bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancing global health accountability through results-oriented monitoring: EC/WHO collaboration
Authors: Roura M , Capa E , Appelt B , Lecompte M , Fernandez M , Schmets G , Porignon D 
Published: October 2023

Abstract

Issue
Governments and organizations must demonstrate accountability and delivery of results. Results-Oriented Monitoring is a European Commission mechanism to enhance internal control and management. The Health System Strengthening for Universal Health Coverage program - the largest Commission grant to the World Health Organization - provides support towards achieving Universal Health Coverage through policy dialogue in 119 countries.

Description
We employ a Results-Oriented Monitoring review of the program conducted in October 2021- April 2022 as a case study to examine the question: what is the value of the Commission's Results-Oriented Monitoring system as a tool to enhance accountability of large Global Health interventions?. We conducted 87 face-to-face/remote interviews to engage stakeholders in assessing specific criteria such as relevance, efficiency, effectiveness, sustainability and human rights, in 12 purposively selected countries including Timor Leste, Colombia, the Democratic Republic of Congo, Zambia, Burkina Faso, Nigeria, Uzbekistan, the Philippines, Mongolia, Egypt, Jordan and Morocco.

Results
The Health System Strengthening for Universal Health Coverage program is a relevant intervention that responds to the needs of target groups because it is demand driven, flexible, and well-integrated within national health plans/regional frameworks. The absence of robust Monitoring and Evaluation frameworks for Universal Health Coverage at country level is a missed opportunity to pull the case for continued investment in health systems strengthening. Co-developing country level monitoring and evaluation frameworks could enhance multi-stakeholder policy dialogues anchored in the Universal Health Coverage concept.

Lessons
Our innovative adaptation of Results-Oriented Monitoring approaches to assess a large Global Health intervention (+100 countries) provided critical data to inform program implementation and fostered consensus building over subsequent steps.

Key messages
• The European commission’s results-oriented monitoring system is a valuable instrument to assess large scale global health interventions.
• Co-developing monitoring and evaluation frameworks at country level could serve as a tool to facilitate multi-stakeholder policy dialogues and to track progress towards universal health coverage.
An evaluation of the severe acute respiratory infection (SARI) surveillance system in Ireland
Authors: Marron L , Duffy R , O'Donnell J , Domegan L 
Published: October 2023

Abstract

Background
Expansion of the current single hospital site Severe Acute Respiratory Infection (SARI) surveillance programme in Ireland, to create a sentinel network, will commence in 2023. This evaluation aimed to assess the performance of key surveillance system attributes to improve and guide expansion.

Methods
A mixed quantitative and qualitative evaluation was conducted from September 2021 to November 2022. SARI surveillance data were analysed to assess completeness, timeliness and positive predictive value (PPV). An online stakeholder questionnaire, semi-structured focus group discussions and key informant interviews evaluated usefulness, simplicity, flexibility and acceptability. Qualitative data were analysed using thematic analysis.

Results
Among SARI cases (n = 747), completeness of key variables including age, sex and outcome was 100%. Symptom data were completed in &gt; 90%, COVID-19 vaccination status was completed in 89% and completeness of ethnicity data was 0.6%. Median times from hospitalisation to data entry commencement and completion were one day (IQR 1-3) and 48 days (IQR 21-81) respectively. Time to receipt of whole genome sequencing (WGS) results was 40 days (IQR 30-61). PPV was 95% (95% CI 93%-97%). The questionnaire response rate was 21% (75/362) and 96% (72/75) agreed that SARI surveillance is important. Key themes identified in the qualitative study (n = 11) were the complexity and importance of SARI surveillance. Suggested areas for improvement included process automation and additional designated resources to improve timeliness, flexibility and acceptability; particularly during epidemic or pandemic surge periods.

Conclusions
The SARI surveillance system reports high-quality data. Timeliness of WGS data and recording of vaccination status and equity stratifiers e.g., ethnicity should be improved. Priorities for expansion should be automation and adequate resource allocation to enable reliable SARI surveillance at all times.

Key messages
• The SARI surveillance system is a resource intensive, complex system that is an important component of national surveillance in Ireland and reports high-quality and timely surveillance data.
• The priorities for expansion are process automation where possible and ensuring adequate resources, specifically skilled staff. These evaluation findings should inform SARI expansion in Ireland.
Impact of the heat waves the Italian elderly population: not just a hot issue
Authors: Cadeddu C , Zjalic D 
Published: October 2023

Abstract

Background
Italy is considered a hotspot for climate change in the Mediterranean Sea e.g. due to heat waves. The year 2022 was the hottest in the past decade, with mean temperatures exceeding those in 1981-2010 by far. Further, it is well-known that socioeconomic disadvantage has a negative impact on health consequences and the risk of death during heat waves.

Methods
Bringing together statistical sources at national and subnational levels, we carry out a descriptive analysis about the vulnerability of specific subgroups of older people towards heat, by age group, region and socio-economic status.

Results
Recent data published by the Italian National Institute of Statistics highlighted 265,000 deaths (about 40% of total deaths) registered in the 4 months with the most critical climate conditions, i.e. January and December for the cold and July and August for hot weather. Except for 2020 when COVID-19 dramatically hit the Italian population, among the most recent 4 years (2003, 2015, 2017, 2022) with mortality rates higher than expected, three of them are concentrated in a period of just 8 years, where the climate crisis has been showing all its negative potential in terms of impact on health and survival, especially for a country where population is highly ageing. We further observe a correlation between the incidence of severe heat waves and the share of socio-economically deprived older people in the Southern part of the country.

Discussion
We identify regions that require specific attention from health policy-makers, especially in the Southern part of Italy where heat waves are extremely severe and older people are more socio-economically vulnerable and/or cannot protect themselves from heat adequately, e.g. due to adequate housing insulation. We underline the need for countries experiencing frequent and prolonged heat waves to rapidly intervene with national mitigation and adaptation plans, to protect vulnerable populations from negative health consequences.
An investigation into the awareness of cancer and it's social determinants in the Fiji Islands
Authors: Naidu C , Harris N , Wiseman N 
Published: October 2023

Abstract

Introduction
Cancer is a major public health concern worldwide, with increasing mortality rates, especially in low-middle income countries. The predicted global cancer burden by 2040 is expected to be over 27 million new cases per year, a nearly 50% increase compared to 2018. This research presents recent statistics on cancer incidence and mortality in Fiji from 2010 to 2018 and the barriers associated with early detection of cancer.

Methods
The study used a mixed-method model to determine cancer incidence and understand the factors associated with accessing breast cancer care in the Fiji Islands. Age-standardized incidence and mortality rates were calculated and semi-structured interviews were conducted with breast cancer patients, community women, a health care professional and a traditional healer.

Results
This study analysed cancer rates in Fiji from 2010 to 2018. Out of 12,433 reported cases, women had higher incidence rates (8,457 cases) compared to men (3,965 cases), but men had a higher death rate of nearly 59%. Breast, cervical, and endometrial cancer were the top three cancers among women, while prostate, liver, and lung cancer were the top three among men. Education, awareness, culture and distance were some of the factors identified as barriers to accessing cancer care services.

Conclusions
The findings emphasize the need to understand lifestyle factors affecting cancer risk, especially among women and rural populations. It underscores the importance of prioritizing cancer epidemiology, prevention, and control at the national level and investing in improved cancer treatment delivery. These efforts can help address the challenges of cancer in Fiji and reduce its burden on individuals.

Key messages
• The analysis serves as a foundation for future research to understand the barrier to access cancer healthcare services.
• This research aims to inform strategies for early detection of cancer and timely treatment for men and women in the Fiji Islands.
Qualitative research for improving positive health in deprived neighbourhoods
Authors: van Pomeren T , van der Meer I M 
Published: October 2023

Abstract

Background
There has been increased interest in the concept of ‘Positive Health’ in recent years, as it includes the ability to deal with physical, emotional and social life challenges. We used quantitative data to illustrate the positive health ‘spiderwebs’ for various deprived neighbourhoods. As this data did not provide information on personal experiences and barriers faced, qualitative data from the residents’ point of view were used to complete the positive health spiderweb.

Methods
Qualitative data from semi-structured interviews with residents and professionals from eight deprived neighbourhoods in The Hague, The Netherlands were used to supplement quantitative data from a recent national health survey. The interviewed professionals worked in and with the community in the field of health and wellbeing. Participants were asked about what is going well in the neighbourhood and what was needed to improve the health and wellbeing of residents. Transcripts were coded and analysed to identify key themes per neighbourhood.

Results
Compared to the average score of the city, the neighbourhood spiderwebs showed unfavourable results on all domains. Interviews with residents and professionals highlighted aspects of the living environment as a priority, such as (useable) green space, environmental safety (traffic, parked cars, safe crossings), lack of (free) space and waste management. These aspects negatively affected the health and exercise habits of the residents. Though data on living environment is collected in national surveys, the qualitative approach provides more detail on the current priorities of residents.

Conclusions
This research shows the key role which living environment plays in the health of people in deprived neighbourhoods. Also, it illustrates the value of using the needs and experiences of residents to shape interventions addressed at improving positive health.

Key messages
• Addressing health of residents in deprived neighbourhoods of the city of The Hague requires a broader approach that includes environmental factors.
• When trying to improve health in neighbourhoods, it is pertinent that existing quantitative data is supplemented with qualitative data from residents themselves.
Physical and mental health among citizens with chronic disease in the Capital Region of Denmark
Authors: Elsborg P , Goltermann Toxværd C , Andreasen A H , Eliasen M H , Grønkjær M 
Published: October 2023

Abstract

Background
Chronic disease is a significant problem affecting those living with them, and often also leading to negative effects on other areas of health. This study aims to investigate if individuals with chronic disease have a higher prevalence of poor physical and mental health compared with the general population in the Capital Region of Denmark, and to compare mental and physical health among those with different chronic diseases.

Methods
Data from the Danish Capital Region Health Survey 2021 among individuals (≥16 years) in the Capital Region of Denmark in 2021 (N = 56,245, response rate=54.9%) were used to obtain information on physical and mental health status (SF-12), stress (Cohens’ Perceived Stress Scale), and loneliness (Three-Item Loneliness Scale). Information from national registers on hospital diagnoses and medical treatment were used to identify individuals with chronic diseases. In the presentation, results from several diseases will be presented, but in this abstract, heart disease is used as an example.

Results
Preliminary results show that individuals with heart disease have a higher prevalence of poor physical health compared to the general population in the Capital Region. For example, 42% of individuals with heart disease reported poor general health (Capital Region: 16%), while 38% had low score on the physical health scale (Capital Region: 9.1%), and 50% were greatly affected by pain or discomfort in the musculoskeletal system (Capital Region: 29%). However, there were also health indicators (such as stress and loneliness) where there was no or only a minor difference between individuals with heart disease and the general population.

Conclusions
Among individuals with heart disease, there are two to four times as many with poor physical health on certain indicators compared with the general population in the Capital Region. It is important to be aware that individuals with chronic disease often also have other health challenges.

Key messages
• Individuals with heart disease have a significantly higher prevalence of poor physical health compared to the general population in the Capital Region.
• Healthcare professionals and other professionals should incorporate knowledge in their work about the other health challenges that citizens with specific chronic diseases often face.
'But we survived': Older adults’ strategies to cope with the lockdowns due to the COVID-19 pandemic
Authors: Jarego M , Tasker F , Costa P A , Pais-Ribeiro J , Ferreira-Valente A 
Published: October 2023

Abstract

Background
Older adults are one of the most vulnerable groups to severe illness associated with the SARS-COV-2 virus. Therefore, it would be expected that the elderly would suffer great impact of the COVID-19 pandemic on their mental health. However, it seems not to be the case, possibly due to contextual aspects and the strategies used by them to deal with the COVID-19 pandemic. Our study aimed at exploring the strategies older adults in Portugal deployed during the mandatory lockdowns in 2020 and 2021 to protect their mental health.

Methods
A total of 22 older adults were interviewed and included in this study (36% women; age range between 66 and 92 years old). Qualitative data was collected through semi-structured interviews between Jan-Sept 2020 and analysed according to codebook thematic analysis.

Results
Three main themes were identified. The first theme - ‘finding things to do and activities that can protect me’ - referred to behavioural coping strategies adopted to deal with the pandemic (e.g., preventing behaviours to avoid COVID-19 infection, social support). The second theme - ‘identifying how my thoughts can protect me’ - encompassed cognitive coping strategies, such as engaging in meaning-making processes to make sense out of the circumstances. Finally, the third theme - ‘counting myself lucky: me and my home advantages’ - included aspects perceived as beneficial to the wellbeing of participants during lockdowns (e.g., being healthy, living in a rural area).

Conclusions
The thematic strategies identified by older adults to manage the pandemic and lockdown-related stresses could be linked to meaning-centred coping and could be further developed via existential therapy.

Key messages
• As older adults with health problems and living in urban areas may be at a disadvantage when facing lockdowns, they should be identified by government health entities and forward to psychologists.
• The efficacy of preventing behaviours to avoid COVID-19 dissemination, distraction, social support, and meaning-making processes during health hazards should be targeted by treatment programmes.
Coverage and associated factors with cervical cancer screening in Spain
Authors: Marín Caba E , Pérez de Rojas J , Soler Iborte E , García Blázquez Pérez C-M , Luque Martínez A , Homar Regnault de Maulmin T , Jiménez Moleón J 
Published: October 2023

Abstract

Background
Cervical cancer is a preventable cancer due to vaccination and screening. In Spain 80% of new cases of cervical cancer are women that haven't ever participated in screening programmes. It is outlined if this participation is properly done and if cervical cancer screening is still a challenge for public health in Spain. Our aims are to estimate cervical cancer screening coverage, distinguishing female participation ever and participation every three years according to current recommendations, and to identify the associated factors with participation in the screening.

Methods
An analysis from a subpopulation of the European Health Survey in Spain in 2020 was conducted. Women between 25 and 65 years old that answered the Adult and Home questionnaires were included. Our main variables were “not participating ever in cervical cancer screening”, and “incorrect participation”. A descriptive analysis of the variables and logistic regression models were developed to identify the determinants for the participation in cervical cancer screening.

Results
6924 women fulfilled the selection criteria. The percentage of not participating ever in cervical cancer screening was 11.7%. The percentage of incorrect regularity of participation was 18.0%. Young and elderly women, low socio-economic educational level, sedentary lifestyle, absence of private health insurance, good self-perceived health and working as informal carer were associated with deficient women's participation in screening.

Conclusions
Despite high percentage of participation in cervical cancer screening, the frequency of women that participate correctly can be improved. Socio-economic factors, health perception and assurance, lifestyle, and informal care, have an influence in producing disparities in women's participation and regularity in cervical cancer screening. Future studies are needed to analyse the association among lifestyles, role of carer women and coverage of cervical cancer screening.

Key messages
• Impact of social determinants of health have been recognised in cervical cancer screening.
• Specific programs for vulnerable women are needed to improve their participation in cervical cancer screening.
Making sense of ‘implementation gaps’ as a governance problem of antimicrobial resistance
Authors: Jeleff M , Haddad C , Kutalek R 
Published: October 2023

Abstract

Background
Antimicrobial resistance (AMR) is a pressing global health issue. National Action Plans on AMR (NAP-AMR) are key to mitigate AMR, however, effective translation of action plans has been a governance challenge worldwide. This study explores the implementation gap in Austria by examining experiences of experts involved in domestic AMR policy.

Methods
This study was guided by grounded theory. Data were collected through qualitative interviews, a focus group, and participation in AMR symposia. Overall, 13 participants were identified through theoretical sampling. Data collection and analysis took place until theoretical saturation was achieved.

Results
Experts identified the following central themes affecting AMR mitigation: absence of a binding legal framework, paucity of AMR data, low risk perception among decision makers, lack of funding, and insufficient incentive systems for people dedicated to AMR stewardship.

Conclusions
The interpretation of these findings suggests policy fragmentation, scattered responsibilities, agenda conformity and a lack of recognition as core features which impede a sustainable and effective AMR-related governance. The results should alert policymakers to sustainable public health interventions in the following areas:
a) Institutional responsibilities need to be restructured to prioritize AMR stewardship as a guiding principle.
b) Investments are necessary for nationwide implementation of AMR stewardship and surveillance systems.
c) Financial and symbolic incentives for people dedicated to AMR mitigation are imperative.

Key messages
• There is a tension between local efforts to make adjustments to mitigate AMR and the current approach of ‘superimposing’ reforms on existing structures.
• Effective measures to address AMR require that priority be given to mitigating AMR.
Climate and Health Toolkit for Public Health Registrars
Authors: Ralph A , McGushin A , Booth H , Cullum R , Harpur A , Sahare P 
Published: October 2023

Abstract

Background
The UK Faculty of Public Health (FPH)'s Climate and Health Strategy vision is for the public health (PH) workforce to “lead on strategies to protect health and wellbeing for current and future generations”, and the UK PH curriculum requires registrars to “demonstrate leadership in environmental sustainability” (ES). However, UK PH training currently provides limited opportunities and support for ES work: a 2022 survey of 18 PH registrars in the East of England found that most (78%) had never or infrequently incorporated ES into past projects, due to uncertainty of appropriate sustainability measures or limitations of supervisory knowledge or support. The majority (89%) felt building ES into their future work was “very important” or “important”, and that a toolkit to support this would be useful (89%).

Methods
Formulation of this ES toolkit for UK PH registrars is embedded within the FPH's Sustainable Development Special Interest Group (SIG)'s 2023 workplan. The working group comprises current registrars recruited from diverse UK training locations. To inform toolkit contents, previous registrar projects incorporating ES were collected, via national and regional registrar networks, and through interviews with SIG contacts. Usefulness and accessibility will be evaluated following toolkit dissemination to UK registrars.

Results
The toolkit, structured by placement type, will include: advice on incorporating ES into common placement projects and topics; wider placement activities registrars can undertake to promote greater sustainability; and case studies exploring lessons learned from previous registrar projects that incorporated ES.

Conclusions
Formulation of a practical toolkit will enable PH registrars to develop knowledge and expertise in ES, equipping the next generation of PH professionals with the leadership skills to champion ES in our climate-changing world.

Key messages
• It is imperative that public health registrars gain the skills to tackle the health effects of climate change, but additional support for building these skills is required.
• This practical toolkit will support UK PH registrars to incorporate ES into their work, thereby building knowledge, expertise and leadership skills around climate and public health.