bluuebunny/crossref_metadata_2025_split huggingface dataset:
Towards an EU sustainable health information infrastructure. Integrating technical and political views and interest
Authors: Padrón-Monedero A , Sarmiento-Suárez S , Gómez-García T , Ortiz-Pinto M , Pérez-Gómez B , Fernández-Navarro P , Galán I , Noguer I 
Published: October 2020

Abstract

Background
Health information systems (HIS) play a key role in providing information for decision-making. Europe lacks of an integrated HIS on non-communicable diseases (NCD) and Health Systems Performance (HSP) able to compare health problems across countries. NCDs are the main contributor to the EU-burden of disease, including the highest mortality rates. There is a general agreement among public health policy makers and researchers on the need of an integrated EU health information (HI) infrastructure to monitor risk factors, NCD and HSP. Such infrastructure would provide common inputs for public health and research to prioritize health policies. However, there is no EU-EEA consensus on how to go forward with this initiative.

Methods
The Information for Action (InfAct) project is aimed at establishing a sustainable HI infrastructure on HIS and HSP by cataloging resources, experience, research capacities and expertise into a 'one-stop shop'. Significant political will is needed to support and systematically feed a functional and permanent governance structure. InfAct provides a ground for Member States to discuss and generate consensus through two main boards: 1) Technical Dialogues (TD), composed by national experts, to discuss scientific aspects, feasibility and added value; and 2) Assembly of Members (AoM) where political representatives from Ministries of Health and Research provide the framework of political acceptance and guarantee of implementation and future development.

Results
Both boards reveal different interests and concerns. The AoM rather focused on resources and necessary political decisions based on expected returns. The TD focused on feasibility aspects and new adaptations required from current systems. The feedback provided by both boards is key to develop a sustainable EU-HIS infrastructure.

Conclusions
The TD and the AoM are key forums to provide feedback, guidance and advocacy to build a sustainable EU-HIS infrastructure
14.M. Workshop: Health policy responses to the European “refugee crisis”
Authors:   Organised by: European Observatory on Health Systems and Policies,   Chair persons: Bernd Rechel - European Observatory
Published: October 2020

Abstract
This workshop explores how health systems in Europe have responded to the so-called “refugee crisis” in 2015 and what lessons can be drawn for the future. Based on contributions to a Special Issue of Health Policy, it offers a platform for sharing examples from across Europe, facilitating cross-country learning.
Although the arrival of large numbers of new migrants in Europe in 2015 was often portrayed as a crisis or a threat and has exposed a lack of preparedness and responsiveness in many countries, many things have worked well in the reception of and provision for newly arriving migrants. There have been instructive case studies and sometimes things worked well without further ado and for this reason went unnoticed. While the exact dynamics of future migratory movements are difficult to predict and depend on sometimes questionable “deals with the devil” at the EU's outside borders, refugees will continue to come to Europe and health systems have to be prepared to respond to their needs.
This workshop aims to build on recent experience and inform current debates on how health systems can best respond. It provides examples from three European countries (Austria, Germany and Finland) that have been at the forefront of receiving migrants. The first presentation, on Finland, recalls how this country received one of the highest numbers of refugees per capita and how its parallel system of health services coped with this influx. The second presentation, using the example of one federal state in Germany, illustrates that there is sometimes considerable scope for action at the local level and provides examples of how this scope can best be used. The third presentation explores how mental health needs of refugees develop in the asylum process. It argues that for more cooperation on this issue and the existence of low threshold services. A final presentation, on Austria, illustrates the needs of undocumented migrants in Vienna. It argues that non-governmental organizations (NGOs) play a crucial role in providing accessible health services and that they can also help in public health surveillance and data collection.
The workshop will provide opportunity for the audience to comment on and discuss presentations and to consider current policy options in Europe to better address the health needs of newly arrived migrants. It will also ask what barriers exist that existing good practices are not being taken up. The workshop will be of interest to public health researchers, practitioners and policy-makers working on migration-related issues across Europe.

Key messages
The workshop provides a forum for discussing European responses to the 2015 “refugee crisis”. It explores health policy options at the European and national level.
Governance of health services for asylum-seekers in Finland
Authors: Tuomisto K , Tiittala P , Keskimäki I , Helve O 
Published: October 2020

Abstract

Background
In 2015 Finland received the 4th highest number of asylum-seekers in Europe per capita, exceeding numbers of any previous year by ten times. Health services to them are provided in a parallel system with entitlements similar to most Western European countries. Our study explored the governance of this system following a right to health approach, along three dimensions: formal recognition of the right to health, standards, and coordination mechanisms.

Methods
We were involved in the Finnish policy response as medical specialists on refugee health at the National Institute for Health and Welfare, as physicians within the Finnish Immigration Service and as senior medical officer at the Ministry of Social Affairs and Health. We also conducted a review of academic and grey literature.

Results
Prior to the “refugee crisis” in 2015, Finland was considered to have a functioning system for providing health services to asylum-seekers. However, the arrival of many new asylum-seekers in 2015-2016 exposed many weaknesses in the governance of the system. We identified three major obstacles in the governance system for health services for asylum-seekers: 1) ineffective and reactive national level coordination and stewardship; 2) inadequate legislative and supervisory frameworks; and 3) discrepancies between constitutional rights to health, legal entitlements to services and available guidance.

Conclusions
In view of the governance weaknesses related to the parallel system for asylum-seekers, we recommend removing the parallel system and integrating health services for asylum-seekers into the national health system.
Shaping access to health care for refugees at the local level in Germany
Authors: Rolke K , Wenner J , Razum O 
Published: October 2020

Abstract

Background
In Germany, the federal states and even the municipalities have considerable scope for shaping implementation of national health policies for newly arrived refugees, including in the way they organize access to health services. We analysed how gatekeepers can shape access to health care at the local level, exploring access models in six municipalities in the federal state of North Rhine-Westphalia.

Methods
We assessed the implementation of local access models and the consequences for access for refugees. Our study covered three municipalities with a health care voucher model and three with an electronic health card model. We combined data from official reports and from 21 semi-structured interviews with gatekeepers.

Results
Our research illustrates how gatekeepers at the local level can shape and facilitate access to health care for refugees, irrespective of the access model chosen. Larger municipalities are more likely to implement an electronic health card model. Gatekeepers report that costs, workload and control are the major aspects underlying the choice of model in municipalities. Access plays only a minor role, although some gatekeepers claim that the electronic health card model can improve access.

Conclusions
National health policies can support gatekeepers in their role as facilitators, such as through financial incentives or a minimum amount of bureaucracy. They can also allow newly arrived refugees to become members of the statutory health insurance system, which would relieve social welfare offices and general practitioners (GPs) from their role of gatekeepers.
FAO/WHO GIFT platform - hands on
Authors: Ferreira de Sousa R , Padula de Quadros V , Balcerzak A , Bevere T 
Published: October 2020

Abstract
The FAO/WHO Global Individual Food consumption data Tool (FAO/WHO GIFT) is a novel open-access online platform hosted by FAO and supported by WHO. FAO/WHO GIFT is aimed at increasing the quality, availability and use of individual quantitative food consumption (IQFC) data in low- and middle-income countries (LMIC) to enable evidence-based decision-making and policy development for better nutrition and food safety. The platform is developed in synergy with other global initiatives working with food consumption data (e.g. Intake, Global Dietary Database, FAO/WHO FOSCOLLAB).
The main objective of the session is to give the opportunity to participants to apply the knowledge gained over the previous sessions.
Participants will be divided in small groups to do hands-on exercises using the features of the platform. Participants will learn how to identify existing IQFC surveys worldwide using the FAO/WHO GIFT inventory map. Participants will also explore the potential of the Indicators section of the platform according to the needs of different fields of work (food consumption, food safety and nutrition). Expert users will learn how to download dietary microdata and how to take advantage of other data sources using the same food classification and description system - FoodEx2.
The workshop will close with a brainstorm session on how the FAO/WHO GIFT platform can be improved to support participants work.
Tobacco control’s effects on social inequalities in smoking: Moving towards a health equity approach
Authors: Lapalme J 
Published: October 2020

Abstract
Population-level public health policies aim to improve health for the entire population. Yet, in doing so, they may unintentionally neglect vulnerable populations' specific needs, which may perpetuate social inequalities in health. As an example, tobacco control policies (e.g. media campaigns, smoke-free places, tax increases, and tobacco product regulation) have been found to significantly reduce overall smoking prevalence in many high-income countries. However, social inequalities in smoking have been increasing, with smoking prevalence being higher, notably for those of low socio-economic status (SES). Low SES individuals start smoking at younger ages, smoke more cigarettes per day, have lower cessation rates, and are exposed to more second-hand smoke than higher SES individuals. These social inequalities in smoking translate into social inequalities in health such that low SES groups carry a disproportionately heavier burden of smoking-related illnesses.
Based on data from a critical discourse analysis of tobacco control policy in Quebec, Canada, as well as from a literature review of vulnerable populations' experiences with tobacco control policies, this presentation will: 1) illustrate ways in which tobacco control policies may be increasing social inequalities in smoking, including the absence of vulnerable populations who smoke from policy planning, smoking denormalization's unintended stigmatizing effects, and targeting behaviours rather than the 'causes of the cause' in policy; 2) provide ideas for future population-level policies based on a health equity approach, which includes integrating vulnerable population's voices in policy design, prioritizing vulnerable populations and health equity in policy, and shifting attention towards policies addressing social inequalities in access to social determinants (e.g. education, income, employment security, safe, clean, and affordable housing) to improve health rather than targeting behaviours, such as smoking.
Equality versus equity: Barriers to health care access for Indigenous populations in Canada
Authors: Tremblay M 
Published: October 2020

Abstract
Canada's universal and publicly funded health-care system aims to promote universal and equitable access to care based on the needs of individuals, rather than on their capacity to pay for these services. Despite these principles, some groups, such as Indigenous peoples, experience significant and persistent social inequalities in health compared to the general population. This situation results from the continuing impacts of colonialism, which has an undeniable influence on social determinants of health, including access to care. This is surprising for many health professionals because it contradicts the democratic ideals of justice and equality that underlie the health-care system, as well as the rhetoric of their professional practice which asserts that 'everyone is treated the same'.
Based on literature and on research findings, this presentation will demonstrate several ways in which a universal and homogeneous approach to health-care can contribute to creating social inequalities in health for Indigenous populations. First, health professionals tend to favor socially and culturally neutral practice, which can hinder the recognition of the influence of historical and socio-cultural factors on patients' health. This kind of practice may encourage a distorted reading of patients' issues and can lead to inappropriate responses. Second, a homogenous approach to care refers by default to health-care models and practices that are rooted in values and perspectives of the dominant culture, which contributes to the provision of culturally unsafe care for Indigenous patients. Finally, this type of approach overlooks the critical and specific needs of vulnerable groups, who often require more than the general population to achieve the same results. We will conclude by outlining some potential solutions, mainly how cultural safety as a transformative approach to care allows health professionals to better consider the needs and cultural identity of Indigenous patients.
Community outreach workers: Perceived practices and impacts on families and young children
Authors: Roy M , Lavoie-Trudeau E , Benkhalti M , Couturier Y , Lane J , Clapperton I , Roy M A , Bibeau L , Ouellette M , Camden C 
Published: October 2020

Abstract

Background
Community outreach workers support individuals accessing healthcare and other services that could be useful to respond to their needs. Even though community outreach workers have been working in the province of Quebec (Canada) for the past 40 years, their practice is poorly documented and evaluated, especially with respect to young children aged 0 to 5 years. This study aimed to document the practice of community outreach workers and its perceived impacts among children and families.

Methods
A qualitative methodology with a descriptive research design was used. We performed a content analysis on 55 scientific and grey literature documents, 24 individual interviews, and 3 focus groups with stakeholders including parents, community outreach workers, healthcare employees, and inter-sectoral partners.

Results
Our analysis reveals three main themes: 1) characteristics of the population served, 2) concrete actions performed by community outreach workers, and 3) perceived impacts of community outreach on families and children. Community outreach workers were perceived as essential to reach families with vulnerable circumstances and children with special needs. With respect to concrete actions, community outreach workers were reported to tailor their interventions to respond in different but complementary ways to the healthcare system. Perceived impacts included increased access for children and families to appropriate services, decreased social isolation, increased empowerment (especially with respect to parental abilities), increased social capital of families, and confidence towards the healthcare system. Results showed that community outreach workers helped to reduce inequalities in health

Conclusions
Community outreach work help the healthcare system to fulfill its legal mandate to protect citizen and increase health and well-being. It is crucial that such type of proximity approaches be not only encouraged but also sustained.

Key messages
Community outreach workers adapt their practices to act in a complementary way to the healthcare system. Community outreach workers help to reduce inequalities in health.
Tuberculosis: where and how fast are stone quarry workers infected?
Authors: Carvalho Sousa S , Magalhães Alves C , Santos S , Marques F , Duarte R , Gonçalves G , Carvalho C 
Published: October 2020

Abstract

Background
In 2018 an annual tuberculosis (TB) screening program targeting stone quarry workers was implemented in two municipalities in Northern Portugal. These have been hotspots for TB (76 and 59 cases per 100 000 population per year in 2012-2016, well above the 18 cases per 100 000 population observed in Portugal in 2016), with 30% of active TB cases occurring among stone quarry workers. Screening in this setting is recommended by the World Health Organization, as exposure to silica and silicosis increase the risk of TB. Occupational health services, TB outpatient centers, the hospital, a laboratory, primary health care and public health services work closely together with employers, employees, municipal council and the community promoting meetings and continuous training.
Screening activities included a symptom questionnaire, chest X-ray and sputum exam; and, after exclusion of active TB, interferon-gamma release assay (IGRA) for latent tuberculosis infection (LTBI). Preventive treatment was offered.

Objective
Assess annual rate of TB infection

Methods
Workers without history of TB/LTBI were IGRA tested in 2018, and retested in 2019. Annual rate of infection was calculated as the proportion of workers IGRA negative in 2018 becoming positive in 2019.

Results
In 2018-2019, 274 workers were screened yearly. In 2018, 22 were diagnosed with LTBI and 26 had previous history of TB/LTBI. Out of 226 IGRA negative workers in 2018, 19 tested positive in 2019 (8.4% annual rate of infection). These individuals were not identified as close contacts of any new TB case and no cases of active TB were reported in their stone quarries. Some active TB cases were regular customers of specific bars.

Conclusions
Active transmission of TB seems to be occurring among stone quarry workers. Workers that converted from IGRA negative to positive had no co-workers with active TB in the study period, suggesting they could have been infected away from the workplace, possibly in community public places.

Key messages
Stone quarry workers in a high-risk TB sub-region were infected at an 8.4% annual rate, and could have been infected in community public places such as bars. Besides screening close contacts and at workplace, more efforts should be made identifying social contacts of active TB cases.
Experiences of humanitarian assistance programs with corporate funding
Authors: Makhoul J , Nasser F , El-Amine Z , Nakkash R 
Published: October 2020

Abstract

Background
Dwindling governmental funding for widespread natural disasters and armed conflicts have attracted corporate funding for humanitarian assistance. Although such funding has allowed expansion of humanitarian programs and capacity building, evaluations of such partnerships are rare and focus only on management aspects, without attention to possible influences on the organizations themselves and the populations they serve. Given the well-established conflicts of interest of corporations and their adverse influence on public health, an assessment of industry funding to humanitarian assistance is necessary to identify potential violations and harms.

Methods
The research explores the experiences and views of a sample of humanitarian agencies in Lebanon which serve refugee populations about corporate funding and influences on their programs. In-depth interviews with international and local humanitarian agency representatives in Lebanon were conducted and analyzed by thematic analysis.

Results
Findings indicate perceived advantages with financial assistance, flexible agendas and mutual learning. Meanwhile, challenges fall in project coordination, implementation, and the lack of attention of the private sector to the work ethics with vulnerable populations. Also, this collaboration could impact refugees positively or negatively depending on the type of corporations, their branding and how they are perceived by the populations served. Organizations trust that their processes of detection and reporting are an impervious firewall against conflicts of interest.

Conclusions
Corporate power expressed through funding to humanitarian agencies may influence the decision making and the implementation of the programs for humanitarian assistance. The study highlights the need for critical thinking about corporate funding, and creating opportunities for discussion about this issue for humanitarian agencies.

Key messages
Industry conflicts of interest on public health are well-established, but understudied in humanitarian assistance programs. Corporate funding for humanitarian assistance may hide potential conflicts of interest for the corporation.