Pub Date : 2020-01-01DOI: 10.1080/23779497.2020.1819854
A. Byrne, Bronwyn Nichol
ABSTRACT Background: Communities have a key role to play in global health security. The Red Cross/Red Crescent epidemic preparedness programme empowers volunteers and communities to: identify risks; recognise and notify epidemic alerts; take early action to control disease. The programme set out to establish community-based surveillance (CBS) as a preparedness model – yielding earlier detection and action to halt outbreaks at the outset. This paper reports on the mid-stage CBS implementation experience and results in Indonesia, Kenya, Sierra Leone and Uganda. Methods: Volunteers detect potential epidemic alerts and report immediately by mobile apps. The receiving supervisor cross-checks the alert and enters in a real-time database triggering response actions. Supervisors report to local authorities, integrating CBS alerts as notifications into national disease surveillance systems. Results: To develop health literacy and trust, volunteers achieved over 390,000 instances of contact with people; 70,000 house visits; 547 school health activities; and 17 radio shows. Volunteers are placed with wide geographic coverage and their weekly ‘zero’ reporting of 63%-83% indicates maintenance of the CBS system. The average accuracy of volunteers to identify alerts matching community case definitions is high in Sierra Leone 96%, Indonesia 90%, and Uganda 73%, however low in Kenya at 35%. Timeliness rates were high across all countries. Alerts were detected and notified to authorities within the targeted 24 hours at an average of 94%. Challenges and risks have related to: securing free SMS channels for alerts, time required for contextualised design, ensuring response action, and managing expectations of the scope of CBS. Conclusion: Early-stage results show positive impact and feasibility of preparedness CBS in high-risk zones to prevent large-scale outbreaks. Community engagement, stage-wise capacity building, monitoring and response actions, and collaborative relationships with stakeholders are important programme components for effectiveness. Communities themselves can be central change agents in global health security.
{"title":"A community-centred approach to global health security: implementation experience of community-based surveillance (CBS) for epidemic preparedness","authors":"A. Byrne, Bronwyn Nichol","doi":"10.1080/23779497.2020.1819854","DOIUrl":"https://doi.org/10.1080/23779497.2020.1819854","url":null,"abstract":"ABSTRACT Background: Communities have a key role to play in global health security. The Red Cross/Red Crescent epidemic preparedness programme empowers volunteers and communities to: identify risks; recognise and notify epidemic alerts; take early action to control disease. The programme set out to establish community-based surveillance (CBS) as a preparedness model – yielding earlier detection and action to halt outbreaks at the outset. This paper reports on the mid-stage CBS implementation experience and results in Indonesia, Kenya, Sierra Leone and Uganda. Methods: Volunteers detect potential epidemic alerts and report immediately by mobile apps. The receiving supervisor cross-checks the alert and enters in a real-time database triggering response actions. Supervisors report to local authorities, integrating CBS alerts as notifications into national disease surveillance systems. Results: To develop health literacy and trust, volunteers achieved over 390,000 instances of contact with people; 70,000 house visits; 547 school health activities; and 17 radio shows. Volunteers are placed with wide geographic coverage and their weekly ‘zero’ reporting of 63%-83% indicates maintenance of the CBS system. The average accuracy of volunteers to identify alerts matching community case definitions is high in Sierra Leone 96%, Indonesia 90%, and Uganda 73%, however low in Kenya at 35%. Timeliness rates were high across all countries. Alerts were detected and notified to authorities within the targeted 24 hours at an average of 94%. Challenges and risks have related to: securing free SMS channels for alerts, time required for contextualised design, ensuring response action, and managing expectations of the scope of CBS. Conclusion: Early-stage results show positive impact and feasibility of preparedness CBS in high-risk zones to prevent large-scale outbreaks. Community engagement, stage-wise capacity building, monitoring and response actions, and collaborative relationships with stakeholders are important programme components for effectiveness. Communities themselves can be central change agents in global health security.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"4 1","pages":"71 - 84"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83566436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/23779497.2020.1729220
E. Herring, L. Ismail, Tom B. Scott, J. Velthuis
ABSTRACT Scholars have not regarded Somalia as a place of relevance to thinking about nuclear security. This article gives four reasons why this perspective is not well founded. First, as the state strengthens it needs an International Atomic Energy Agency (IAEA) nuclear security regime for the control of nuclear materials. Second, it has unsecured uranium reserves that could be smuggled abroad. Third, those unsecured uranium reserves could be accessed by terrorists for use in a ‘dirty’ bomb. Fourth, there is evidence of past ‘ecomafia’ intent and planning, and possible success, in dumping radioactive waste on land in Somalia or in its territorial waters. The article proposes an innovative system of uranium ore fingerprinting, covert sensors, mobile phone reporting and surveying and evaluation capabilities that would address all four issues. The proposed system would include a low-cost method for turning any smart phone into a radiation detector to crowdsource reporting of possible nuclear materials, plus aerial and underwater drones with low cost radiation sensors.
{"title":"Nuclear security and Somalia","authors":"E. Herring, L. Ismail, Tom B. Scott, J. Velthuis","doi":"10.1080/23779497.2020.1729220","DOIUrl":"https://doi.org/10.1080/23779497.2020.1729220","url":null,"abstract":"ABSTRACT Scholars have not regarded Somalia as a place of relevance to thinking about nuclear security. This article gives four reasons why this perspective is not well founded. First, as the state strengthens it needs an International Atomic Energy Agency (IAEA) nuclear security regime for the control of nuclear materials. Second, it has unsecured uranium reserves that could be smuggled abroad. Third, those unsecured uranium reserves could be accessed by terrorists for use in a ‘dirty’ bomb. Fourth, there is evidence of past ‘ecomafia’ intent and planning, and possible success, in dumping radioactive waste on land in Somalia or in its territorial waters. The article proposes an innovative system of uranium ore fingerprinting, covert sensors, mobile phone reporting and surveying and evaluation capabilities that would address all four issues. The proposed system would include a low-cost method for turning any smart phone into a radiation detector to crowdsource reporting of possible nuclear materials, plus aerial and underwater drones with low cost radiation sensors.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"60 1","pages":"1 - 16"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83897438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/23779497.2020.1813048
A. Asres, Woldeamilak Adamu Hunegnaw, A. Ferede, Habtamu Temesgen Denekew
ABSTRACT Various problems were faced by patients in any hospital outpatient department. But, Patients seek quick and convenient services. Patient satisfaction improves clinical outcomes and patient retention and reduces medical malpractices. Efficient and patient-centered health care delivery is of utmost importance. Thus, patient satisfaction is a very effective indicator to measure the success of health outcomes and plays a key role in improving health service quality and early report of new outbreaks (e.g., Covid-19) or other outbreaks (e,g measles, polio). Objective of this study was to assess patient satisfaction and associated factors on outpatient department, Dangila Primary Hospital, Awi zone, Northwest Ethiopia, 2018. Cross sectional study design was conducted from April 1st to August 31st, 2018. A total of 304 respondents were selected using systematic random sampling. Structured questionnaire was used for data collection. EPI Data version 3.1 and SPSS version 20 were used for data entry and analysis, respectively. Multiple logistic regression was employed to describe associated factors and control potential confounders. Of all 304 participants, 175 (57.6%) were males and 129 (42.4%) were females. About 100 (32.9%) were with age range of 30-39 years. Nearly three-fourth of respondents, 233 (76.6%) were dissatisfied with the queue system to see a doctor. Level of patient satisfaction and waiting time in outpatient department was 48.2% and 48 minutes, respectively. Multivariate logistic regression indicated that satisfaction with courtesy and respect (p=0.013) and satisfaction with confidentiality taken by the examiner during physical examination (p=0.012) were associated factors for patient satisfaction. Patient satisfaction in outpatient department in Dangila primary hospital was lower than regional target. Courtesy and respect and satisfaction with confidentiality taken by the examiner during physical examination were associated factors for patient satisfaction. Outpatient waiting time was less than one hour.
摘要任何医院的门诊患者都面临着各种各样的问题。但是，患者寻求的是快捷方便的服务。患者满意度提高了临床结果和患者保留率，并减少了医疗事故。高效和以患者为中心的医疗保健服务至关重要。因此，患者满意度是衡量健康结果成功与否的一个非常有效的指标，在提高卫生服务质量和早期报告新疫情(如Covid-19)或其他疫情(如麻疹、脊髓灰质炎)方面发挥着关键作用。本研究的目的是评估2018年埃塞俄比亚西北部阿维区丹吉拉初级医院门诊患者满意度及相关因素。横断面研究设计于2018年4月1日至8月31日进行。采用系统随机抽样的方法，共抽取304名调查对象。采用结构化问卷进行数据收集。数据录入采用EPI Data 3.1版本，分析采用SPSS 20版本。采用多元逻辑回归来描述相关因素和控制潜在的混杂因素。在所有304名参与者中，175名(57.6%)是男性，129名(42.4%)是女性。年龄30 ~ 39岁，约100例(32.9%)。近四分之三的受访者，233人(76.6%)对看病排队制度不满意。患者满意度为48.2%，门诊候诊时间为48分钟。多因素logistic回归分析显示，对体检人员礼貌和尊重的满意度(p=0.013)和对体检人员保密的满意度(p=0.012)是影响患者满意度的相关因素。丹格拉基层医院门诊患者满意度低于区域目标。在体检过程中，检查人员的礼貌和尊重以及对保密的满意度是患者满意度的相关因素。门诊候诊时间不足1小时。
{"title":"Assessment of patient satisfaction and associated factors in an outpatient department at Dangila primary hospital, Awi zone, Northwest Ethiopia, 2018","authors":"A. Asres, Woldeamilak Adamu Hunegnaw, A. Ferede, Habtamu Temesgen Denekew","doi":"10.1080/23779497.2020.1813048","DOIUrl":"https://doi.org/10.1080/23779497.2020.1813048","url":null,"abstract":"ABSTRACT Various problems were faced by patients in any hospital outpatient department. But, Patients seek quick and convenient services. Patient satisfaction improves clinical outcomes and patient retention and reduces medical malpractices. Efficient and patient-centered health care delivery is of utmost importance. Thus, patient satisfaction is a very effective indicator to measure the success of health outcomes and plays a key role in improving health service quality and early report of new outbreaks (e.g., Covid-19) or other outbreaks (e,g measles, polio). Objective of this study was to assess patient satisfaction and associated factors on outpatient department, Dangila Primary Hospital, Awi zone, Northwest Ethiopia, 2018. Cross sectional study design was conducted from April 1st to August 31st, 2018. A total of 304 respondents were selected using systematic random sampling. Structured questionnaire was used for data collection. EPI Data version 3.1 and SPSS version 20 were used for data entry and analysis, respectively. Multiple logistic regression was employed to describe associated factors and control potential confounders. Of all 304 participants, 175 (57.6%) were males and 129 (42.4%) were females. About 100 (32.9%) were with age range of 30-39 years. Nearly three-fourth of respondents, 233 (76.6%) were dissatisfied with the queue system to see a doctor. Level of patient satisfaction and waiting time in outpatient department was 48.2% and 48 minutes, respectively. Multivariate logistic regression indicated that satisfaction with courtesy and respect (p=0.013) and satisfaction with confidentiality taken by the examiner during physical examination (p=0.012) were associated factors for patient satisfaction. Patient satisfaction in outpatient department in Dangila primary hospital was lower than regional target. Courtesy and respect and satisfaction with confidentiality taken by the examiner during physical examination were associated factors for patient satisfaction. Outpatient waiting time was less than one hour.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"11 1","pages":"57 - 64"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88608632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/23779497.2020.1801352
A. Tu
ABSTRACT VX is a strong nerve-gas agent. In this paper, murder or injury of human made by VX is reported. First use of VX against human was made by Aum Shimrikyo in 1994 and 1995. More recently, VX was used in the assassination of Mr. Kim Jong-Nam in Kuala Lumpur, Malaysia, on 13 February 2017. In this review article, the use of VX against human is discussed together and described in detail.
{"title":"The use of VX as a terrorist agent: action by Aum Shinrikyo of Japan and the death of Kim Jong-Nam in Malaysia: four case studies","authors":"A. Tu","doi":"10.1080/23779497.2020.1801352","DOIUrl":"https://doi.org/10.1080/23779497.2020.1801352","url":null,"abstract":"ABSTRACT VX is a strong nerve-gas agent. In this paper, murder or injury of human made by VX is reported. First use of VX against human was made by Aum Shimrikyo in 1994 and 1995. More recently, VX was used in the assassination of Mr. Kim Jong-Nam in Kuala Lumpur, Malaysia, on 13 February 2017. In this review article, the use of VX against human is discussed together and described in detail.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"239 1","pages":"48 - 56"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77523265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/23779497.2021.1872402
Shingo Hamanaka
ABSTRACT This study examines the rally round the flag effect during Operation Protective Edge, a war between Israel and Palestinians. Research has demonstrated the mechanisms by which military crises escalate, and the public perceives the threat, which in turn leads to support for government leadership. Forming the basis of this theory is Social Identity Theory; however, in the context of international relations, there seems to be little research that examines the mechanism from which Social Identity Theory causes the rally to affect the minority group. This is probably because, in inter-state and inter-ethnic conflicts, there have been few opportunities to access research information on situations where there is a part of a hostile nation or ethnic group within one state. Public opinion polls were conducted repeatedly during Operation Protective Edge, and Arab Israelis were included in the target population for this poll. Subsequently, the mechanisms that determined the attitudes of Arab Israelis during this Israeli-Palestinian military conflict can be determined. This study adjusted for covariates by using an Interrupted Time-Series analysis to infer causality of the ground war rush on the rally effect.
{"title":"The ground operation sent citizens into a frenzy: the rally around the flag effect during operation protective edge","authors":"Shingo Hamanaka","doi":"10.1080/23779497.2021.1872402","DOIUrl":"https://doi.org/10.1080/23779497.2021.1872402","url":null,"abstract":"ABSTRACT This study examines the rally round the flag effect during Operation Protective Edge, a war between Israel and Palestinians. Research has demonstrated the mechanisms by which military crises escalate, and the public perceives the threat, which in turn leads to support for government leadership. Forming the basis of this theory is Social Identity Theory; however, in the context of international relations, there seems to be little research that examines the mechanism from which Social Identity Theory causes the rally to affect the minority group. This is probably because, in inter-state and inter-ethnic conflicts, there have been few opportunities to access research information on situations where there is a part of a hostile nation or ethnic group within one state. Public opinion polls were conducted repeatedly during Operation Protective Edge, and Arab Israelis were included in the target population for this poll. Subsequently, the mechanisms that determined the attitudes of Arab Israelis during this Israeli-Palestinian military conflict can be determined. This study adjusted for covariates by using an Interrupted Time-Series analysis to infer causality of the ground war rush on the rally effect.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"5 1","pages":"142 - 152"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86493159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/23779497.2020.1796520
Royce Tsukayama, S. Hinjoy, Pensom Jumriangrit, Walaiporn Jiaranairungroj
ABSTRACT The considerable health, social and economic implications of Zika virus along with the World Health Organization’s declaration of a Public Health Emergency of International Concern in 2016, led to the gathering of Southeast Asian countries for a committed response to Zika virus in Southeast Asia. For the technical and collaborative efforts to be successful, existing gaps had to be overcome. Guidance for relevant authorities to build preparedness and response capacities, enhancement of networks, and the provision of a forum to share best practices of Zika and mosquito-borne diseases across the region were still needed to address Zika virus as a global health security threat. Operating outside of formal structures, government health officials from Southeast Asian countries assembled to update knowledge, share experiences, and develop a comprehensive framework that could navigate Zika virus prevention and control. This framework would include guidelines that encompass cross-sectoral efforts including 1) Surveillance, Outbreak Investigation, and Containment, 2) Laboratory Detection, 3) Zika in Healthcare Facilities, 4) Prevention and Vector Control, and 5) Coordination and Risk Communication. The result of the unofficial network was a candid dialogue between government officials on best practices and a functional, adaptable set of Zika virus operational guidelines specific to Southeast Asia.
{"title":"Regional collaboration in the context of Zika virus in Southeast Asia: the development of the zika operational guidelines for the preparedness and response of Southeast Asian countries, 1st edition","authors":"Royce Tsukayama, S. Hinjoy, Pensom Jumriangrit, Walaiporn Jiaranairungroj","doi":"10.1080/23779497.2020.1796520","DOIUrl":"https://doi.org/10.1080/23779497.2020.1796520","url":null,"abstract":"ABSTRACT The considerable health, social and economic implications of Zika virus along with the World Health Organization’s declaration of a Public Health Emergency of International Concern in 2016, led to the gathering of Southeast Asian countries for a committed response to Zika virus in Southeast Asia. For the technical and collaborative efforts to be successful, existing gaps had to be overcome. Guidance for relevant authorities to build preparedness and response capacities, enhancement of networks, and the provision of a forum to share best practices of Zika and mosquito-borne diseases across the region were still needed to address Zika virus as a global health security threat. Operating outside of formal structures, government health officials from Southeast Asian countries assembled to update knowledge, share experiences, and develop a comprehensive framework that could navigate Zika virus prevention and control. This framework would include guidelines that encompass cross-sectoral efforts including 1) Surveillance, Outbreak Investigation, and Containment, 2) Laboratory Detection, 3) Zika in Healthcare Facilities, 4) Prevention and Vector Control, and 5) Coordination and Risk Communication. The result of the unofficial network was a candid dialogue between government officials on best practices and a functional, adaptable set of Zika virus operational guidelines specific to Southeast Asia.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"10 1","pages":"42 - 47"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87170117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/23779497.2020.1824584
E. Herring, Peter Campbell, M. Elmi, L. Ismail, J. Jama, S. McNeill, A. Rubac, Asma Saed Ali, Amel Saeed, M. Yusuf
ABSTRACT The research aimed to understand the impact of COVID-19 and responses to it on sustainable development in Somalia and its breakaway region Somaliland. It explored how sustainable development could be protected and promoted through, during and as a method of COVID-19 response. It explored the themes of lives, livelihoods and inclusion. Due to COVID-19, it used three non-face-to-face methods: desk-based analysis of literature and secondary data; 175 phone interviews; and five phone Focus Group Discussions. The research was co-produced with 40 participants, which ensured that the study was carried out with as well as for those who could potentially benefit from it. COVID-19 and responses to it have generated intense and multi-dimensional concerns and deprivation, especially among those on low incomes. Livelihoods are being destroyed but people are receiving little or no financial support. People are receiving too little help to cope with the many problems they face. Limited action to prevent COVID-19 infection is more due to structural and social factors than lack of information. Public health education is still necessary; it should include challenging stigmatisation, explaining that wearing a face covering does not mean a person is infectious, and explaining that those recovered from the virus are not still infectious. Health care is mostly unavailable, unaffordable and not trusted. There is broad and deep agreement across all major issues explored in the research, including the immediate actions needed and the fundamentals of what building back better would mean. Responses to COVID-19 have mainly had the effect of undermining the prospects for sustainable development in Somalia/Somaliland. Despite this, the existence of broad and deep agreement on the major issues explored in the research could form the basis of a new commitment to sustainable development.
{"title":"COVID-19 and sustainable development in Somalia/Somaliland","authors":"E. Herring, Peter Campbell, M. Elmi, L. Ismail, J. Jama, S. McNeill, A. Rubac, Asma Saed Ali, Amel Saeed, M. Yusuf","doi":"10.1080/23779497.2020.1824584","DOIUrl":"https://doi.org/10.1080/23779497.2020.1824584","url":null,"abstract":"ABSTRACT The research aimed to understand the impact of COVID-19 and responses to it on sustainable development in Somalia and its breakaway region Somaliland. It explored how sustainable development could be protected and promoted through, during and as a method of COVID-19 response. It explored the themes of lives, livelihoods and inclusion. Due to COVID-19, it used three non-face-to-face methods: desk-based analysis of literature and secondary data; 175 phone interviews; and five phone Focus Group Discussions. The research was co-produced with 40 participants, which ensured that the study was carried out with as well as for those who could potentially benefit from it. COVID-19 and responses to it have generated intense and multi-dimensional concerns and deprivation, especially among those on low incomes. Livelihoods are being destroyed but people are receiving little or no financial support. People are receiving too little help to cope with the many problems they face. Limited action to prevent COVID-19 infection is more due to structural and social factors than lack of information. Public health education is still necessary; it should include challenging stigmatisation, explaining that wearing a face covering does not mean a person is infectious, and explaining that those recovered from the virus are not still infectious. Health care is mostly unavailable, unaffordable and not trusted. There is broad and deep agreement across all major issues explored in the research, including the immediate actions needed and the fundamentals of what building back better would mean. Responses to COVID-19 have mainly had the effect of undermining the prospects for sustainable development in Somalia/Somaliland. Despite this, the existence of broad and deep agreement on the major issues explored in the research could form the basis of a new commitment to sustainable development.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"192 1","pages":"93 - 110"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77688699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/23779497.2020.1782247
E. Brennan, S. Abimbola
ABSTRACT Despite much lauded change in recent years, Myanmar’s national health system still lags behind its regional counterparts. Decades of civil war and military rule have created, at the national level, a ‘centralisation by fiat’. This was most recently consolidated prior to the beginning of the country’s transition to democracy through the military-drafted 2008 constitution, which centralises power in the military. In part, Myanmar’s experience is also one of ‘decentralisation by default’. Civil war as well as the country’s geographic and demographic circumstances led to greater independence of well over a dozen territories and varying degrees of strength in sub-national structures. In the current period of relative de-confliction and political dialogue, discussions of decentralisation and federalism have never been so important – not the least within political dialogue following the nationwide ceasefire agreement. Moreover, several recent studies have found that public health was a top tier indicator of how Myanmar people of all ethnicities perceive the country’s progress. Decentralisation of the health system, as well as some centralisation or convergence of previously separate health systems in terms of information sharing and resource sharing, will be crucial to consolidate the progress made in the peace and democratisation processes. Indeed, the establishment of a decentralised and equitable public health system should be a leading priority for stabilising the country and ensuring its future prosperity. This paper explores decentralisation in Myanmar’s health system through current theoretical frameworks. It suggests that Myanmar’s experience of ‘decentralisation by default’ may find similarities in other post-conflict and conflict states.
{"title":"Understanding and progressing health system decentralisation in Myanmar","authors":"E. Brennan, S. Abimbola","doi":"10.1080/23779497.2020.1782247","DOIUrl":"https://doi.org/10.1080/23779497.2020.1782247","url":null,"abstract":"ABSTRACT Despite much lauded change in recent years, Myanmar’s national health system still lags behind its regional counterparts. Decades of civil war and military rule have created, at the national level, a ‘centralisation by fiat’. This was most recently consolidated prior to the beginning of the country’s transition to democracy through the military-drafted 2008 constitution, which centralises power in the military. In part, Myanmar’s experience is also one of ‘decentralisation by default’. Civil war as well as the country’s geographic and demographic circumstances led to greater independence of well over a dozen territories and varying degrees of strength in sub-national structures. In the current period of relative de-confliction and political dialogue, discussions of decentralisation and federalism have never been so important – not the least within political dialogue following the nationwide ceasefire agreement. Moreover, several recent studies have found that public health was a top tier indicator of how Myanmar people of all ethnicities perceive the country’s progress. Decentralisation of the health system, as well as some centralisation or convergence of previously separate health systems in terms of information sharing and resource sharing, will be crucial to consolidate the progress made in the peace and democratisation processes. Indeed, the establishment of a decentralised and equitable public health system should be a leading priority for stabilising the country and ensuring its future prosperity. This paper explores decentralisation in Myanmar’s health system through current theoretical frameworks. It suggests that Myanmar’s experience of ‘decentralisation by default’ may find similarities in other post-conflict and conflict states.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"1 1","pages":"17 - 27"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91266521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/23779497.2020.1831396
P. Kaur, M. Murhekar, J. Thangaraj, M. Prakash, K. Kolandaswamy, Premkumar Balasubramanian, P. Jesudoss, K. Karupasamy, Velmurugan Ganesh, G. Parasuraman, V. Balagurusamy, Vettrichelvan Venkatasamy, K. Laserson, S. Balajee
ABSTRACT We describe the process and experience of implementing a Community event-based Surveillance (CEBS) pilot project in one district in Tamil Nadu, India. The project was implemented by National Institute of Epidemiology (NIE) in collaboration with the Tamil Nadu State Public Health Department and US Centres for Disease Control and Prevention. The design and process of implementation of the pilot project was developed in collaboration with the Tamil Nadu State Public Health Department. Training materials and an SMS/phone call-based system was developed for community-level reporting. Data pertaining to signals, verified events and response were collected from April – December 2017 and February – December 2019. The frequency of reported signals, the proportion of verified events and the percentage/type of events responded by the health staff were computed. The stakeholders agreed on seven signals for detection of events. Three hundred health workers, 85 doctors and 8214 volunteers were trained. A total of 144 signals were reported of which the three most commonly reported signals were fever with rash (35%), clusters of similar illness (26%) and death of three or more animals or birds in one week (23%). Among the 25 events requiring action, 16 were not reported from existing surveillance systems. The current project demonstrated that CEBS can add value to the existing surveillance systems by engaging the communities to detect and report. Although the current pilot project was implemented in only one district, many important lessons were learnt including, the challenges that should be mitigated before expansion. The State Level leadership is actively exploring ways to strengthen a culture of reporting by initiating programmes that routinely and publicly acknowledge and appreciate reporters and to actively sensitise communities to reduce stigma of reporting.
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Pub Date : 2019-06-07DOI: 10.1007/978-3-030-23491-1_9
Chris Reynolds
{"title":"Global Health Security and Weapons of Mass Destruction Chapter","authors":"Chris Reynolds","doi":"10.1007/978-3-030-23491-1_9","DOIUrl":"https://doi.org/10.1007/978-3-030-23491-1_9","url":null,"abstract":"","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"47 1","pages":"187 - 207"},"PeriodicalIF":0.0,"publicationDate":"2019-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81763284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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