المؤلفون: Nyawira L; Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya., Tsofa B; Health Systems and Research Ethics Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Musiega A; Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya., Munywoki J; Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya., Njuguna RG; Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya., Hanson K; Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK., Mulwa A; Directorate of Medical Services, preventive and promotive health, Ministry of Health, Nairobi, Kenya., Molyneux S; Health Systems and Research Ethics Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Maina I; Health Financing Department, Ministry of Health, Nairobi, Kenya., Normand C; Centre for Health Policy and Management, Trinity College, the University of Dublin, Dublin, Ireland., Jemutai J; Health Systems and Research Ethics Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Barasa E; Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya. ebarasa@kemri-wellcome.org.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK. ebarasa@kemri-wellcome.org.; Institute of Healthcare Management, Strathmore Business School, Strathmore University, Nairobi, Kenya. ebarasa@kemri-wellcome.org.

المصدر: BMC health services research [BMC Health Serv Res] 2022 Aug 16; Vol. 22 (1), pp. 1046. Date of Electronic Publication: 2022 Aug 16.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

مواضيع طبية MeSH: Government Programs* , Local Government*, Humans ; Kenya ; Medical Assistance ; Workforce

مستخلص: Background: Human resources for health consume a substantial share of healthcare resources and determine the efficiency and overall performance of health systems. Under Kenya's devolved governance, human resources for health are managed by county governments. The aim of this study was to examine how the management of human resources for health influences the efficiency of county health systems in Kenya.
Methods: We conducted a case study using a mixed methods approach in two purposively selected counties in Kenya. We collected data through in-depth interviews (n = 46) with national and county level HRH stakeholders, and document and secondary data reviews. We analyzed qualitative data using a thematic approach, and quantitative data using descriptive analysis.
Results: Human resources for health in the selected counties was inadequately financed and there were an insufficient number of health workers, which compromised the input mix of the health system. The scarcity of medical specialists led to inappropriate task shifting where nonspecialized staff took on the roles of specialists with potential undesired impacts on quality of care and health outcomes. The maldistribution of staff in favor of higher-level facilities led to unnecessary referrals to higher level (referral) hospitals and compromised quality of primary healthcare. Delayed salaries, non-harmonized contractual terms and incentives reduced the motivation of health workers. All of these effects are likely to have negative effects on health system efficiency.
Conclusions: Human resources for health management in counties in Kenya could be reformed with likely positive implications for county health system efficiency by increasing the level of funding, resolving funding flow challenges to address the delay of salaries, addressing skill mix challenges, prioritizing the allocation of health workers to lower-level facilities, harmonizing the contractual terms and incentives of health workers, and strengthening monitoring and supervision.
(© 2022. The Author(s).)

المؤلفون: Ogbuabor DC; Department of Health Systems and Policy, Sustainable Impact Resource Agency, Enugu, Enugu State, Nigeria.; Department of Health Administration and Management, University of Nigeria Enugu Campus, Enugu, Enugu State, Nigeria., Okoronkwo IL; Department of Health Administration and Management, University of Nigeria Enugu Campus, Enugu, Enugu State, Nigeria.

المصدر: PloS one [PLoS One] 2019 Jul 24; Vol. 14 (7), pp. e0220292. Date of Electronic Publication: 2019 Jul 24 (Print Publication: 2019).

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

مواضيع طبية MeSH: Job Satisfaction* , Local Government* , Workplace*/psychology , Workplace*/statistics & numerical data, Government Programs/*organization & administration , Personnel Turnover/*statistics & numerical data , Tuberculosis/*prevention & control, Adult ; Cross-Sectional Studies ; Female ; Government Programs/standards ; Government Programs/statistics & numerical data ; Humans ; Infection Control/methods ; Infection Control/organization & administration ; Male ; Middle Aged ; Motivation/physiology ; Nigeria/epidemiology ; Preventive Medicine/organization & administration ; Quality of Life ; Rural Health Services/organization & administration ; Rural Health Services/statistics & numerical data ; Surveys and Questionnaires

مستخلص: Introduction: Significant gap exists in knowledge about employee-centred human resources practices that address motivation and retention of local government tuberculosis control programme supervisors (LGTBS) in Nigeria. The study examined the role of quality of worklife (QWL) in motivating and retaining LGTBS.
Materials and Methods: The study was conducted in south-eastern region of Nigeria comprising five states and 95 local government areas. The design was mixed-methods. We used cross-sectional survey to collect quantitative data on socio-demographic factors, QWL, motivation and retention from a total sample of LGTBS. The qualitative component involved focus group discussions (n = 3) with 26 LGTBS. Quantitative data were analysed using exploratory factor analysis, descriptive statistics, Spearman correlation, Mann-Whitney test, Kruskal-Wallis test and multiple linear regression. Qualitative data were analysed using a thematic framework approach.
Results: The final 40-item QWL scale was found to be valid and reliable. The LGTBS had high QWL (M = 5.15, SD = 0.88) and motivation (M = 5.92, SD = 1.08), but low intention to leave their jobs (M = 2.68, SD = 1.59). Education significantly predicted satisfaction with overall QWL, work-family balance and work design; but tenure predicted satisfaction with work context. Work design and work-family balance significantly predicted motivation of LGTBS. Motivation mediated the relationship between QWL and intention to leave and accounted for 29% variance in intention to leave. Whereas LGTBS were motivated by responsibility, learning opportunities, achievement and recognition; they were dissatisfied with lack of flexible work schedules, involvement in non-TB tasks, long hours at work, limited opportunities for vacation, resource inadequacy, work-related stigma, lack of promotional opportunities, and pay disparity and delay.
Conclusion: Addressing work design, work-family balance and working conditions may increase the motivation and retention of LGTBS and improve human resources for TB at the district level and performance of the TB control programme.
Competing Interests: The authors have declared that no competing interests exist.

المؤلفون: Root ED; Department of Geography & Division of Epidemiology, The Ohio State University, 151 N. Oval Mall, Columbus, OH 43210, USA., Zarychta A; School of Social Service Administration, University of Chicago, 969 E. 60th Street, Chicago, IL 60637, USA., Tapia BB; Department of Sociology, University of Colorado Boulder, 327 UCB, Ketchum 195, Boulder, CO 80309, USA.; Institute of Behavioral Science, University of Colorado Boulder, 1440 15th St, 483 UCB, Boulder, CO 80309, USA., Grillos T; Department of Political Science, Purdue University, 100 N University St, West Lafayette, IN 47907, USA., Andersson K; Institute of Behavioral Science, University of Colorado Boulder, 1440 15th St, 483 UCB, Boulder, CO 80309, USA.; Department of Political Science & Center for the Governance of Natural Resources, University of Colorado Boulder, 333 UCB, Boulder, CO 80309, USA., Menken J; Department of Sociology, University of Colorado Boulder, 327 UCB, Ketchum 195, Boulder, CO 80309, USA.; Institute of Behavioral Science, University of Colorado Boulder, 1440 15th St, 483 UCB, Boulder, CO 80309, USA.

المصدر: Health policy and planning [Health Policy Plan] 2020 Nov 20; Vol. 35 (9), pp. 1168-1179.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Oxford University Press in association with the London School of Hygiene and Tropical Medicine Country of Publication: England NLM ID: 8610614 Publication Model: Print Cited Medium: Internet ISSN: 1460-2237 (Electronic) Linking ISSN: 02681080 NLM ISO Abbreviation: Health Policy Plan

مواضيع طبية MeSH: Developing Countries*/statistics & numerical data , Health Services*/statistics & numerical data , Local Government*, Government Programs ; Honduras ; Humans

مستخلص: Health systems strengthening is at the forefront of the global health agenda. Many health systems in low-resource settings face profound challenges, and robust causal evidence on the effects of health systems reforms is lacking. Decentralization has been one of the most prominent reforms, and after more than 50 years of implementation and hundreds of studies, we still know little about whether these policies improve, harm or are inconsequential for the performance of health systems in less-developed countries. A persistent problem in existing studies is the inability to isolate the effect of decentralization on health outcomes, struggling with heterogeneous meanings of decentralization and missing counterfactuals. We address these shortcomings with a quasi-experimental, longitudinal research design that takes advantage of a unique staggered reform process in Honduras. Using three waves of household survey data over 10 years for a matched sample of 65 municipalities in Honduras, we estimated difference-in-difference models comparing changes in outcomes over time between local health systems that were decentralized using one of three types of organizations [municipal governments, associations of mayors or non-governmental organization (NGOs)] and those that remained centrally administered. We find evidence of overall improvements between 2005 and 2016 in several service delivery-related outcomes, and additional improvements in decentralized municipalities governed by NGOs. NGO-led municipalities saw a 15% decrease in home delivery relative to centralized municipalities in 2016, a 12.5% increase in MCH facility delivery and a 7% increase in the use of a skilled birth attendant. There were no detectable positive treatment effects for vaccination, and a slight decline in the weight-for-length z-scores in NGO municipalities, but we find no systematic evidence of decentralization negatively impacting any maternal and child health outcomes. These findings highlight the importance of considering implementation context, namely organization type, when assessing the effects of decentralization reform.
(© The Author(s) 2020. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

المؤلفون: Muthathi IS; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 27 St Andrews Road, Parktown, Johannesburg, 2193, South Africa. Sabelile.Muthathi@wits.ac.za., Rispel LC; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 27 St Andrews Road, Parktown, Johannesburg, 2193, South Africa.; Centre for Health Policy & Department of Science and Innovation/National Research Foundation Research Chair, University of the Witwatersrand, 27 St Andrews Road, Johannesburg, 2193, South Africa.

المصدر: Health research policy and systems [Health Res Policy Syst] 2020 Jun 03; Vol. 18 (1), pp. 55. Date of Electronic Publication: 2020 Jun 03.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101170481 Publication Model: Electronic Cited Medium: Internet ISSN: 1478-4505 (Electronic) Linking ISSN: 14784505 NLM ISO Abbreviation: Health Res Policy Syst Subsets: MEDLINE

مواضيع طبية MeSH: Health Policy* , Local Government* , National Health Programs* , Quality of Health Care*, Ambulatory Care Facilities/*standards , Government Programs/*standards , Primary Health Care/*standards, Cognition ; Decision Making ; Health Care Reform ; Humans ; Leadership ; Motivation ; Pilot Projects ; Policy Making ; Power, Psychological ; Program Development ; Qualitative Research ; Resource Allocation ; Social Responsibility ; South Africa ; Universal Health Insurance

مستخلص: Background: Universal health coverage is a key target of the Sustainable Development Goals and quality of care is fundamental to its attainment. In South Africa, the National Health Insurance (NHI) system is a major health financing reform towards universal health coverage. The Ideal Clinic Realisation and Maintenance (ICRM) programme aims to improve the quality of care at primary healthcare level in preparation for NHI system implementation. This study draws on Bressers' Contextual Interaction Theory to explore the wider, structural and specific policy context of the ICRM programme and the influence of this context on policy actors' motivation, cognition and perceived power.
Methods: This was a nested qualitative study, conducted in two NHI pilot districts in the Gauteng and Mpumalanga Provinces of South Africa. Following informed consent, we conducted in-depth interviews with key informants involved in the conceptualisation and implementation of the ICRM programme. The questions focused on ICRM policy context, rationale and philosophy, intergovernmental relationships, perceptions of roles and responsibilities in implementation, ICRM programme resourcing, and implementation progress, challenges and constraints. We used thematic analysis, informed by Bressers' theory, to analyse the data.
Results: A total of 36 interviews were conducted with key informants from national, provincial and local government. The wider context of the ICRM programme implementation was the drive to improve the quality of care at primary healthcare level in preparation for NHI. However, the context was characterised by contestations about the roles and responsibilities of the three government spheres and weak intergovernmental relationships. Notwithstanding examples of strong local leadership, the disjuncture between two national quality of care initiatives and resource constraints influenced policy actors' experiences and perceptions of the ICRM programme. They expressed frustrations about the lack of or diffuse accountability and their lack of involvement in decision-making, thus questioning the sustainability of the ICRM programme.
Conclusions: National health sector reforms should consider the context of policy implementation and potential impact on actors' motivation, cognition and power. All relevant policy actors should be involved in policy design and implementation. A clear communication strategy and ongoing monitoring and evaluation are prerequisites for implementation success.

المؤلفون: Jacobs E; University of Basel, Petersplatz 1, 4001, Basel, Switzerland. e.jacobs@kit.nl.; KIT Royal Tropical Institute, Mauritskade 63, Amsterdam, 1092 AD, The Netherlands. e.jacobs@kit.nl., Baez Camargo C; University of Basel, Petersplatz 1, 4001, Basel, Switzerland.; Basel Institute on Governance, Steinenring 60, 4051, Basel, Switzerland.

المصدر: International journal for equity in health [Int J Equity Health] 2020 Mar 02; Vol. 19 (1), pp. 30. Date of Electronic Publication: 2020 Mar 02.

نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101147692 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-9276 (Electronic) Linking ISSN: 14759276 NLM ISO Abbreviation: Int J Equity Health Subsets: MEDLINE

مواضيع طبية MeSH: Delivery of Health Care* , Empowerment* , Local Government* , Organizations* , Social Responsibility*, Case-Control Studies ; Government Programs ; Health Resources ; Humans ; Stakeholder Participation ; Tajikistan

مستخلص: Background: Relationships of power, responsibility and accountability between health systems actors are considered central to health governance. Despite increasing attention to the role of accountability in health governance a gap remains in understanding how local accountability relations function within the health system in Central Asia. This study addresses this gap by exploring local health governance in two districts of Tajikistan using principal-agent theory.
Methods: This comparative case study uses a qualitative research methodology, relying on key informant interviews and focus group discussions with local stakeholders. Data analysis was guided by a framework that conceptualises governance as a series of principal-agent relations between state actors, citizens and health providers. Special attention is paid to voice, answerability and enforceability as crucial components of accountability.
Results: The analysis has provided insight into the challenges to different components making up an effective accountability relationship, such as an unclear mandate, the lack of channels for voice or insufficient resources to carry out a mandate. The findings highlight the weak position of health providers and citizens towards state actors and development agents in the under-resourced health system and authoritarian political context. Contestation over resources among local government actors, and informal tools for answerability and enforceability were found to play an important role in shaping actual accountability relations. These accountability relationships form a complex institutional web in which agents are subject to various accountability demands. Particularly health providers find themselves to be in this role, being held accountable by state actors, citizens and development agencies. The latter were found to have established parallel principal-agent relationships with health providers without much attention to the role of local state actors, or strengthening the short accountability route from citizens to providers.
Conclusion: The study has provided insight into the complexity of local governance relations and constraints to formal accountability processes. This has underlined the importance of informal accountability tools and the political-economic context in shaping principal-agent relations. The study has served to demonstrate the use and limitations of agency theory in health governance analysis, and points to the importance of entrenched positions of power in local health systems.

المؤلفون: Grossman E; Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Illinois, Chicago (Mss Grossman and Hathaway and Dr Dorevitch); Division of Public Health Services, New Hampshire Department of Health & Human Services, Concord, New Hampshire (Dr Bush and Mr Cahillane); Office of Health Equity, California Department of Public Health, Richmond, California (Ms English); Departments of Urban & Regional Planning (Dr Holmes) and Geography (Dr Uejio), Florida State University, Tallahassee, Florida; Wisconsin Department of Health Services, Madison, Wisconsin (Ms Moran); and Oregon Health Authority, Portland, Oregon (Ms York)., Hathaway M, Bush KF, Cahillane M, English DQ, Holmes T, Moran CE, Uejio CK, York EA, Dorevitch S

المصدر: Journal of public health management and practice : JPHMP [J Public Health Manag Pract] 2019 Mar/Apr; Vol. 25 (2), pp. 113-120.

نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.

بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9505213 Publication Model: Print Cited Medium: Internet ISSN: 1550-5022 (Electronic) Linking ISSN: 10784659 NLM ISO Abbreviation: J Public Health Manag Pract

مواضيع طبية MeSH: Climate Change* , Local Government*, Civil Defense/*methods , Financing, Organized/*statistics & numerical data , Public Health/*methods, Centers for Disease Control and Prevention, U.S./organization & administration ; Centers for Disease Control and Prevention, U.S./statistics & numerical data ; Civil Defense/instrumentation ; Cross-Sectional Studies ; Government Programs ; Humans ; United States

مستخلص: Context: Human health is threatened by climate change. While the public health workforce is concerned about climate change, local health department (LHD) administrators have reported insufficient knowledge and resources to address climate change. Minigrants from state to LHDs have been used to promote a variety of local public health initiatives.
Objective: To describe the minigrant approach used by state health departments implementing the Centers for Disease Control and Prevention's (CDC's) Building Resilience Against Climate Effects (BRACE) framework, to highlight successes of this approach in promoting climate change preparedness at LHDs, and to describe challenges encountered.
Design: Cross-sectional survey and discussion.
Intervention: State-level recipients of CDC funding issued minigrants to local public health entities to promote climate change preparedness, adaptation, and resilience.
Main Outcome Measures: The amount of funding, number of LHDs funded per state, goals, selection process, evaluation process, outcomes, successes, and challenges of the minigrant programs.
Results: Six state-level recipients of CDC funding for BRACE framework implementation awarded minigrants ranging from $7700 to $28 500 per year to 44 unique local jurisdictions. Common goals of the minigrants included capacity building, forging partnerships with entities outside of health departments, incorporating climate change information into existing programs, and developing adaptation plans. Recipients of minigrants reported increases in knowledge, engagement with diverse stakeholders, and the incorporation of climate change content into existing programs. Challenges included addressing climate change in regions where the topic is politically sensitive, as well as the uncertainty about the long-term sustainability of local projects beyond the term of minigrant support.
Conclusions: Minigrants can increase local public health capacity to address climate change. Jurisdictions that wish to utilize minigrant mechanisms to promote climate change adaptation and preparedness at the local level may benefit from the experience of the 6 states and 44 local health programs described.

المؤلفون: Nakamura Y; Department of Community Health Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Japan., Matsumoto H; Department of Community Health Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Japan., Yamamoto-Mitani N; Department of Gerontological Home Care and Long-Term Care Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Japan., Suzuki M; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Japan., Igarashi A; Department of Gerontological Home Care and Long-Term Care Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Japan. Electronic address: igarashi-a@umin.ac.jp.

المصدر: Health policy (Amsterdam, Netherlands) [Health Policy] 2018 Dec; Vol. 122 (12), pp. 1377-1383. Date of Electronic Publication: 2018 Sep 28.

نوع المنشور: Journal Article; Observational Study

بيانات الدورية: Publisher: Elsevier Scientific Publishers Country of Publication: Ireland NLM ID: 8409431 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-6054 (Electronic) Linking ISSN: 01688510 NLM ISO Abbreviation: Health Policy

مواضيع طبية MeSH: Commerce* , Local Government* , Self-Help Groups*, Government Programs/*methods , Public Health/*methods, Aged ; Aged, 80 and over ; Cooperative Behavior ; Female ; Humans ; Male ; Retrospective Studies ; Surveys and Questionnaires

مستخلص: In the continuously aging society, private sectors are expected to play a role in older adult care. Implementing an agreement between municipalities and private sectors is one of the key mechanisms for encouraging private sectors to participate in supporting older adults. The study's aim was to evaluate whether the support agreement has promoted support activities by convenience store staff for older adults. A retrospective observational study was conducted between 2013 and 2016 using data from a nationwide survey of convenience stores. The municipality-level matching produced 168 municipality pairs, with 2242 convenience stores that entered into a support agreement with municipalities from 2014 to 2015, and 2141 stores without such an agreement. Convenience store-level logistic regression analysis evaluated the impact of the agreement on staff activities. The analysis showed that some staff activities increased significantly with the support agreement, such as corresponding or collaborating with community support centers (AOR = 3.40; 95% CI: 2.22 to 5.26), participating in role-playing programs for older adult care (AOR = 2.05; 95% CI: 1.01 to 4.26), and attending dementia support lectures (AOR = 18.21; 95% CI: 8.27 to 45.34). Emergency protection for older adults did not increase with the support agreement. The results suggest that the support agreement positively influenced some convenience store staff's support activities for older adults.
(Copyright © 2018 Elsevier B.V. All rights reserved.)

المؤلفون: Baizerman M; School of Social Work, Youth Studies, University of Minnesota., Roholt RV, Korum K, Rana S

المصدر: New directions for youth development [New Dir Youth Dev] 2013 Fall; Vol. 2013 (139), pp. 121-46.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Wiley Subscription Services Country of Publication: United States NLM ID: 101090644 Publication Model: Print Cited Medium: Internet ISSN: 1537-5781 (Electronic) Linking ISSN: 15338916 NLM ISO Abbreviation: New Dir Youth Dev Subsets: MEDLINE

مواضيع طبية MeSH: Cooperative Behavior* , Government Programs* , Local Government* , Program Evaluation* , Recreation*, Organizations/*organization & administration, Adolescent ; Humans

مستخلص: Organizational development is based in part on knowledge development, both formal, scientifically proven and also nonscientific practice wisdom. This article brings together all of the lessons learned over our six years of work with Saint Paul Parks and Recreation, and suggests the practice utility of these.
(Copyright © 2013 Wiley Periodicals, Inc., A Wiley Company.)

المؤلفون: Cuffe KM, Esie P, Leichliter JS, Gift TL

المصدر: MMWR. Morbidity and mortality weekly report [MMWR Morb Mortal Wkly Rep] 2017 Apr 07; Vol. 66 (13), pp. 355-358. Date of Electronic Publication: 2017 Apr 07.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: U.S. Centers for Disease Control Country of Publication: United States NLM ID: 7802429 Publication Model: Electronic Cited Medium: Internet ISSN: 1545-861X (Electronic) Linking ISSN: 01492195 NLM ISO Abbreviation: MMWR Morb Mortal Wkly Rep Subsets: MEDLINE

مواضيع طبية MeSH: Local Government* , State Government*, Government Programs/*statistics & numerical data , HIV Infections/*prevention & control , Sexually Transmitted Diseases/*prevention & control, Humans ; United States

مستخلص: The incidence of human immunodeficiency virus (HIV) infection in the United States is higher among persons with other sexually transmitted diseases (STDs), and the incidence of other STDs is increased among persons with HIV infection (1). Because infection with an STD increases the risk for HIV acquisition and transmission (1-4), successfully treating STDs might help reduce the spread of HIV among persons at high risk (1-4). Because health department STD programs provide services to populations who are at risk for HIV, ensuring service integration and coordination could potentially reduce the incidence of STDs and HIV. Program integration refers to the combining of STD and HIV prevention programs through structural, service, or policy-related changes such as combining funding streams, performing STD and HIV case matching, or integrating staff members (5). Some STD programs in U.S. health departments are partially or fully integrated with an HIV program (STD/HIV program), whereas other STD programs are completely separate. To assess the extent of provision of HIV services by state and local health department STD programs, CDC analyzed data from a sample of 311 local health departments and 56 state and directly funded city health departments derived from a national survey of STD programs. CDC found variation in the provision of HIV services by STD programs at the state and local levels. Overall, 73.1% of state health departments and 16.1% of local health departments matched STD case report data with HIV data to analyze possible syndemics (co-occurring epidemics that exacerbate the negative health effects of any of the diseases) and overlaps. Similarly, 94.1% of state health departments and 46.7% of local health departments performed site visits to HIV care providers to provide STD information or public health updates. One fourth of state health departments and 39.4% of local health departments provided HIV testing in nonclinical settings (field testing) for STD contacts, and all of these programs linked HIV cases to care. STD programs are providing some HIV services; however, delivery of certain specific services could be improved.

المؤلفون: Garcia-Silva B; At the time of writing, Bernadet Garcia-Silva was with the Waste Not Orange County Coalition, Orange County Health Care Agency, Santa Ana, CA. Eric Handler is with the Orange County Health Care Agency. Julia Wolfe is with the Orange County Public Health Laboratory, Orange County Health Care Agency., Handler E; At the time of writing, Bernadet Garcia-Silva was with the Waste Not Orange County Coalition, Orange County Health Care Agency, Santa Ana, CA. Eric Handler is with the Orange County Health Care Agency. Julia Wolfe is with the Orange County Public Health Laboratory, Orange County Health Care Agency., Wolfe J; At the time of writing, Bernadet Garcia-Silva was with the Waste Not Orange County Coalition, Orange County Health Care Agency, Santa Ana, CA. Eric Handler is with the Orange County Health Care Agency. Julia Wolfe is with the Orange County Public Health Laboratory, Orange County Health Care Agency.

المصدر: American journal of public health [Am J Public Health] 2017 Jan; Vol. 107 (1), pp. 105. Date of Electronic Publication: 2016 Oct 13.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: American Public Health Association Country of Publication: United States NLM ID: 1254074 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1541-0048 (Electronic) Linking ISSN: 00900036 NLM ISO Abbreviation: Am J Public Health Subsets: MEDLINE

مواضيع طبية MeSH: Local Government*, Food Supply/*statistics & numerical data , Government Programs/*organization & administration , Public-Private Sector Partnerships/*organization & administration, California ; Humans ; Poverty Areas

مستخلص: Food insecurity is a global issue that arises owing to systemic socioeconomic inequities and environmental constraints. To highlight the existence and the extent of food insecurity and food waste, the Orange County Health Department in Orange County, California, created a coalition called "Waste Not Orange County." Orange County is the sixth most populous county in California and has the highest median income, yet 11.4% of those residing in Orange County are food insecure, and 24.0% live in poverty. The overall vision of the coalition is to mitigate hunger in Orange County by educating the community about food donations, identifying food-insecure individuals, and connecting those individuals to sources of food. We examine the coalition's impacts between 2014 and 2016.