Suchergebnisse

Recruiters for the various US armed forces have free access to our nation's high schools, as mandated by the No Child Left Behind Act. Military recruiter behaviors are disturbingly similar to predatory grooming.

"War & Global Health: Transforming Our Professions, Changing our World," a conference organized at the University of Washington in the spring of 2010 by the Department of Global Health in the School of Public Health and Physicians for Social Responsibility, aimed to promote a public health approach to war and frame the prevention of war as a legitimate and imperative academic endeavor. The conference planners drew on substantial, yet under-acknowledged, work on the health consequences of war in both research and practice. They considered historical lessons on how a human behavior with negative consequences—generated by political and economic forces—can be framed as a health issue by health professionals. Key elements in the planning and execution of the conference were a strategic partnership between an academic department and an activist organization and the harnessing of considerable student energies. Conference organizers built on a policy statement adopted by the American Public Health Association in 2009 outlining the responsibility of public health professionals to prevent war. The authors document the important elements and the convergence of forces that resulted in a successful conference, examine the lessons learned, and offer a Web-based resource for those interested in staging a similar event.

Abstract Background Lebanon is witnessing an increased emigration of physicians. The objective of this study was to understand the perceptions of Lebanese policymakers of this emigration, and elicit their proposals for future policies and strategies to deal with this emigration. Methods We conducted semi-structured individual interviews with the deans of Lebanon's seven medical schools, the presidents of the two physicians professional associations, and governmental officials. We analyzed the results qualitatively. Results Participants differed in the assessment of the extent and gravity of emigration. Lebanon has a surplus of physicians, driven largely by the over-production of graduates by a growing number of medical schools. Participants cited advantages and disadvantages of the emigration on the personal, financial, medical education system, healthcare system, and national levels. Proposed strategies included limiting the number of students entering medical schools, creating job opportunities for graduating students, and implementing quality standards. Most participants acknowledged the globalization of the Lebanese physician workforce, including exchanges with the Gulf region, exchanges with developed countries, and the involvement of North American medical education institutions in the region. Conclusion Many Lebanese policy makers, particularly deans of medical schools, perceive the emigration of the physician workforce as an opportunity in the context of the globalization of the profession.

We sought to portray how collective bargaining contracts promote public health, beyond their known effect on individual, family, and community well-being. In November 2014, we created an abstraction tool to identify health-related elements in 16 union contracts from industries in the Pacific Northwest. After enumerating the contract-protected benefits and working conditions, we interviewed union organizers and members to learn how these promoted health. Labor union contracts create higher wage and benefit standards, working hours limits, workplace hazards protections, and other factors. Unions also promote well-being by encouraging democratic participation and a sense of community among workers. Labor union contracts are largely underutilized, but a potentially fertile ground for public health innovation. Public health practitioners and labor unions would benefit by partnering to create sophisticated contracts to address social determinants of health.

Stijn van Weezel and Michael Spagat (2017) have critiqued our 2011 report of mortality in Iraq following the 2003 US-led invasion in this issue of Research & Politics. In this response, we make our case for reporting both direct and indirect excess war-related deaths (while distinguishing the difference), defend our efforts to account for survival bias, and provide evidence for including all household-reported deaths, not just those cases where a death certificate can be demonstrated. We also point out Van Weezel and Spagat's misunderstanding of our sample selection method, despite our citation of our separate paper that thoroughly describes our approach.

We explored the effects on health of both household asset inequality and political armed conflict in Sudan. Using the 2010 Sudan household survey, we evaluated the role of both household asset distribution (measured by the Gini coefficient) and armed conflict status at the state level. We measured associations with six health-related outcomes: life expectancy, infant mortality, height-for-age (stunting), adequacy of food consumption, teenage birth rates and vaccination coverage for young children. For each of six measures of health in Sudan, outcomes were significantly worse in the states with more unequal asset distribution, with correlation coefficients ranging between -0.56 (stunting) and -0.80 (life expectancy). Conflict status predicted worse outcomes. Wealth redistribution in the more unequal states, as well as a political resolution of conflict, may improve population health.

In 2009 the American Public Health Association approved the policy statement, "The Role of Public Health Practitioners, Academics, and Advocates in Relation to Armed Conflict and War." Despite the known health effects of war, the development of competencies to prevent war has received little attention. Public health's ethical principles of practice prioritize addressing the fundamental causes of disease and adverse health outcomes. A working group grew out of the American Public Health Association's Peace Caucus to build upon the 2009 policy by proposing competencies to understand and prevent the political, economic, social, and cultural determinants of war, particularly militarism. The working group recommends that schools of public health and public health organizations incorporate these competencies into professional preparation programs, research, and advocacy.

Achieving an AIDS-free generation will require the adoption and implementation of critical health policy reforms. However, countries with high HIV burden often have low policy development, advocacy, and monitoring capacity. This lack of capacity may be a significant barrier to achieving the AIDS-free generation goals. This manuscript describes the increased focus on policy development and implementation by the United States President's Emergency Plan for AIDS Relief (PEPFAR). It evaluates the curriculum and learning modalities used for two regional policy capacity building workshops organized around the PEPFAR Partnership Framework agreements and the Road Map for Monitoring and Implementing Policy Reforms. A total of 64 participants representing the U.S. Government, partner country governments, and civil society organizations attended the workshops. On average, participants responded that their policy monitoring skills improved and that they felt they were better prepared to monitor policy reforms three months after the workshop. When followed-up regarding utilization of the Road Map action plan, responses were mixed. Reasons cited for not making progress included an inability to meet or a lack of time, personnel, or governmental support. This lack of progress may point to a need for building policy monitoring systems in high HIV burden countries. Because the success of policy reforms cannot be measured by the mere adoption of written policy documents, monitoring the implementation of policy reforms and evaluating their public health impact is essential. In many high HIV burden countries, policy development and monitoring capacity remains weak. This lack of capacity could hinder efforts to achieve the ambitious AIDS-free generation treatment, care and prevention goals. The Road Map appears to be a useful tool for strengthening these critical capacities.

We report on the implementation experience of carrying out data collection and other activities for a public health evaluation study on whether U.S. President's Emergency Plan for AIDS Relief (PEPFAR) investment improved utilization of health services and health system strengthening in Uganda. The retrospective study period focused on the PEPFAR scale-up, from mid-2005 through mid-2011, a period of expansion of PEPFAR programing and health services. We visited 315 health care facilities in Uganda in 2011 and 2012 to collect routine health management information system data forms, as well as to conduct interviews with health system leaders. An earlier phase of this research project collected data from all 112 health district headquarters, reported elsewhere. This article describes the lessons learned from collecting data from health care facilities, project management, useful technologies, and mistakes. We used several new technologies to facilitate data collection, including portable document scanners, smartphones, and web-based data collection, along with older but reliable technologies such as car batteries for power, folding tables to create space, and letters of introduction from appropriate authorities to create entrée. Research in limited-resource settings requires an approach that values the skills and talents of local people, institutions and government agencies, and a tolerance for the unexpected. The development of personal relationships was key to the success of the project. We observed that capacity building activities were repaid many fold, especially in data management and technology.