Thursday, March 31, 2011

[EQ] Planning, Monitoring and Evaluation (PM&E) Framework for Capacity Strengthening in Health Research - ESSENCE

ESSENCE - harmonizing policies and practices of research funders

Planning, Monitoring and Evaluation (PM&E) Framework for Capacity Strengthening in Health Research

ESSENCE Secretariat :
TDR, Special Programme for Research and Training in Tropical Diseases executed by the World Health Organization (WHO) and co-sponsored by UNICEF, UNDP, the World Bank and WHO
ESSENCE Good practice document series – January 2011

The PM&E Framework is posted at: http://bit.ly/eXTHtu

“…..Enhancing Support for Strengthening the Effectiveness of National Capacity Efforts (ESSENCE on Health Research) is a collaborative framework between funding agencies to scale up research capacity for health. It aims to improve the impact of investments in institutions and people, and provides enabling mechanisms that address needs and priorities within national strategies on research for health.

ESSENCE members embrace the principles of donor harmonization and country alignment. According to these principles, donors/funders should align with priorities of countries in which they work, and harmonize their actions and procedures to facilitate complementarity among funders and to reduce administrative overload for recipients of funding.  To achieve these goals, ESSENCE members jointly developed and produced good practice documents that incorporate current best knowledge and practice on health research and development issues.  This Framework is the first ESSENCE good practice document….”

            Content:

Introduction
      
1 Shared principles on the "how-to" of capacity strengthening
        2 A PM&E matrix with key indicators
        3 Lessons learned
PART I: Shared principles on the "how-to" of capacity strengthening
PART II: PM&E matrix with key indicators - definitions of key concepts
PART III: Lessons learned
Sources

Contact: Dr Garry Aslanyan Manager, Portfolio Policy, WHO/TDR aslanyang@who.int

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[EQ] Assessing Proposals for Global Health Governance Reform

Student Voices 2:
Assessing Proposals for Global Health Governance Reform

Edited by Steven J. Hoffman

Assistant Professor, Department of Clinical Epidemiology & Biostatistics, McMaster University

Adjunct Faculty, McMaster Health Forum, McMaster University
Research Fellow, Global Health Diplomacy Program, Munk School of Global Affairs, University of Toronto

McMaster Health Forum, March 2011
Hamilton, Ontario, Canada - ISBN 978-1-894088-27-5


Available online [180p.] at: http://bit.ly/hGpkir

 

           

“…This edited volume offers evidence-based assessments of thirteen existing proposals for global health governance reform. These include proposals that call for the creation of or a larger role for the:

1.       Health 8 (H8)

2.       Committee C of the World Health Assembly

3.       International Health Partnership and Related initiatives (IHP+)

4.       Group of 8 (G8)

5.       Global Fund for Health

6.       Biosecurity Concert

7.       World Development Organization

8.       Networked Governance

9.       Global Action Networks

10.   Framework Convention on Global Health

11.   Global Plan for Justice

12.   Issue-Specific Global Health Laws

13.   Health Impact Fund

 

Each chapter relies on an extensive review of the available research evidence and a broad range of insights to: (a) summarize the key elements of each proposed global health governance reform; (b) identify the needs it seeks to address; (c) examine the extent to which it could strengthen global health governance and ameliorate known weaknesses in its existing architecture; (d) analyze the proposal’s political attractiveness; (e) raise implementation considerations such as costs, risks, possible harms, feasibility and equity; and (f) offer recommendations on whether the proposal should be further explored for possible implementation.

 

A common analytical framework was developed and utilized to help structure each chapter and ensure a comprehensive approach to each assessment. For example, when examining the extent to which each proposal may address the various challenges facing global health governance, the authors used Gostin and Mok’s six “grand challenges in global health governance” as their evaluation criteria for assessing the merit of each proposal. The use of a common analytical framework also offered the added benefit of enhancing comparability across the examined proposals (see Tables 1-3).

 

The authors of this report are all students at McMaster University who prepared these essays for the fourth-year undergraduate Law & Disorder in Global Health (HTH SCI 4LD3) course, offered from September to December 2010 by the Bachelor of Health Sciences (Honours) Program in collaboration with the McMaster Health Forum. In publishing this report, it is our belief that today’s students have an important role to play in global health decision-making for both their innovative ideas and future leadership of the global health community. Through this publication, it is hoped that these students can help shape the future of global health governance reform while preparing themselves to confront tomorrow’s greatest challenges…”

 

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Wednesday, March 30, 2011

[EQ] The impact of health and health behaviours on educational outcomes in high-income countries

The impact of health and health behaviours on educational outcomes in high-income countries:
a review of the evidence


Marc Suhrcke, School of Medicine, Health Policy and Practice, University of East Anglia, United Kingdom

Carmen de Paz Nieves, FundaciĆ³n Ideas, Madrid, Spain

WHO Regional Office for Europe - Copenhagen, Denmark 2011

Available online PDF file [48p.] at: http://bit.ly/giHFXO

“…..Education and health are known to be highly correlated – that is, more education indicates better health and vice versa – but the actual mechanisms driving this correlation are unknown. The effect of health on education has been well researched in developing countries, as has the effect of education on health in both developing and industrialized countries. Such imbalance could signal lack of attention not only in research but also in the public policy debate.


While children in developing countries face more serious health challenges than those in industrialized ones, the potentially relevant effect of health on their educations (and perhaps on labour force participation) cannot be ruled out.

The analytical framework we used to guide our research posits a path leading from health behaviours (e.g. smoking) and health conditions (e.g. asthma) to educational attainment (level of education) and educational performance (e.g. grades). We searched literature in the fi elds of health, socioeconomic research, and education and ultimately narrowed our selected publications to 53, all of them based in countries belonging to the Organisation for Economic Co-operation and Development……..

 

Content:

Executive summary

1. Introduction

2. The association between education and health

3. From health to education: a conceptual framework

Health outcomes and conditions

Mediating factors and educational outcomes

External or control factors affecting both health and education

Impact of health on future prospects through education and intergenerational transmission of inequalities

4. Search methodology

5. Results of the literature review

Selected summary statistics

Impact of health-related behaviours and risk factors on educational outcomes: detailed findings

Impact of health conditions on educational outcomes: detailed findings

6. Conclusions

Annex 1. Online databases used

References

 


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[EQ] Validity and Comparability of Out-of-pocket Health Expenditure from Household Surveys

Validity and Comparability of Out-of-pocket Health Expenditure from Household Surveys:
A review of the literature and current survey instruments

Richard Heijink, Ke Xu, Priyanka Saksena and David Evans

Series: Department of Health Systems Financing (WHO, Geneva) Discussion Paper Series, 01/2011

Available online PDF file [30p.] at: http://bit.ly/i9rOVG

Objective:
 Measurement errors have been a persistent concern in survey research. In this study we investigate the current evidence on measurement errors in self-reported household expenditure and health expenditure.

Methodology: 
We performed a review of the literature on measurement error in healthcare-related surveys. A Pubmed-search was performed and in addition reference tracking was used. In the second part of the study we examined current survey instruments. We collected 90 household surveys, such as household budget surveys, from the International Household Survey Network. We included surveys that were conducted after 1990, with a focus on low-income countries and studied differences in survey design features.

Results:
The literature review demonstrated that the probability of misreporting increases when the time between interview and event increases. Also, longer and shorter recall periods have generated different outcomes, although the magnitude of this difference varied across populations. Furthermore, respondents reported higher aggregate household spending when more items were used. Respondents may also lose motivation in long-term diaries. Some studies found a relationship between measurement error and respondent characteristics, although results were inconsistent. The review of current household surveys showed a non-negligible variation in design features such as the recall period, the number of disaggregation items and the wording of questions.

Conclusion:
From reviewing the existing studies and literature we did not find evidence of the optimal survey design features in collecting data on health spending. However, some practical suggestions emerge from the study in terms of question design, recall period and methods of data collection. The study strongly suggests the need for validation studies in order to improve survey instruments and data quality. In the meantime, standardization could improve the comparability across countries and surveys, yet this may discourage the efforts on further exploring the best survey instruments and compromise within-country, over-time comparison efforts.

 


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Tuesday, March 29, 2011

[EQ] Altitude, life expectancy and mortality from ischaemic heart disease, stroke, COPD and cancers

Altitude, life expectancy and mortality from ischaemic heart disease, stroke, COPD and cancers:
national population-based analysis of US counties


Majid Ezzati1,2, Mara E M Horwitz3, Deborah S K Thomas4, Ari B Friedman5, Robert Roach6, Timothy Clark7, Christopher J L Murray3, Benjamin Honigman6

 

1MRC-HPA Centre for Environment and Health, Imperial College, London, UK

2Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK

3Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA

4Department of Geography and Environmental Sciences, University of Colorado Denver, Denver, Colorado, USA

5University of Pennsylvania, Philadelphia, Pennsylvania, USA

6Altitude Research Center and Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USA

7US Army Corps of Engineers, Engineering Research and Development Center, Topographic Engineering Center, Alexandria, Virginia, USA

J Epidemiol Community Health 15 March 2011

Website: http://bit.ly/hxRDxO

Background
There is a substantial variation in life expectancy across US counties, primarily owing to differentials in chronic diseases. The authors' aim was to examine the association of life expectancy and mortality from selected diseases with altitude.

Methods
The authors used data from the National Elevation Dataset, National Center for Heath Statistics and US Census. The authors analysed the crude association of mean county altitude with life expectancy and mortality from ischaemic heart disease (IHD), stroke, chronic obstructive pulmonary disease (COPD) and cancers, and adjusted the associations for socio-demographic factors, migration, average annual solar radiation and cumulative exposure to smoking in multivariable regressions.

Results
Counties above 1500 m had longer life expectancies than those within 100 m of sea level by 1.2–3.6 years for men and 0.5–2.5 years for women. The association between altitude and life expectancy became non-significant for women and non-significant or negative for men in multivariate analysis. After adjustment, altitude had a beneficial association with IHD mortality and harmful association with COPD, with a dose–response relationship. IHD mortality above 1000 m was 4–14 per 10000 people lower than within 100 m of sea level; COPD mortality was higher by 3–4 per 10000. The adjusted associations for stroke and cancers were not statistically significant.

Conclusions
Living at higher altitude may have a protective effect on IHD and a harmful effect on COPD. At least in part due to these two opposing effects, living at higher altitude appears to have no net effect on life expectancy.

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Monday, March 28, 2011

[EQ] Leading Health Indicators for Healthy People 202

Key indicators of health in the USA

Editorial - The Lancet, Volume 377, Issue 9771 - 26 March 2011

Website: http://bit.ly/hK1RGB

“….The US Government's Healthy People initiative aims to improve the health of Americans. Last week, the Institute of Medicine released Leading Health Indicators for Healthy People2020, prioritising 12 health indicators and 24 health objectives among 42 topics and nearly 600 objectives.
Those health indicators are access to care services, quality of health-care services, healthy behaviours, physical environment, social environment, chronic disease, mental health, injury, maternal and infant health, tobacco use, substance abuse, and responsible sexual behaviour….”

 

Leading Health Indicators for Healthy People 2020:


Letter Report – March 2011

Committee on Leading Health Indicators for Healthy People 2020

Board on Population Health and Public Health Practice

Available online at: http://bit.ly/g6cxfn

“……In response to a request from the Department of Health and Human Services (HHS), the Institute of Medicine (IOM) established the Committee on Leading Health Indicators for Healthy People 2020 to develop and recommend 12 indicators and 24 objectives for consideration by HHS for guiding a national health agenda and for consideration for inclusion in Healthy People 2020.

 

The product of the committee was to be a consensus letter report.

In conducting its work, the committee was asked to

1. Review current and past health indicators sets, including Healthy People 2010 Leading Health Indicators, the State of the USA (SUSA) indicators, and the Community Health Status Indicators;

2. Give consideration to provisions of the Patient Protection and Affordable Care Act that mandate the establishment of key national indicators and prevention-related measures, goals, and objectives;

3. Define basic principles or purposes for Healthy People 2020 Leading Health Indicators;

4. Develop criteria for selecting Healthy People 2020 Leading Health Indicators. Such criteria should be actionable and reflect the importance of science, evidence, and public health concerns. Development of such criteria should involve consideration of Healthy People 2010 Leading Health Indicators and reflect the Healthy People 2020 framework that includes new issues and topics (e.g., health communication and health information technology);

5. Choose indicators that, to the extent possible, have annual data sources, with comparable data available at the state and county level; and

6. Identify 24 objectives drawn from Healthy People 2020 and 12 topics under which the selected objectives will be organized…..”



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[EQ] Learning from others - in advancing the health of all

Learning from others

Amartya Sen
Thomas W Lamont University Professor and Professor of Economics and Philosophy, Harvard University, Cambridge, MA, USA

The Lancet, Volume 377, Issue 9761, 2011

Website: http://bit.ly/giZNan

“…..Thailand has made huge use of what they call the National Health Assembly, in which there are open discussions on what problems the public faces in health care and in related fields and also on how they can be removed. This has gone with the progress made in Thailand in introducing universal public health care, and it has been nicely supplemented by feedback from the people, with considerable gain in efficiency and reach. As a functioning democracy, India can learn from others on how the public can be engaged in advancing the health of all. There is a huge role for the media and for political leadership, of all parties, in advancing this important national cause, in making the best use of the facilities provided by democracy.

As it happens, some of the real progress that has happened in recent years in India has come from public discussion—and agitation. This applies, for example, to the delivery of cooked midday meals in schools, and selected interventions in child development in preschool institutions. These new changes have had positive effects, even though their use is uneven across the country, and has to be expanded and improved.

China does not yet have either of these important instruments of basic health care, but they could be important for China too, since China—despite its high average performance—does have identifiable gaps (the existence of which has been pioneeringly studied by the China Development Research Foundation). China too may have to learn from others to eliminate the resisting pockets of deprivation. India faces, of course, a much larger task.

Learning from other countries remains as important today as it was in Yi Jing's time, almost 1400 years ago………”

 


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[EQ] Cross-border health care in the European Union - Mapping and analysing practices and policies

Cross-border health care in the European Union. Mapping and analysing practices and policies

Mapping and analyzing practices and policies

Edited by

Matthias Wismar, Willy Palm, Josep Figueras, Kelly Ernst, Ewout van Ginneken
European Observatory on Health Systems and Policies Study Series No. 22
World Health Organization 2011, on behalf of the European Observatory on Health Systems and Policies

Available online PDF [348p.] at: http://bit.ly/hApZOw

“…..The book presents a rich and detailed cross-European analysis of different dimensions that determine the scope and policy of cross-border care: access to health care, benefits and tariffs, quality and safety, patients’ rights, cross-border collaboration and crossborder health care data…..”

 

“….We hope that the book can further inform the political debate on the future of cross-border health care in the EU, a debate that will continue even after the final adoption of a proposed directive in early 2011. Uncertainties surrounding cross-border health care will remain, and new issues are likely to emerge given the constant flow of new European Court of Justice rulings on cross-border health care. We also believe that the transposition and implementation of a directive on cross-border health care in the Member States will benefit from an informed debate in the relevant countries, to which this book can make a contribution…”  Editors

Content

Chapter 1 The Health Service Initiative: supporting the construction of a framework for cross-border health care

Chapter 2 Towards a renewed Community framework for safe, high-quality and efficient cross-border health care within the European Union

Chapter 3 Access to health care services within and between countries of the European Union

Chapter 4 Benefit baskets and and tariffs

Chapter 5 Quality and safety

Chapter 6 Mapping national practices and strategies relating to patients’ rights

Chapter 7 Cross-border collaboration

Chapter 8 Past impacts of cross-border health care

Chapter 9 Cross-border health care data

Chapter 10 Annexes to Chapter 5 and Chapter 6


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