased after migration to Greece. Unmet medical care needs were reported by 41.3% with one NCD after arrival in Greece. Compared with young adults, adults aged 51+ years were in increased risk of reporting unmet medical needs in Greece [odds ratio = 7.59; p = 0.015].

Conclusions
The high number of persons who report NCDs underscore the need for availability of diagnostic tools and agents to ensure that the refugee claimants receive the right healthcare assistance. Tools and guidelines to provide continuity of NCD care when people migrate are likewise important. Many European countries that receive this group of refugees should take the disease patterns, including multi-morbidity, into consideration when planning for health reception and the organization of healthcare.

Key messages
The prevalence of NCDs among refugee claimants decreased during migration and increased after migration to Greece. Unmet medical care needs were reported by 41.3% with one NCD after arrival in Greece.
Access to health care among people with foreign background and the general population in Finland
Authors: Kuusio H , Seppänen A , Lilja E , Vehko T , Jokela S , Koponen P 
Published: November 2019

Abstract

Background
Prior studies suggest that people with foreign background (PFB) often face problems in access to health care, although access to care may vary between the different PFB groups. This study explores 1) the potential differences in perceived access to care between different PFB groups and the general population, and 2) if marital status, education, employment, self-perceived health, long-term illness, length of stay, age moved to Finland or language skills are associated with access to care among PFB.

Methods
The data were gathered from the cross-sectional survey on well-being among the PFB (FinMONIK), conducted in Finland 2018. Its random sample consisted of 12 877 persons, aged 18-64 years and the response rate was 53%. Three items were used to assess perceived access to care: I was able to contact the place of care smoothly, I was able to make an appointment without undue delay and I was examined without undue delay (e.g. laboratory tests, X-ray, ultrasound). Logistic regression was used to test which factors were associated with accesses to care, adjusted for age, sex and region.

Results
After controlling for age, sex and region, the results showed significant differences in access to care among different migrant groups and the general population (p &lt; 0.001). Of those of Estonian background 37% felt that access to care was smooth while only 17% of those coming from Middle-East, and 26% of the general population. Employed persons, persons who had good self-perceived health, and people with no long-term illness, and those who had lived in Finland less than five years, had better access to health care. Marital status, education, language skills and age moved to Finland, were not associated with access to care.

Conclusions
Large inequities in access to care were identified among people with foreign background. Access to services seems to be better for employed persons and those who have good self-perceived health.

Key messages
Special attention should be given to improve access to care among non-employed migrants. Migrants should not be considered as a uniform group when planning services.
Mental health treatment gap in adults of Russian, Somali, and Kurdish origin in Finland
Authors: Cilenti K , Rask S , Kuusio H , Castaneda A 
Published: November 2019

Abstract

Background
Migration affects migrating persons’ health in many levels. Populations of migrant origin, and in particular refugees, are known to have an increased risk of mental ill health. Previous research from Finland has shown that the prevalence of mental health symptoms is significantly higher among Russian origin women and Kurdish origin men and women than in the general population. Building on prior research, we explore the prevalence of perceived need for mental healthcare among Russian, Somali, and Kurdish origin populations and compare this to the general population in Finland. Additionally, we present prevalence of mental health treatment gap in these groups.

Methods
We used data from the Finnish Migrant Health and Wellbeing Study (n = 1404) and the Health 2011 Survey (n = 1459). Prevalence was calculated using predicted margins (95% confidence level). P-value of less than 0.05 was considered significant. Mental health treatment gap was examined by constructing a combined variable of perceived need for mental health services and prevalence of service use.

Results
The perceived need for mental health services was higher in Kurdish origin persons (16%) and lower in Somali origin persons (&lt;1%) than in the general population (8%). Both Kurdish origin men (11%) and women (20%) expressed more need for mental health services than men (4%) and women (11%) in the general population. The mental health treatment gap was highest in Russian origin women (10%) and Kurdish origin women (10%) and men (8%). For the general population, the treatment gap was only 1% (men 2 %, women &lt;1%).

Conclusions
Untreated mental health problems are unjust, problematic and can be a source of great human suffering. Evidence from Finland shows that especially persons of Kurdish origin experience a mental health treatment gap. To expand coverage and reduce inequalities in health services, national development projects (e.g. PALOMA) have been launched to improve mental healthcare.

Key messages
Perceived need for mental health services is more common among certain foreign-born populations than the general population in Finland; this is in line with prior research on mental health symptoms. Untreated mental health problems are unjust, problematic and can be a source of great human suffering; evidence of mental health treatment gap should lead to improved access to mental health services.
Health among immigrants in Norway, results from the Living Condition Survey among immigrants 2016
Authors: Kjøllesdal M K , Straiton M L , Øien-Ødegaard C , Aambø A , Holmboe O , Johansen R , Grewal N K , Indseth T 
Published: November 2019

Abstract

Introduction
To manage immigrants` health needs is an important challenge for the society. This report gives knowledge about the status of immigrant health in Norway, which can be used in planning of health services.

Methods
Statistics Norway carried out a Living Condition Survey among immigrants in 2016. We report the prevalence of health outcomes (self-reported health, cardiovascular diseases, hypertension, diabetes, back- and neck problems, impaired functioning, mental health problems, problems with sleeping, overweight) and lifestyle (alcohol, smoking, physical activity) by country of origin and assess associations between health and sociodemographic (age, education, income) and migration related (age at immigration, duration of residence, Norwegian proficiency) variables, as well as discrimination and employment. Immigrants from twelve countries were interviewed. The questionnaire was translated into the main languages in the twelve countries and English. In this report, 4399 participants aged 16-66 years were included.

Results
There were large variations in health according to country of origin and gender. Immigrants experienced a deterioration in health at younger age than non-immigrants did. The educational gradient in health was less pronounced among immigrants than among others. Perceived discrimination was related to mental health problems. Some immigrant groups had a high proportion of smokers. In most groups a considerable proportion was drinking alcohol and a low proportion were physically active.

Conclusions
Future research should take into account differences in health according to country of origin and gender. The importance of physical and social circumstances for immigrant health emphasizes the need for structural population-based initiatives to promote health.

Key messages
Immigrant health varies by country of origin and gender. Physical and social environment is important for immigrant health.