bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of social-cultural factors and gender on health workforce absenteeism: a qualitative study from Nigeria
Authors: Omwujekwe O 
Published: October 2020

Abstract

Background
Absenteeism is widespread across the Nigerian health sector among all cadres of providers. Little is known about the health worker incentives and drivers of absenteeism among staff working in primary health care settings in rural areas in Enugu State.

Methods
We focused on six primary care centers in rural and urban regions in Enugu State, south-east Nigeria. We conducted in-depth interviews and focus group discussions with 70 respondents living nearby: comprising 12 frontline health workers, 12 healthcare managers, 6 Health Facility Committee leaders and 40 service users. We used thematic data analysis, drawing on conceptualisations of culture and gender.

Results
Socio-cultural causes of absenteeism included gender roles (caregiving responsibilities, home keeping, child bearing issues, etc.), marital status, attending to social events and cultural ceremonies. Consequently, women were more likely to be absent than men, given traditional roles (e.g. home keeping, caregiving, farming) and child bearing. Male absenteeism reflected a need to generate additional income through dual practice and other jobs. Sanctions against those absent was similar for men and women. Individual health workers who were connected to politically powerful individuals “godmothers” or “godfathers” were able to use these connections to improve their placements and protect themselves from potential sanction.

Conclusions
Effective strategies to tackle absenteeism will require socio-economic and these factors to be taken into account when addressing health systems and structural factors. Long-term change also requires addressing the power imbalances that give rise to these conditions, something that is likely to be especially challenging.
Towards the development of a national Mental Health Surveillance System in Germany
Authors: Mauz E , Peitz D P , Kersjes C K , Hoelling H H , Thom J T 
Published: October 2020

Abstract

Background
On behalf of the federal ministry of health the Robert Koch Institute as the German public health institute is currently developing a concept for a national Mental Health Surveillance (MHS). This surveillance should systematically gather, process and analyze primary and secondary data, thus integrating different data sources to comprehensively inform about mental health trends in the population. To do so, selected mental health indicators should be reported on a regular basis to detect changes over time and reveal need for public health measures.

Methods
To build up a national MHS, a conceptual framework and a core indicator set were established according to a two-stage procedure: 1) scoping review to collect a broad range of indicators in the field of public mental health on a population based level, 2) consensus among public mental health experts and stakeholders by an iterative Delphi process which considered quantitative and qualitative information.

Results
Drawing on theoretical foundation, an action-guiding conceptual framework with basic action goals referring to mental health promotion and prevention, mental health determinants, mental health status as well as mental health care and burden of mental disorders was developed. Within the consensus process, the 184 indicators resulting from the scoping review could be reduced to a parsimonious core indicator set.

Conclusions
The contribution shows background, method and first results of developing a German MHS. Next, the feasibility of the hereby presented core indicator set will be tested by identifying and closing data gaps. In the long run, the MHS should be integrated in a broader surveillance of non-communicable diseases. It should serve as a reliable database for epidemiological as well as health care research and evidence-based policy advice on public health measures to protect and strengthen mental health in the population.
20.E. Round table: Health tourist and health promotion: introducing the European Charter for Sustainable Health Tourism
Authors:   Organised by: EUPHA Health promotion section, PROMIS, Sicilian Health Government, CEFPAS,   Chair persons: Luís Saboga-Nunes - EUPHA-HP, Roberta Arnone - Italy
Published: October 2020

Abstract
The goal of this workshop is to bring health tourism (HT) to the public health perspective, raise awareness for viable HT in the context of the Sustainable Development Goals (SDG), while introducing the “European Charter for Sustainable Health Tourism”!
Mobility and the EU open market, have incremented a new trend in the European global economy, based in HT. In 2017 of the general tourism in the EU28, 5% was due to HT. It is expected that this share will increase in the near future. The concept of HT needs to be refurbished since it does not represent only medical tourism (that is the object of an increasing set of regulations among member states) but it includes also wellbeing and wellness (e.g with spa and quality of life tourism) that is not scrutinized by treaties, international or even national regulatory agencies. Citizens, therefore, play a major role in the marked demand of HT, either by being active actors in the procurement of services or commodities (Prosumers), or by being passive consumers (Passumers) of a strategic market not always aligned with well-being and quality of life. Therefore, the need for a “European Charter for Sustainable Health Tourism” is a set of references to increase health literacy about HT and its real impact in public health. Moreover, the aim of this workshop is to study opportunities, offer examples and discuss on how to develop, evolve and improve health promotion practices by actions taken at the HT setting. First we want to invite the audience to discuss HT from the salutogenesis perspective; In a second moment an interregional point of view of the Silver Economy will frame the conceptual framework on HT; a third presentation will look at a particular case of HT and public health and the added value of multilateralism; from here the participants will be invited to consider the particular case of Health and Wellness tourism in Sicily; the final presenters will look at HT in the perspective of the Reference Sites Collaborative Network. This workshop will use interactive methodologies of participation so that the audience will be actively involved in the discussion and wants to offer a forum for public health researchers, practitioners and policy-makers interested in HT and methodological insights and will allow discussing results, facilitate exchange, and support further synergies between countries.

Key messages
The goal of this workshop is to raise awareness for sustainable health tourism in the context of the SDG, by proposing the adoption of the first “European Charter for Sustainable Health Tourism”. Explore how in European Countries (study cases) health tourism answers health promotion principles for a more sustainable society.
Health tourism and public health in the perspective of the Reference Sites Collaborative Network (RSCN)
Authors: Illario M , Bousquet J 
Published: October 2020

Abstract

Background
In the EU tourism strategy 'Europe, the first tourist destination in the world: a new political framework for tourism in Europe', accessibility of tourism services is highlighted. In this context Health Tourism (HT) deserves special attention. Sensitize interested parties in HT to generate greater know-how on the demand and profiles of travelers with specific needs and evaluate the economic impact of the age-friendly and patient-friendly HT, are today pressing issues. Older adults (an important market share) require adaptation of services. Tourists with reduced mobility (recently estimated at 127 million people), disabilities or suffering from chronic illnesses, have needs that must be integrated into the provision of HT services. Assessment of these needs is a mandate in order to tailor HT to public health concerns. The Reference Sites Collaborative Network (RSCN) of the European Innovation Partnership on Active and Healthy Ageing aims to assess HT offer accessible to older adults and citizens with special health needs and reference successful examples in order to create awareness towards a comprehensive HT agenda in Europe.

Methods
A survey has been set up, aimed at assessing the experiences in the RSCN, where innovations (eHealth, telecare, integrated care, independent living etc) are scanned regarding effectiveness, accessibility, efficiency and sustainability.

Results
Although experiences are available, they are still fragmented and could take advantage of networking at local, national and international levels to exploit HT full potential. Several gaps have been identified, that can be strengthened by investments (e.g. infrastructure, training).

Conclusions
The HT sector provides opportunities arising from the improvement of health services to residents that could strengthen a personalized service offer targeting tourists increasing sustainability of such services.
Dental care in Europe: financing, coverage and provision
Authors: Winkelmann J , Henschke C , Scarpetti S , Panteli D 
Published: October 2020

Abstract

Background
In Europe, countries have adopted very different approaches to providing publicly subsidized dental insurance coverage. However, little attention has been paid on these variations in the coverage, financing and provision of oral health care and its implications. This cross-country Health Systems in Transition (HiT) Review aims to fill this gap in the field of comparison of oral health systems.

Methods
The comparative HiT draws on multiple data sources. It builds on detailed country information from national HiTs and other international sources (MISSOC, OECD/OBS country profiles). International databases (Eurostat, OECD, EHIS, EU-SILC) are used as main sources to compare available oral health related indicators. National and international policy documents and information by country experts complement this information. The HiT covers all EU members states and countries belonging to the EU's single market (UK, Iceland, Norway, Switzerland).

Results
In almost all countries, dental care is funded to a greater extent by private patient payments than other health care sectors. Overall, contribution of voluntary health insurances (VHI) to dental spending is low, while out-of-pocket spending is substantial in many countries leading to high levels of unmet needs for dental care for financial reasons, mainly for poor households. Comparison of coverage reveals that most countries commit to a minimum scope of basic dental care (emergency care, children), but there is large variation in terms of restriction of service packages ranging from countries with very limited, partial to comprehensive coverage.

Conclusions
Dental care has become a priority for European policy makers as countries extend statutory dental care coverage recognising the importance of prevention of oral diseases. However, there remain wide variations in the level of coverage resulting in differences of likelihood of dental care use.
Comparing dental care coverage for older adults in eight jurisdictions
Authors: Allin S , Farmer J , Quiñonez C , Peckham A , Marchildon G , Panteli D , Henschke C , Fattore G , Lamloum D 
Published: October 2020

Abstract

Background
Oral health is an important component of general health and healthy aging, yet financial protection for the costs of oral health care is often limited.

Methods
We systematically compare dental care coverage in Australia (New South Wales), Canada (Alberta), England, France, Germany, Italy, Sweden, and the United States. Drawing on the WHO Universal Coverage Cube, we compare breadth (who is covered), depth (share of total costs covered), and scope (services covered), with a focus on adults aged 65 and older. We populated data collection templates to provide detailed and comparable descriptions of dental care coverage in 8 jurisdictions.

Results
Overall there were four general types of coverage models: 1) deep public coverage for a small subset of the population based on strict eligibility criteria jurisdictions: Canada, Australia and Italy; 2) universal but shallow coverage of the population, combined with deeper coverage for a sub-set of the population meeting eligibility criteria: England, France, Sweden; 3) universal, and predominantly deep coverage for the whole population: Germany; and 4) shallow coverage available to some subgroups of the population in the United States.

Conclusions
While age, specifically turning 65, is an important consideration in the design of public coverage in Canada, Australia and the United States, many jurisdictions do not consider age as an eligibility criterion for public coverage. Yet all jurisdictions we include, except Sweden, provide differential coverage for those who meet a specific low-income threshold. Due to the limited availability of comparable data within and across jurisdictions, further research would benefit from standardized data collection initiatives for oral health measures.

Key message
Given the important role oral health plays in promoting healthy aging, the limited public coverage of oral health within statutory health systems warrants policy and research attention.
HIV test and knowledge of U=U: insights from MSM living in Portugal and participating in EMIS 2017
Authors: Costa J P , Meireles P , Aguiar A , Schmidt A J , Barros H 
Published: October 2020

Abstract
Recently, it became clear that undetectable equals untransmittable (U=U), stressing the importance of engaging in medical care and adhering to antiretroviral therapy. HIV testing and counselling (HTC) are offered in different settings and can be an opportunity to inform people. We aimed to understand if HIV testing history, including recency, place and, result, was associated with U=U knowledge.
We used data from 2242 MSM living in Portugal participating in EMIS 2017 that answered if they already knew that “A person with HIV who is on effective treatment (called 'undetectable viral load') cannot pass their virus to someone else during sex”, opting of 5 possible answers, dichotomized in “I already knew” vs. any other option. Regarding HIV testing history, participants were categorized as follows:1. HIV positive; 2. HIV negative and last test ≤12 months in a community setting; 3. HIV negative and last test ≤12 months in a medical setting, and 4. never tested for HIV or last test &gt;12 months or tested in other settings (reference). Logistic regression models were fitted to estimate crude and city size and education-adjusted associations.
The median (P25; P75) age of participants was 34 (25; 43) years. No significant statistical association was found with age or current occupation. Those with more years of education and living in a big or very big city were more likely to know that U=U (aOR:1.55; 95%CI:1.20-1.99 and aOR:1.26; 95%CI:1.04-1.53, respectively). Considering HIV testing history and diagnosis, men with diagnosed HIV (aOR:6.33; 95%CI:4.50-8.90), those who had the last test in community setting (aOR:2.44; 95%CI:1.87-3.17) and those who had the last test in a medical setting (aOR: 1.57; 95%CI:1.26-1.95) were more aware of U=U than those not tested in the last 12 months.
Our results suggest that there is a gradient of U=U knowledge associated with HIV testing history among MSM. Efforts should focus on improving counselling about U=U at all HIV testing settings.

Key messages
The knowledge of U=U seems to be associated with the place, recency and result of the last HIV test. Counselling should focus on the best evidence available at all HIV testing settings, to inform and empower the individuals.
Advocating for Front-line Health Advocates- A Scoping Review of Health Advocacy Pedagogy
Authors: Somaroo H , Naidoo S 
Published: October 2020

Abstract

Background
Health advocacy (HA) is a core competency of transformed, socially- and contextually-responsive, 21st century medical graduates though remains challenging for medical educators, including in South Africa. The optimal delivery of HA education has been vulnerable to vague definitions, lacking distinct or measurable dimensions, varied judgement, and poor prioritization in curricula which balance competing interests. We aimed to clarify HA definitions and explore current practices of HA pedagogy.

Methods
A step wise, scoping review approach was adopted, for evidence on HA and HA pedagogy. This included electronic database searches of published literature, and internet searches for non-journal publications, from 2000 to 2020 and limited to reports published in English. Websites of relevant regulatory bodies and professional organizations were also explored. Inductive thematic analysis was used to analyze the data.

Results
Sixty-four total articles and documents were included. Majority emerged from North America, the field of health education, and medical disciplines of family medicine, internal medicine, and pediatrics. HA compels graduates to be change agents and activists, at both the individual and community levels, and to promote equitable access to quality healthcare. It is increasingly associated with social accountability, consideration of the social determinants of health, and progression from advocating with, rather than for, individuals and populations. Various curricular approaches were evident, including didactic and experiential learning, and longitudinal and integrated designs.

Conclusions
Although HA is a core competency for medical graduates in South Africa, there is little evidence related to HA pedagogy in the country and the African continent. Despite distinct variability in current instructional approaches, there is potential for consolidation, contextual relevance, enhanced HA pedagogy, and improved HA competencies.

Key messages
HA is a core medical graduates’ competency but HA education is often sub-optimally engaged with and delivered. Enhanced, contextually relevant HA pedagogy could empower medical graduates to be better health advocates and more confident change agents for patients and communities they serve.
The gethnic approach for explaining the search for health information on social media
Authors: Rosenberg D , Mano R , Mesch G 
Published: October 2020

Abstract
Gender and ethnic inequalities in searching for health information have been studied extensively in the context of the internet as a whole, but rarely with respect to social media. Moreover, locality size has rarely been considered as a determinant in the search for health information. Furthermore, little attention has been paid to differences between searching for health information in general and for information on specific health issues. This study proposes a gethnic diversification approach to understand these phenomena. This approach maintains that the triple disadvantage of belonging simultaneously to three disadvantaged groups is translated into an advantage with respect to the probability of searching for health information online. The sample consisted of social media users in Israel (N = 803). The study's outcomes variables were general types of health information (medical vs. non-medical) and searching for specific health issues. The results of logistic regression analyses provide support for the gethnic diversification approach. These results imply that disadvantaged minorities residing in small localities (but also in large ones) use social media to search for health information to a greater extent than their counterparts from larger localities and than members of the advantaged group in order to compensate for their restricted amount of health-related social capital. This finding signals a major need for accessible and quality health services in small localities where many disadvantaged minority groups reside.

Key messages
Minority women residing in small localities should be treaten as a special group by the public health officials. More resources should be invested in developing health services in localities populated by minorities.
Knowledge at palm of hand: supported self-management and audiovisual content School of Patients DF
Authors: Cubas-Rolim E , Yung F R , Gripp M R , Oliveira C L A , Marques L A , Fagundes M C , Souza B V , Ribeiro L , Faria-Tostes E , Santana F 
Published: October 2020

Abstract

Background
The region of practice of the School of Patients DF is vulnerable at health literacy and income. Audiovisual information is strategic in primary care for its great power of reach and information retention.

Objectives
Since 2016 videos of health education have been produced, initially technical on the Planification for hypertension and diabetes. After the focus switched to popular health education, aiming at improving communication between health professionals and patients on chronic diseases and health promotion, including testimonials. The is potential for video exhibition in qualified waiting rooms and forwarding in social network.

Results
There are videos from diabetes, hypertension, obesity to dengue, pre-natal care and other APS themes, which follow printed orientation with pertinent links. There are graduate and post-graduate studies in course for optimizing audio-visual content for support and capacitation of the family caregivers, especially regarding the facilitated visual model of prescription (“Illustrated Prescription”). Data until 2020-January: YOUTUBE 3146 views, 118,6 hours of exhibition, 50 videos. FACEBOOK page with a reach of 369.248 views. INSTAGRAM 10.119 followers, 193 posts, 37.800 likes and 1003 commentaries.

Conclusions
Modifications in lifestyle and adherence to medication are fundamental for treatment, and videos are promising for health promotion and selfcare capacitation. There is potential for reducing the hierarchy barriers (testimonials). The shared construction of knowledge and its dissemination makes the patient active part in community diffusion of information.

Key messages
Health professionals have a vital role as educators, including for social online networks. Patients have a protagonist role in their treatment, as well as multipliers of knowledge at their community.