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PubMed2006

The providers of health services in Lebanon: a survey of physicians.

BACKGROUND: Emerging from civil distress carries with it major challenges to reforming a health system. One such challenge is to ensure an adequate supply of competent human resources. The objective of this study was to assess the supply of physicians in Lebanon in 1998, with an assessment of their practice patterns and capacity building. METHODS: Lists of members of physician's associations were examined to determine the number of physicians in Lebanon and their geographical distribution. A self-administered survey targeted 388 physicians (5%) randomly stratified by the five regions of Lebanon. Some 377 providers reported information on their demographic profile, practice patterns and development. Further, information on continuing education activities was acquired. RESULTS: In Lebanon, the overall physician-to-population ratio was 248 per 100, 000, characterized by an evident maldistribution at the intracountry regional level. Physicians worked 38 hours per week examining on average 21 patients per day, with an average time of 30 minutes spent per visit. They also reported spending 11% of their time waiting for patients. Respondents reported a very wide range of income, with 90% earning less than USD 2,000 per month. Moreover, the continuing education profile revealed a total of 43.7 hours per year, similar to that required for board certification in many developed countries. Conference attendance was the dominant continuing education activity (95% of respondents) and consumed most of the time allotted for continuing education, reported at 32 hours per year. DISCUSSION AND CONCLUSION: Various economic indicators point to an oversupply of physicians in Lebanon and a poor allocation of their time for capacity building. Therefore, it is crucial for decision-makers to closely monitor the increasing supply of providers and institute appropriate intervention strategies, taking into consideration appropriate provision of good-quality services and ensuring that continuing education activities are well established, organized and monitored.

Journal Article↗
PubMed2006

Evaluating a program to build data capacity for core public health functions in local maternal child and adolescent health programs in california.

OBJECTIVES: To improve local Maternal and Child Health programs' capacity to collect and analyze data to support core public health functions, the California Maternal and Child Health Branch (CAMCHB) and the University of California San Francisco Family Health Outcomes project (FHOP) entered into a cooperative agreement. FHOP utilizes a 6-pronged strategy: face-to-face training, telephone technical assistance, on-site consultation, development of automated analytic tools, development of written guidelines, and web dissemination of data and materials. We evaluated the acceptability and effectiveness of these approaches. METHODS: Local Health Jurisdiction (LHJ) staff completed a self-administered questionnaire on use of and satisfaction with FHOP's services. A 34-item assessment tool was used to independently evaluate each 5-year community assessment plan submitted by LHJs to the CAMCHB. Administrative data on the use of FHOP's service was also considered. Correlational analyses were done to determine if use of FHOP services and materials was related to more adequate plans. RESULTS: LHJs with higher overall adequacy scores on their plans had an overall higher level of use of FHOP's products and services. LHJs with higher adequacy scores reported calling FHOP for technical assistance more frequently, using FHOP's book - "Developing an Effective Planning Process: A Guide for Local MCH Programs," and using FHOP's automated tools including EpiBC, an EpiINFO based program for birth certificate analysis, and Microsoft Excel data analysis templates. CONCLUSION: This 6-pronged strategy is well utilized and accepted by local MCH staff and appears to have some degree of association with better quality of local MCH plan documents.

Adolescent↗
PubMed2006

Building and sustaining community-institutional partnerships for prevention research: findings from a national collaborative.

The Examining Community-Institutional Partnerships for Prevention Research Project began in October 2002 with funding from the Centers for Disease Control and Prevention Research Center Program Office through a cooperative agreement between the Association of Schools of Public Health and the CDC. The three-year project aimed to synthesize knowledge about community-institutional partnerships for prevention research and to build community and institutional capacity for participatory research. These ten organizations collaborated on the project because they were all involved in community-institutional partnerships for prevention research, had access to research and evaluation data on these partnerships, and believed that the shared learning and action that would result through a collaborative effort could significantly advance collective knowledge about partnerships and lead to substantive capacity-building responses: the Community Health Scholars Program, Community-Based Public Health Caucus of the American Public Health Association, Community-Campus Partnerships for Health, Detroit Community-Academic Urban Research Center, Harlem Health Promotion Center, National Community Committee of the CDC Prevention Research Centers Program, New York Urban Research Center, Seattle Partners for Healthy Communities, Yale-Griffin Prevention Research Center and the Wellesley Institute. This paper reports on the project's findings, including common characteristics of successful partnerships and recommendations for strengthening emerging and established partnerships.

Community Participation↗
PubMed2005

Building postgraduate capacity in medical and public health research in Vietnam: an in-service training model.

In Vietnam, needs to update medical and public health research capacity, but advanced training in research methodology in universities is still very limited. The first university-certified research training course aimed at physicians was conducted in Ho Chi Minh City in 2000. This paper describes the processes, outcomes and lessons learned from the project, to enable the training course to be repeated to increase research capacity among health professionals in Vietnam and other developing countries. Based on needs assessment, the 9-month, part-time course offered advanced training in practical research skills, including epidemiology, biostatistics and qualitative research methods. Thirty-seven trainees (teaching staff, interns and clinicians) completed the course, which included four group research projects. With active support from university management, the course was rigorous and participation was excellent. Trainees's knowledge of research methodologies increased, and their self-evaluation of achievement of the training objectives was high. The total score of the epidemiology and biostatistics test improved from 56% (median) in the pre-course test to 83% in the post-course test. The group research project results were disseminated through a conference and publication in peer-reviewed journals. The course has since been repeated twice as a 1-month intensive course to accommodate trainees from distant regions. This type of rigorous in-service research training at universities and teaching hospitals in developing countries appears to be an effective, sustainable approach. It also holds promise for producing research data that are responsive to a country's own needs and which are likely to be applied in health policy and practice. Further evaluation of the impact and cost of such models is indicated.

Biomedical Research↗
PubMedDate not supplied

Midwives and maternal and child health: building resource capacity.

With dramatic changes in health, social services, and welfare systems and escalating pressure to increase clinical productivity, midwives need to enhance their capacity to work with federal, regional, and state partners to promote and protect comprehensive, culturally competent, and community-based quality health care for pregnant women and their families. Information about maternal and child health (MCH) regional and state resources is provided, and strategies for obtaining additional MCH resources are suggested, so that midwives and other women's health care providers can more effectively improve health care programs and systems that benefit women and their families. In addition, ways to work with MCH programs at the regional and state levels are described.

Community Health Planning↗
PubMed1997

Building the capacity of schools to improve the health of the nation. A call for assistance from psychologists.

During the past several years, about two dozen major reports have called for the nation to reconceive and regenerate its school health programs. Proposals to reform health, education, and social services have included means to improve such programs. This article (a) identifies the leading causes of mortality and morbidity in the United States, (b) delineates 6 categories of behavior established during youth that contribute to these causes, (c) outlines ways in which a modern school health program might prevent such behaviors and address critical health and social problems among students, (d) describes practical research and development strategies that are being established to help schools implement effective school health programs, and (e) suggests how psychologists might help improve these programs.

Adolescent↗
PubMed2003

Paradigms and progress in building research capacity in international environmental health.

Populations in low- and middle-income nations bear significant risks for poor health due to air, land and water contamination; natural resource depletion; deterioration of ecosystems; contaminated food supplies and other conditions related to poverty, including poor housing, crowding and inadequate nutrition and health care. These risks, related to rapid industrialization, increasing urbanization, poor land use, natural changes in ecology and other conditions, will only increase in the coming decades if current trends persist. The implications on populations' health include increased spread or emergence of disease, particularly those that impact children disproportionately, and added stress on already overburdened or weakened health care systems. To address environmental health conditions in a relevant manner in resource-poor settings, the training of scientists and health professionals from these settings is key to setting priorities and identifying cost-effective interventions. Training of professionals in a range of environmental health disciplines is a prerequisite for the establishment of effective national and international policies. Working to strengthen local expertise and scientific capacity is one of the most effective and lasting ways to affect positive policy change in environmental health. This paper describes four paradigms that support research training and research programs to meet the increasing and changing needs in this field. Factors influencing the development of the programs and their evolution are discussed as well as trends for the future.

Curriculum↗
PubMed2005

Building leadership capacity in medical education: developing the potential of course coordinators.

The School of Medicine at the University of Southampton has undergone a process of consultation and staff development aimed at developing the leadership role of course coordinators. The paper reports on the negotiation of a generic framework of tasks and the development of a successful leadership training programme for course coordinators. The authors recommend a complex adaptive style of leadership based on whole systems theory and argue that leadership training for course coordinators is vital to the success of undergraduate medical programmes.

Adult↗