scholarly journals Direct from the COVID-19 crisis: research and innovation sparks in Brazil

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Mário Fabrício Fleury Rosa ◽  
Everton Nunes da Silva ◽  
Christina Pacheco ◽  
Marcos Vinícius Pereira Diógenes ◽  
Christopher Millett ◽  
...  
Keyword(s):  
Health System ◽  
Scientific Community ◽  
Universal Access ◽  
Innovation System ◽  
Phase Iii ◽  
Research Development ◽  
Health Coverage ◽  
The Public ◽  
The Impact ◽  
Universal Health

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has spread throughout more than 160 countries, infecting millions of people worldwide. To address this health emergency, countries have organized the flow of production and innovation to reduce the impact on health. This article shows the response of the Brazilian scientific community to meet the urgent needs of the public unified health system [SUS], aiming to guarantee universal access to an estimated population of 211 million. By December 2020, Brazil had recorded more than six million cases and approximately 175,000 deaths. Methods We collected data on research, development and innovation projects carried out by 114 public universities (plus Oswaldo Cruz Foundation [Fiocruz] and Butantan Institute), as reported on their websites. Additionally, we examined the studies on COVID-19 approved by the National Comission for Research Ethics, as well as those reported on the Ministry of Education website as of May 15, 2020. Results The 789 identified projects were classified according to research categories as follows: development and innovation (n = 280), other types of projects (n = 226), epidemiologic research (n = 211), and basic research on disease mechanisms (n = 72). Most proposals focused on the development and innovation of personal protective equipment, medical devices, diagnostic tests, medicines and vaccines, which were rapidly identified as research priorities by the scientific community. Some promising results have been observed from phase III vaccine trials, one of which is conducted in partnership with Oxford University and another of which is performed with Sinovac Biotech. Both trials involve thousands of volunteers in their Brazilian arms and include technology transfer agreements with Fiocruz and the Butantan Institute, respectively. These vaccines proved to be safe and effective and were immediately licensed for emergency use. The provision of doses for the public health system, and vaccination, started on January 17, 2021. Conclusions The mobilized Brazilian scientific community has generated comprehensive research, development and innovation proposals to meet the most urgent needs. It is important to emphasize that this response was only possible due to decades of investment in research, development and innovation in Brazil. We need to reinforce and protect the Brazilian science, technology and innovation system from austerity policies that disregard health and knowledge as crucial investments for Brazilian society, in line with the constitutional right of universal health access and universal health coverage.

scholarly journals The impact of the fragile health system on the implementation of health policies in Yemen

2020 ◽  
Author(s):  
Taha Hussein ◽  
Fekri Dureab ◽  
Raof Al-Waziza ◽  
Hanan Noman ◽  
Lisa Hennig ◽  
...  
Keyword(s):  
Health Promotion ◽  
Health System ◽  
Universal Health Coverage ◽  
Peace Building ◽  
Health Policies ◽  
Health Coverage ◽  
Health Security ◽  
The Public ◽  
The Impact ◽  
Universal Health

The on-going humanitarian crisis in Yemen is one of the worst in the world, with more than14 million people in acute need. The conflict in Yemen deteriorated the already fragile health system and lead to the collapse of more than half of the health facilities. Health system fragmentation is also a problem in Yemen, which is complicated by the existence of two health ministries with different strategies. The aim of this study is to evaluate the effect of health system fragmentation on the implementation of health policies in Yemen across the global agendas of Universal Health Coverage (UHC), Health Security (GHS) and Health Promotion (HP) in the context of WHO priorities achieving universal health coverage, addressing health emergencies and promoting healthier populations. Methods The study is qualitative research using key informant in-depth interviews and documents analysis. Results There are many health stakeholders in Yemen, including the public, private, and NGO sectors - each with different priorities and interests, which did not always align with national policies and strategies. The WHO and Ministry of Public Health and Population (MoPHP) are the main supporters to implement all policies related to the UHC, GHS and HP agendas. Interestingly, initiatives initially pursuing a health security approach to control the cholera epidemic realigned with the UHC concept and moved from an initial focus on health security, to propose a minimum health service package, a classical UHC intervention. Overall, Universal Health Coverage is the most adapted agenda, health security agendas were highly disrupted due to conflicts and health staffs were caught unprepared for emerging outbreaks. The health promotion agenda was largely ignored. Conclusion Restoring peace, building on synergies between the three health agendas through joint planning between the MoPHP and other health actors are highly recommended.

scholarly journals NGOs, austerity, and universal health coverage in Mozambique

2019 ◽  
Vol 15 (S1) ◽  
Author(s):  
James Pfeiffer ◽  
Rachel R. Chapman
Keyword(s):  
Public Health ◽  
Public Sector ◽  
Health System ◽  
Universal Health Coverage ◽  
Public Health System ◽  
Health Coverage ◽  
Donor Funding ◽  
The Public ◽  
Public Sector Health ◽  
Universal Health

AbstractIn many African countries, hundreds of health-related NGOs are fed by a chaotic tangle of donor funding streams. The case of Mozambique illustrates how this NGO model impedes Universal Health Coverage. In the 1990s, NGOs multiplied across post-war Mozambique: the country’s structural adjustment program constrained public and foreign aid expenditures on the public health system, while donors favored private contractors and NGOs. In the 2000s, funding for HIV/AIDS and other vertical aid from many donors increased dramatically. In 2004, the United States introduced PEPFAR in Mozambique at nearly 500 million USD per year, roughly equivalent to the entire budget of the Ministry of Health. To be sure, PEPFAR funding has helped thousands access antiretroviral treatment, but over 90% of resources flow “off-budget” to NGO “implementing partners,” with little left for the public health system. After a decade of this major donor funding to NGOs, public sector health system coverage had barely changed. In 2014, the workforce/ population ratio was still among the five worst in the world at 71/10000; the health facility/per capita ratio worsened since 2009 to only 1 per 16,795. Achieving UHC will require rejection of austerity constraints on public sector health systems, and rechanneling of aid to public systems building rather than to NGOs.

scholarly journals Universal access to essential health information: accelerating progress towards universal health coverage and other SDG health targets

2020 ◽  
Vol 5 (5) ◽  
pp. e002475
Author(s):  
Geoff Royston ◽  
Neil Pakenham-Walsh ◽  
Chris Zielinski
Keyword(s):  
Health Information ◽  
Universal Health Coverage ◽  
Health Workers ◽  
Universal Access ◽  
Health Coverage ◽  
Health Targets ◽  
The Sustainable Development ◽  
Development Goals ◽  
The Impact ◽  
Universal Health

The information that people need to protect and manage their own health and the health of those for whom they are responsible is a fundamental element of an effective people-centred healthcare system. Achieving universal health coverage (UHC) requires universal access to essential health information. While it was recently recognised by the World Medical Association, universal access to essential health information is not yet reflected in official monitoring of progress on UHC for the sustainable development goals (SDGs). In this paper, we outline key features that characterise universal access to essential health information and indicate how it is increasingly achievable. We highlight the growing evidence of the impact of wider access to practical and actionable information on health for the public, carers and frontline health workers and provide illustrative, evidence-based, examples of how increasing access to essential health information can accelerate the achievement of UHC and other health targets of the SDGs. The paper ends with an assessment of reasons why universal access to essential health information has not yet been achieved, and an associated call to action to key stakeholders—such as governments, multilaterals, funding bodies, policy-makers, health professionals and knowledge intermediaries—to explicitly recognise the foundational role of universal access to essential health information for achieving UHC and the rest of the health SDGs, to include it in the relevant SDG target and associated monitoring indicators, and to incorporate actions in their own policies and programmes to promote and enable this access.

scholarly journals Geographic barriers to establishing a successful hospital referral system in rural Madagascar

2021 ◽  
Author(s):  
Felana Angella Ihantamalala ◽  
Matthew H. Bonds ◽  
Mauricianot Randriamihaja ◽  
Luc Rakotonirina ◽  
Vincent Herbreteau ◽  
...  
Keyword(s):  
Health System ◽  
Universal Health Coverage ◽  
Travel Speed ◽  
Health System Strengthening ◽  
Local Health ◽  
Health Coverage ◽  
Geographic Accessibility ◽  
Hospital Referral ◽  
The Impact ◽  
Universal Health

Background: The provision of emergency and hospital care has become an integral part of the global vision for universal health coverage. It is recommended that at least 80% of a country s population should be within two hours of a facility with essential surgery and anesthetic services. In order to strengthen health systems to achieve this goal, there needs to be an understanding of the time necessary for populations to reach a hospital. The goal of this study was to develop methods that accurately estimate referral and pre-hospital time for rural health districts in LMICs. We used these estimates to assess how the local geography can limit the impact of a strengthened referral program in a rural district of Madagascar. Methods: We developed a database containing 1) travel speed in a subset of routes by foot and motorized vehicles in Ifanadiana District; 2) a full mapping of all roads, footpaths and households in the district; and 3) remotely sensed data on terrain, land cover and climatic characteristics. We used this information to calibrate estimates of referral and pre-hospital time based on shortest route algorithms and statistical models of local travel speed. We compared these estimates with those from other commonly used methods in geographic accessibility modeling. Finally, we studied the impact of referral time on the evolution of the number of referrals completed by each health center in the district in 2014-2020 via generalized linear mixed models, using model estimates to predict the impact on referral numbers of strategies aimed at reducing referral time for underserved populations. Results: About 10% of the population lived less than two hours from the hospital, and more than half lived over four hours away, with variable access depending on climatic conditions. Only the four health centers (out of 21) located near the paved road had referral times to the hospital within one hour, which contributed over 75% of all 8,464 hospital referrals. Referral time remained the main barrier limiting the number of referrals despite health system strengthening efforts. The addition of two new referral centers is estimated to triple the population living within two hours from a center with higher acute care capacity and nearly double the number of referrals expected. Conclusion: This study demonstrates how adapting geographic accessibility modeling methods to local scales can occur through improving the precision of travel time estimates and pairing them with data on health facility data. Such information can substantially improve the design of a local health system to overcome existing barriers to care and achieve universal health coverage.

scholarly journals Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Amare Worku Tadesse ◽  
Kassu Ketema Gurmu ◽  
Selamawit Tesfaye Kebede ◽  
Mahlet Kifle Habtemariam
Keyword(s):  
Health Promotion ◽  
Global Health ◽  
Health System ◽  
Universal Health Coverage ◽  
World Health ◽  
Health Coverage ◽  
Health Security ◽  
Universal Health ◽  
Health Agenda

Abstract Background Evidence exists about synergies among universal health coverage, health security and health promotion. Uniting these three global agendas has brought success to the country’s health sector. This study aimed to document the efforts Ethiopia has made to apply nationally synergistic approaches uniting these three global health agendas. Our study is part of the Lancet Commission on synergies between these global agendas. Methods We employed a case study design to describe the synergistic process in the Ethiopian health system based on a review of national strategies and policy documents, and key informant interviews with current and former policymakers, and academics. We analyzed the “hardware” (using the World Health Organization’s building blocks) and the “software” (ideas, interests, and power relations) of the Ethiopian health system according to the aforementioned three global agendas. Results Fragmentation of health system primarily manifested as inequities in access to health services, low health workforce and limited capacity to implementation guidelines. Donor driven vertical programs, multiple modalities of health financing, and inadequate multisectoral collaborations were also found to be key features of fragmentation. Several approaches were found to be instrumental in fostering synergies within the global health agenda. These included strong political and technical leadership within the government, transparent coordination, and engagement of stakeholders in the process of priority setting and annual resource mapping. Furthermore, harmonization and alignment of the national strategic plan with international commitments, joint financial arrangements with stakeholders and standing partnership platforms facilitated efforts for synergy. Conclusions Ethiopia has implemented multiple approaches to overcome fragmentation. Such synergistic efforts of the primary global health agendas have made significant contributions to the improvement of the country’s health indicators and may promote sustained functionality of the health system.

Advocacy for a Digital Oral Health That Leaves No One Behind

2021 ◽  
pp. 238008442110266
Author(s):  
N. Giraudeau ◽  
B. Varenne
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Access To Health Care ◽  
Universal Access ◽  
Digital Health ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Central Component ◽  
Health Coverage ◽  
The Impact

During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, the lockdown enforced led to considerable disruption to the activities of dental services, even leading to closures. To mitigate the impact of the lockdowns, systems were quickly put in place in most countries to respond to dental emergencies, giving priority to distance screening, advice to patients by remote means, and treatment of urgent cases while ensuring continuous care. Digital health was widely adopted as a central component of this new approach, leading to new practices and tools, which in turn demonstrated its potential, limitations, and possible excesses. Political leaders must become aware of the universal availability of digital technology and make use of it as an additional, safe means of providing services to the public. In view of the multiple uses of digital technologies in health—health literacy, teaching, prevention, early detection, therapeutics, and public health policies—deployment of a comprehensive program of digital oral health will require the adoption of a multifaceted approach. Digital tools should be designed to reduce, not increase, inequalities in access to health care. It offers an opportunity to improve healthy behavior, lower risk factors common to oral diseases and others noncommunicable diseases, and contribute to reducing oral health inequalities. It can accelerate the implementation of universal health coverage and help achieve the 2030 Sustainable Development Agenda, leaving no one behind. Digital oral health should be one of the pillars of oral health care after COVID-19. Universal access to digital oral health should be promoted globally. The World Health Organization’s mOralHealth program aims to do that. Knowledge Transfer Statement: This position paper could be used by oral health stakeholders to convince their government to implement digital oral health program.

scholarly journals Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Denise Bryant-Lukosius ◽  
Ruta Valaitis ◽  
Ruth Martin-Misener ◽  
Faith Donald ◽  
Laura Morán Peña ◽  
...  
Keyword(s):  
Latin America ◽  
Universal Health Coverage ◽  
Universal Access ◽  
Advanced Practice Nursing ◽  
Advanced Practice ◽  
Health Coverage ◽  
Access To Health ◽  
The Caribbean ◽  
Universal Health ◽  
Role Implementation

ABSTRACT Objective: to examine advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method: we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries.

scholarly journals A Risk-Based Strategy for Evaluating Mitigation Options for Process-Formed Compounds in Food

2016 ◽  
Vol 35 (3) ◽  
pp. 358-370 ◽  
Author(s):  
Paul Hanlon ◽  
Gregory P. Brorby ◽  
Mansi Krishan
Keyword(s):  
North America ◽  
Decision Tree ◽  
Scientific Community ◽  
Life Sciences ◽  
Technical Committee ◽  
Global Approach ◽  
Chemical Safety ◽  
The Public ◽  
The North ◽  
The Impact

Processing (eg, cooking, grinding, drying) has changed the composition of food throughout the course of human history; however, awareness of process-formed compounds, and the potential need to mitigate exposure to those compounds, is a relatively recent phenomenon. In May 2015, the North American Branch of the International Life Sciences Institute (ILSI North America) Technical Committee on Food and Chemical Safety held a workshop on the risk-based process for mitigation of process-formed compounds. This workshop aimed to gain alignment from academia, government, and industry on a risk-based process for proactively assessing the need for and benefit of mitigation of process-formed compounds, including criteria to objectively assess the impact of mitigation as well as research needed to support this process. Workshop participants provided real-time feedback on a draft framework in the form of a decision tree developed by the ILSI North America Technical Committee on Food and Chemical Safety to a panel of experts, and they discussed the importance of communicating the value of such a process to the larger scientific community and, ultimately, the public. The outcome of the workshop was a decision tree that can be used by the scientific community and could form the basis of a global approach to assessing the risks associated with mitigation of process-formed compounds.

scholarly journals Universal Access to Health and Universal Health Coverage: identification of nursing research priorities in Latin America

2015 ◽  
Vol 23 (6) ◽  
pp. 1195-1208 ◽  
Author(s):  
Silvia Helena De Bortoli Cassiani ◽  
Alessandra Bassalobre-Garcia ◽  
Ludovic Reveiz
Keyword(s):  
Public Health ◽  
Latin America ◽  
Health Systems ◽  
Research Funding ◽  
Universal Access ◽  
Research Priorities ◽  
Nursing Research ◽  
Health Coverage ◽  
Access To Health ◽  
Universal Health

Objective: To estabilish a regional list for nursing research priorities in health systems and services in the Region of the Americas based on the concepts of Universal Access to Health and Universal Health Coverage. Method: five-stage consensus process: systematic review of literature; appraisal of resulting questions and topics; ranking of the items by graduate program coordinators; discussion and ranking amongst a forum of researchers and public health leaders; and consultation with the Ministries of Health of the Pan American Health Organization's member states. Results: the resulting list of nursing research priorities consists of 276 study questions/ topics, which are sorted into 14 subcategories distributed into six major categories: 1. Policies and education of nursing human resources; 2. Structure, organization and dynamics of health systems and services; 3. Science, technology, innovation, and information systems in public health; 4. Financing of health systems and services; 5. Health policies, governance, and social control; and 6. Social studies in the health field. Conclusion: the list of nursing research priorities is expected to serve as guidance and support for nursing research on health systems and services across Latin America. Not only researchers, but also Ministries of Health, leaders in public health, and research funding agencies are encouraged to use the results of this list to help inform research-funding decisions.

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