Present at the creation: the founding and formative years of the Association of Academic Health Sciences Libraries.
(17/211)
The Association of Academic Health Sciences Libraries (AAHSL) was founded in 1978 with the goal of strengthening academic health sciences libraries and increasing their participation nationally in efforts to improve medical education. A primary objective of the organization was to achieve a formal relationship with the Association of American Medical Colleges (AAMC) through membership in the Council of Academic Societies (CAS). Initial steps in establishing AAHSL are examined, including its efforts to join CAS. The author pays tribute to AAHSL's founders, in particular Gerald Oppenheimer, without whose vision and leadership AAHSL would not have been formed. (+info)
Building integrated health systems in central and eastern Europe: an analysis of WHO and World Bank views and their relevance to health systems in transition.
(18/211)
BACKGROUND: Two questions are addressed. i) What are the views on health and health systems as expressed in the World Development Report 2000/2001 of the WB and the World Health Report 2000 and Health 21 of the World Health Organization, and how compatible are those views? ii) To what extent will compliance of CEEC and NIS with the WHO and WB recommendations result in health systems that produce maximum health for all by adequately addressing the needs of their populations? METHOD: The reports prepared by the World Bank and the World Health Organization were assessed against the theoretical framework of a needs-based public health approach. RESULTS: It is observed that the WHO and WB approaches are currently converging, although there remain differences in their respective focuses. The main merit of the WHO approach is its focus on performance and the systems approach towards health (care). The merit of the WB view is the integrated approach to health, education and poverty. It is argued that CEEC and NIS need to anticipate an ageing population and growing numbers of chronically ill. This calls for integrated health care systems and more integrated funding and payment systems. CONCLUSION: The recommendations provided in the WHR and the WDR with regard to integrated care and integrated financing remain rather abstract. Advisors of CEEC and NIS on health care reform and Western assistance projects should focus more on future needs, in order to avoid building health systems that consistently lag behind the needs of their populations. (+info)
Community participation in externally funded health projects: lessons from Cambodia.
(19/211)
This article provides lessons learned on establishing effective community participation in two externally funded, NGO-implemented health projects working at district level in Cambodia. The first project was implemented in accordance with the Cambodian national guidelines on community participation. The second - using lessons and experiences gained as a result of the first project - worked with Buddhist pagoda volunteers. Primary research was conducted in both settings to assess the effectiveness of the two participation strategies. The article concludes that the success of community participation in externally funded health projects with relatively short implementation timeframes requires engagement with existing community-based organizations and agencies. In Cambodia, where Theravada Buddhism is the dominant religion, pagodas and associated volunteers appear to represent such an organization. Community participation structured around pagoda volunteers - who are held in high esteem within their local communities - is more effective and sustainable than newly (and externally) established community structures with formally elected representatives. Pagodas and associated volunteers in rural Cambodia offer the advantages of effective leadership, local organization, resource mobilization and management. It is recommended that programmes and agencies wishing to adopt community participation strategies in health utilize participatory research to identify the most appropriate local organization to lead such initiatives. (+info)
Training outreach workers for AIDS prevention in rural India: is it sustainable?
(20/211)
Through a process of community diagnosis and participation, a non-governmental organization in rural Karnataka state in India selected and trained peer outreach workers to implement and sustain AIDS prevention education activities. This activity was part of a larger AIDS education project that aimed at creating awareness and promoting risk-reducing behaviours in the community. This paper describes efforts of the project to identify and train peer educators during its implementation phase and discusses strategies used to facilitate sustainability. We evaluate the impact of these efforts by conducting an analysis in the project area 2 years after the end of the project. The findings reveal generalized interest among rural communities in HIV prevention issues. The project originally conducted an extensive survey to understand community organization and composition, which helped to identify potential partners and peer educators. Training peer educators was a multi-step process, and one with high attrition. While individual peer educators were an excellent resource during the life of the project, peer educators affiliated with village level institutions had the interest, access to resources and willingness to sustain project efforts. However, the sustainability of their efforts was associated with the quality of interactions with the project implementation team, the strength and leadership of their own institutions, the perceived benefits of implementing AIDS education activities after project life and the gender of the outreach worker. Non-sustainers did not have an organizational structure to backstop their work, were often poor and unemployed persons who later found gainful employment, and overwhelmingly, were female. We present a conceptual model based on these findings to help future projects plan for and achieve sustainability. (+info)
Cost efficiency in maternal and child health and family planning service delivery in Bangladesh: implications for NGOs.
(21/211)
The main goal of the health reform programme recently initiated in Bangladesh is to reduce costs and improve cost efficiency of the service delivery systems, and thereby ensure the sustainable provision of essential health and family planning services. With significant dependency on external funding, attainment of this objective is more critical for non-government organization (NGO) programmes. The paper analyzes costs of the NGO service delivery systems for maternal and child health and family planning, and identifies areas for increasing efficiency, especially through reducing labour costs and increasing service outputs. The operations research on cost analyses was conducted within the health and family planning programmes of a leading NGO, using the 'ingredients approach'. The findings demonstrated a significantly high proportion of personnel costs in field (outreach) service delivery systems, ranging between 70-85%. More than two-thirds of the working time of providers was spent on support activities, personal preoccupations and idle time. Simulations of various cost reduction options showed that considerable efficiency gains were possible through the combined effects of lowering personnel costs for field activities, increasing service outputs at the clinics, and ensuring more efficient use of providers' time. However, these factors, neither separately nor in combination, resulted in any substantive decrease for certain clinic services (e.g. antenatal care), implying the need to subsidize these services. The findings of the operations research indicated that cost analyses could be an effective decision-making tool for NGOs in developing cost-efficient service delivery strategies. (+info)
HUPO initiatives relevant to clinical proteomics.
(22/211)
The past few years have seen a tremendous interest in the potential of proteomics to address unmet needs in biomedicine. Such unmet needs include more effective strategies for early disease detection and monitoring and more effective therapies, in addition to developing a better understanding of disease pathogenesis. Proteomics is particularly suited for investigating biological fluids to identify disease-related alterations and to develop molecular signatures for disease processes. However, much of the effort undertaken in clinical proteomics to date represents either demonstrations of principles or relatively small-scale studies when compared with genomics effort and accomplishments or more pertinently when contrasted with the tremendous untapped potential of clinical proteomics. Clearly, we are in the early stages. What seems to be urgently needed is an organized effort to build a solid foundation for proteomics that includes developing a much needed infrastructure with adequate resources. The Human Proteome Organization (HUPO) is fostering an organized international effort in proteomics that includes initiatives around organ systems and biological fluids that have disease relevance as well as development of proteomics resources. (+info)
A comparison of the sports safety policies and practices of community sports clubs during training and competition in northern Sydney, Australia.
(23/211)
OBJECTIVES: To compare the safety policies and practices reported to be adopted during training and competition by community sports clubs in northern Sydney, Australia. METHODS: This cross sectional study involved face to face interviews, using an 81 item extensively validated questionnaire, with representatives of 163 community netball, rugby league, rugby union, and soccer clubs (response rate 85%). The study was undertaken during the winter sports season of 2000. Two separate 14 item scales were developed to analyse the level of safety policy adoption and safety practice implementation during training and competition. The statistical analysis comprised descriptive and inferential analysis stratified by sport. RESULTS: The reliability of the scales was good: Cronbach's alpha = 0.70 (competition scale) to 0.81 (training scale). Significant differences were found between the safety scores for training and competition for all clubs (mean difference 11.2; 95% confidence interval (CI) 10.0 to 12.5) and for each of the four sports: netball (mean difference 14.9; 95% CI 12.6 to 17.2); rugby league (mean difference 10.3; 95% CI 7.1 to 13.6); rugby union (mean difference 9.4; 95% CI 7.1 to 11.7); and soccer (mean difference 8.4; 95% CI 6.5 to 10.3). CONCLUSIONS: The differences in the mean competition and training safety scores were significant for all sports. This indicates that safety policies were less often adopted and practices less often implemented during training than during competition. As injuries do occur at training, and sports participants often spend considerably more time training than competing, sporting bodies should consider whether the safety policies and practices adopted and implemented at training are adequate. (+info)
Introducing operations research into management and policy practices of a non-governmental organization (NGO): a partnership between an Indian leprosy NGO and an international academic institution.
(24/211)
This paper reports on a partnership between LEPRA, a non-governmental organization (NGO), and the London School of Hygiene and Tropical Medicine (LSHTM) to explore the feasibility and appropriateness of incorporating operations research into the management and decision-making of a leprosy NGO. A pilot study in Orissa was used to determine the advantages and disadvantages of introducing operations research to assist in decision-making and programme implementation within the organization. The results highlight the difficulty and complexity of the process, but point to several important themes: partnership, changing perspectives, use of time and priority-setting, identification of gaps in systems, and building institutional and personal capabilities. The results of the study provide support to encourage NGOs to become actively involved in research. Because of their work and service to local communities, NGOs have the opportunity to collect information about the perceptions, resources and constraints of individuals, families and the communities themselves in accessing appropriate care. Their proximity to communities gives them a feeling of responsibility for ensuring that this information is translated to the district, national and ultimately international level. This will help to ensure the creation of appropriate infectious disease control policies that support the needs of patients. 'Outside' academic institutions can help NGOs to facilitate this up-stream flow of information from the local to the national and international level, to help to ensure that international disease control policies are appropriately serving local communities. (+info)