Suchergebnisse

In writing an editorial it is difficult to ignore the impact and ramifications of addressing the Covid Pandemic. In Australia, there is emerging political and media signals that are saying we must start to move on and get people back to work and living normally. At the same time our health bureaucracies are pointing to higher vaccination rates, new variants, the need for 'booster shots' and continued reticence in some about opening state and national borders.

It is difficult while writing an editorial, at this time, to ignore the extensive impact of the Corona virus (COVID-19) and it is probably important for us, as health professionals to give it some considered thought, outside the immediacy of current activity. I say this as someone recently returned from work related overseas travel, with my travel not meeting the government-imposed return deadline by some seven hours. This required my quarantine and/or isolation for some two weeks. After my first week of exclusion from most of my family, friends and working remotely and online it seems that the rest of Australia has caught up with my circumstance, many stood down from work, many businesses closed, a massive effort by the health system and economic rescue or support packages being implemented by government. It seems that I will have little opportunity to relax and celebrate with others at the end of this week.

Welcome to this fourth issue of the year, a record in the number of issues produced and yes, we continue to receive significant numbers of articles for publication. We appreciate the enthusiasm of authors but ask for their patience in our ability to process, peer review and publish. Exciting news for the APJHM was that we have been accepted for inclusion in the Directory of Open Access Journals (DOAJ). Allowing that organisation to speak for itself, we quote 'We are absolutely delighted to welcome this journal into DOAJ and look forward to seeing the article metadata soon.' The benefits of supplying DOAJ with our metadata are said to be: - Statistics show more than 900 000-page views and 300 000 unique visitors a month to DOAJ from all over the world. - Many aggregators, databases, libraries, publishers, and search portals collect DOAJ free metadata and include it in their products. Examples are Scopus, Serial Solutions and EBSCO. - DOAJ is OAI compliant and once an article is in DOAJ, it is automatically harvestable. - DOAJ is Open URL compliant and once an article is in DOAJ, it is automatically linkable. - Over 95% of the DOAJ Publisher community said that DOAJ is important for increasing their journal's visibility - DOAJ is often cited as a source of quality, open access journals in research and scholarly publishing circles.' This is encouraging news for our authors, readers the ACHSM and SHAPE who are involved and supportive of the APJHM.The first article in this issue is an important commentary from the National President of ACHSM, Dr Neale Fong, who provides insights into leadership and management in the Covid_19 period, the positioning of the College and its offerings at this time and an announcement about the commencement of a certification process for College members. The editorial again addresses the continuing progress of Covid-19 internationally. The editorial focusses on lessons learned across a number of nation states with a hope that this will encourage health professionals, policy makers, politicians, communities to reflect on the experience so far and develop a reasonably consistent framework and strategy that might improve future approaches to pandemic management. We would welcome contributions in this context. Turato and Oprescu describe enablers for allied health front-line managers in public health environments to deliver sustainable patient care in a review article in the Australian context. This article is followed by Yousef Yaghoobi and colleagues designing an empowerment model for Iranian health centre managers: A comprehensive study that examine empowerment models for Iranian health centre managers to develop capabilities and competencies for this group. Muddle in a research article describes the relationship between leadership style and hospital employee engagement in Papua New Guinea. Arya provides a distinctly unique contribution in being a fine detective in learning health leadership lessons to conclude this group of articles particularly relevant to health management. The next group of articles commences with the contribution of Bain, Goswami, Lloyd and Davis describing the post-implementation evaluation of a digital dictation system in a large health service using HOT-Fit framework, in Victoria Australia. This is followed by an article by seven colleagues from Iran that provides a research article on the assessment of staff performance in a CSSD unit using a 360-degree evaluation method. A further group of colleagues from Iran have also provided systematic review and meta-analysis of the care burden of informal care givers of haemodialysis patients, concluding that we should develop appropriate strategies to improve the quality of life for this group.The next contribution from Yadav from India provides a comparative study of health as an economic dimension in respect to China and India. Colleagues from Nepal, Thailand and Australia make a topical contribution entitled 'infodemic monikers in social media during the covid-19 pandemic. Das and colleagues provide a contribution that addresses community preparedness and responses to prevention and control of Covid_19 in Bangladesh. As usual we conclude with our library bulletin provided by Yaping Liu.

Since the last issue when we first spoke of the impact of Covid-19 we continue to be focused on addressing the challenges this virus has on health systems, nation states, communities, and people. The approach of countries and health systems has been variable as has the political interventions and interpretations of policy with some unfortunately placing parochial populism ahead of evidence and common sense.

During the recent Australian Federal election held on the 18th May 2019 much was made by all sides of the political divide about health and health services, much was praised, and more was promised in the name of health policy and improved approaches to health care delivery. Given that the 'quiet Australians' have made their choice and the political angst and dust has diminished, it might be time to return the debate to determine what it was that we all agreed to and where do we go from here.

Thailand has performed admirably in its health reform over the last few decades. Healthcare is provided at a relatively low cost and healthcare needs have transitioned to begin to address diseases and mortality of developed countries. The challenges now faced by Thailand are similar to most developed countries reflecting adult mortality and risk factors of an uppermiddle income population and the need to modify institutional structures to reflect these changing circumstances. The approach to these challenges has focused on the 'implementation of knowledge based health development' and critically identifies 'the triangle that moves the mountain' (health reform) as a movement that mobilises; the creation of relevant knowledge, social movement and political involvement' to address 'inter-connected, complex and extremely difficult to solve' problems. The move to District Health Systems as the access point to healthcare and the service delivery structure demands competent qualified leadership and management. It requires an understanding of the differences in managing professionally dominated complex adaptive systems compared to traditional approaches of managing within bureaucratic structures. This can be best described as managing connected, integrated care focused both on individuals as patients and communities with a strong emphasis on primaryhealthcare, prevention and evidence-based practice. It also requires an understanding of how distributed networks of practice (DNOP) provide the potential for researchers, practitioners and other agencies and communities to collaborate, learn and improve healthcare across geographic, jurisdictional and organisational boundaries. This approach provides recognition of the need to build the capacity and capability of health professionals in the management and leadership of health systems and Thailand is moving towards this goal in implementing specific health systems management curriculum which focuses on action-based research and learning together at the District health level augurs well for continued ability to address current health challenges and to achieve SDGs. Abbreviations: DHS – District Health System; DNOP – Distributed Networks of Practice; HSRI – Health Systems Research Institute; MoPH – Ministry of Public Health; NHSO – National Health Security Office; SDG – Strategic Development Goal; UHC – Universal Health Coverage.

Purpose
The purpose of this paper is to describe progress in an across sectorial approach to primary health care at the district health service (DHS) level in Thailand in response to recent innovative national public policy directions which have been enshrined in constitutional doctrine and publicly endorsed by the Prime Minister. This paper describes one response to the Prime Minister's challenge for Thailand to become the centre of learning in the sub-region in health management.


Design/methodology/approach
The authors utilised a descriptive case study approach utilising an analysis of the Naresuan University initiative of establishing the College of Health Systems Management (NUCHSM). Within that case study, there is a focus on challenges relevant to the socio-economic determinants of health (SOED) and an emphasis on utilising Sustainable Development Goals (SDGs) within the DHS structure.


Findings
The findings describe the establishment of the NUCHSM. A Master of Science (Health Systems Management) by research and a PhD degree have been created and supported by an international faculty. The Thailand International Cooperation Agency recognised NUCHSM by providing scholarships. International students are from Bangladesh, Bhutan, Kenya, Malawi and Timor Leste. Research consultancy projects include two in Lao People's Democratic Republic; plus, a prototype DHS management system responsive to SDG attainment; and a project to establish a sustainable Ageing Society philosophy for a Thai municipality.


Originality/value
The case study on NUCHSM and its antecedents in its development have demonstrated originality in a long-standing international collaboration, and it has been recognised by the national government to provide scholarships to citizens of the countries in the sub-region to undertake postgraduate studies in health management. The concept of learning from each other and together, simultaneously as a group, through action research projects funded to enhance the evolution of DHSs is innovative.

Kinley Dorji,1,2 Phudit Tejativaddhana,1,3 Taweesak Siripornpibul,1,4 Mary Cruickshank,1,5 David Briggs1,6 1College of Health Systems Management, Naresuan University, Phitsanulok, Thailand; 2Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan; 3ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand; 4Faculty of Science, Department of Mathematics, Naresuan University, Phitsanulok, Thailand; 5School of Nursing and Healthcare Professions, Federation University, Mpunt Helen, VIC, Australia; 6University of New England, Armidale, NSW, Australia Objective: This study aims to identify the required management competencies, current competency levels, and strategies for improving the management competencies of Bhutanese primary health care (PHC) managers.Methods: A quantitative method with a cross-sectional survey using self-administered questionnaires. This study recruited 339 PHC managers across Bhutan. The data were analyzed using statistical software.Results: This study identified three competency domains and seven key sub-domain competencies. People domain was perceived to be the highest required competency with a mean score of 4.2376, followed by execution (4.1851), and the transformation (4.0501) domains. For the seven key sub-domains, the communication sub-domain (4.3220) was perceived as the highest required competency, followed by professionalism (4.2967), managing change (4.1776), relationship building (4.1686), analytical thinking (4.1091), leadership (4.0980), and innovative thinking (3.9794). The current competency levels of PHC managers in domains and sub-domain competencies were the people domain (3.7322), execution (3.6471), and the transformation (3.5554). For the sub-domains, communication (3.8092), professionalism (3.7939), relationship building (3.6603), analytical thinking (3.6396), leadership (3.5805), managing change (3.5723), and innovative thinking (3.4543).Conclusion: Findings of Bhutan health managers' competencies are consistent with the findings of other international contexts. This study suggests that agencies responsible for health system need to focus more on the competencies defined by the study to positively influence health leadership and management development interventions. Keywords: Bhutanese primary health care managers, district health system, health reform, leadership and management competency