Complexity and reform of public administration: findings and case studies
In: Cadernos INA papers 31
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In: Cadernos INA papers 31
Funding Information: This study was funded by the Hans-Böckler Foundation (HBS - https://www.boeckler. de) and the Portuguese Foundation for Science and Technology (FCT - www.fct.pt). PM received a Research Scholarship from the HBS (Scholarship ID: 385759). LVL was funded by the FCT grants (UID/Multi/04413/2013 and UID/Multi/04413/2020). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We would like to express our gratitude to Jonathan O' Mahony for proofreading the manuscript. In addition, we would like to thank Carlos Rodrigues, IT specialist at the Institute of Hygiene & Tropical Medicine in Lisbon, for his support with formatting the graphics included in this manuscript. Publisher Copyright: Copyright: © 2022 Müller, Velez Lapão. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. ; Background Cotrimoxazole and isoniazid preventive therapy (CPT, IPT) have been shown to be efficacious therapies for the prevention of opportunistic infections and tuberculosis (TB) among people living with human immunodeficiency virus (HIV). Despite governments' efforts to translate World Health Organization recommendations into practice, implementation remains challenging. This review aimed to explore and compare CPT and IPT with respect to similarities and differences of barriers identified across high TB/HIV burden countries. A secondary objective was to identify facilitators for implementing both preventive therapies. Methods We searched MEDLINE, Web of Science and SCOPUS databases for peer-reviewed literature published before September 2020. We extracted and synthesized our findings using Maxqda software. We applied framework synthesis in conjunction with metasummary to compare both therapies with respect to similarities and differences of barriers identified ...
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In: Saúde em Debate, Band 39, Heft 104, S. 43-55
ISSN: 0103-1104
Apresenta-se um estudo de caso realizado em Portugal sobre sistemas de avaliação profissional para atenção primária. Os objetivos foram analisar a trajetória de implantação, a estrutura organizacional e as ferramentas de gestão utilizadas, bem como discutir sobre os processos que vêm sendo instituídos no Brasil com o Programa Nacional de Melhoria do Acesso e da Qualidade. Trata-se de estudo descritivo, com investigação bibliográfica de abordagem qualitativa. Os resultados indicam uma estrutura de coordenação, com descentralização dos serviços, que requer maior autonomia dos gestores de saúde e regulamentação do processo avaliativo, contribuindo para a obtenção de melhores resultados.
Background: The Angolan Ministry of Health is prioritizing the strengthening ofthe national health system at the districtlevel. Toattain this objective, theAngolan Ministry of Health decided todevelop a national telemedicine network in partnership with the Geneva University Hospitals(HUG)and the Portuguese Institute of Hygiene and Tropical Medicine(IHMT).Methods: Telemedicine unitswerecreated in strategiclocationsto enable distance education and tele-expertiseactivities, usingsoftwaredeveloped by HUG adaptedto local conditions.Selected participants in each site weretrained with regards to theuse of the tools. A survey using questionnaires distributed to all participants was conducted toevaluate user satisfaction and the impact of the tools. Data were analysedusing a descriptive statistical model. Additionally,two working groups were held to discuss difficulties and find appropriate solutions.Results: Seven telemedicine units were established,and 107 health professionalsweretrained. Regarding distance education activities, over 70 courseswere designed and webcast,and95.6% of participants answered our survey showing a high level of overall satisfaction.Uptake of tele-expertise activities was poor. Only 3 cases were discussed,and 4.7% of participants answered the survey. This was explained by low levels of computer literacyand motivation among the participants. Thelack of a legislative frameworkandinternet accessin some places also played arole. Financial constraintshalted the process of extension of the network to additional sites.Conclusion: More research is neededto assess the impact of the network, to understand how to scale-up to other sites,and to conduct a cost-benefit analysis to justify the pursuit of the investments.
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Background: Among the processes to be experienced by any organization during its establishment is the formation of an organizational identity. This process can be understood as the activity and event through which an organization becomes unique in the mind of its members. An organizational identity leads to an identification and both are directly associated with the success of an institution. This study is about a public higher education institution in health in its early years, with distinctive characteristics in the country where it is situated. In spite of having been successful in the graduation of its students it has fragile institutional bases, lack of autonomy and internal problems common to other institutions of this type. Thus, this study was conducted to understand how this institution defined itself among its own members, the elements of its identity and what justified its relative success despite its weaknesses. Methods: A mixed-method approach was used to evaluate how a representative portion of this organization identifies with it. For the qualitative study two focus groups were conducted with transcripts submitted to content analysis proposed by Bardin, culminating in results from which a Likert scale-based questionnaire was elaborated and applied to 297 subjects. Results: There were six central elements of the organizational identity made evident by the focus groups: political / ideological conflict; active teaching and learning methodologies; location / separation of campuses; time of existence; teaching career; political-administrative transformations. The quantitative analysis revealed in more detail the general impressions raised in the focus groups. Most results were able to demonstrate distinct identifications of the same identity with its exposed weaknesses. Conclusions: Lack of autonomy, administrative and structural shortcomings and ideological or political conflicts presented themselves as problems capable of destabilizing the identity of a public higher education institution. On the other hand, one way to combat such problems is through the development of the institution itself, particularly by becoming more active and useful to the community and seeking in a common interest to the higher administration agencies. ; publishersversion ; published
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© 2022. The Author(s). ; BACKGROUND: In Europe, data on population health is fragmented, difficult to access, project-based and prone to health information inequalities in terms of availability, accessibility and especially in quality between and within countries. This situation is further exacerbated and exposed by the recent COVID-19 pandemic. The Joint Action on Health Information (InfAct) that builds on previous works of the BRIDGE Health project, carried out collaborative action to set up a sustainable infrastructure for health information in the European Union (EU). The aim of this paper is to present InfAct's proposal for a sustainable research infrastructure, the Distributed Infrastructure on Population Health (DIPoH), which includes the setup of a Health Information Portal on population health to be maintained beyond InfAct's time span. METHODS: The strategy for the proposal was based on three components: scientific initiatives and proposals to improve Health Information Systems (HIS), exploration of technical acceptability and feasibility, and finally obtaining high-level political support. The technical exploration (Technical Dialogues-TD) was assumed by technical experts proposed by the countries, and political guidance was provided by the Assembly of Members (AoM), which gathered representatives from Ministries of Health and Science of EU/EEA countries. The results from the AoM and the TD were integrated in the sustainability plan compiling all the major outputs of InfAct. RESULTS: The InfAct sustainability plan was organized in three main sections: a proposal of a new research infrastructure on population health (the DIPoH), new health information tools and innovative proposals for HIS, and a comprehensive capacity building programme. These activities were carried out in InfAct and are being further developed in the Population Health Information Research Infrastructure (PHIRI). PHIRI is a practical rollout of DIPoH facilitating and generating the best available evidence for research on health and ...
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BACKGROUND: In Europe, data on population health is fragmented, difficult to access, project-based and prone to health information inequalities in terms of availability, accessibility and especially in quality between and within countries. This situation is further exacerbated and exposed by the recent COVID-19 pandemic. The Joint Action on Health Information (InfAct) that builds on previous works of the BRIDGE Health project, carried out collaborative action to set up a sustainable infrastructure for health information in the European Union (EU). The aim of this paper is to present InfAct's proposal for a sustainable research infrastructure, the Distributed Infrastructure on Population Health (DIPoH), which includes the setup of a Health Information Portal on population health to be maintained beyond InfAct's time span. METHODS: The strategy for the proposal was based on three components: scientific initiatives and proposals to improve Health Information Systems (HIS), exploration of technical acceptability and feasibility, and finally obtaining high-level political support. The technical exploration (Technical Dialogues—TD) was assumed by technical experts proposed by the countries, and political guidance was provided by the Assembly of Members (AoM), which gathered representatives from Ministries of Health and Science of EU/EEA countries. The results from the AoM and the TD were integrated in the sustainability plan compiling all the major outputs of InfAct. RESULTS: The InfAct sustainability plan was organized in three main sections: a proposal of a new research infrastructure on population health (the DIPoH), new health information tools and innovative proposals for HIS, and a comprehensive capacity building programme. These activities were carried out in InfAct and are being further developed in the Population Health Information Research Infrastructure (PHIRI). PHIRI is a practical rollout of DIPoH facilitating and generating the best available evidence for research on health and wellbeing of populations ...
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Background: In Europe, data on population health is fragmented, difficult to access, project-based and prone to health information inequalities in terms of availability, accessibility and especially in quality between and within countries. This situation is further exacerbated and exposed by the recent COVID-19 pandemic. The Joint Action on Health Information (InfAct) that builds on previous works of the BRIDGE Health project, carried out collaborative action to set up a sustainable infrastructure for health information in the European Union (EU). The aim of this paper is to present InfAct's proposal for a sustainable research infrastructure, the Distributed Infrastructure on Population Health (DIPoH), which includes the setup of a Health Information Portal on population health to be maintained beyond InfAct's time span. Methods: The strategy for the proposal was based on three components: scientific initiatives and proposals to improve Health Information Systems (HIS), exploration of technical acceptability and feasibility, and finally obtaining high-level political support. The technical exploration (Technical Dialogues—TD) was assumed by technical experts proposed by the countries, and political guidance was provided by the Assembly of Members (AoM), which gathered representatives from Ministries of Health and Science of EU/EEA countries. The results from the AoM and the TD were integrated in the sustainability plan compiling all the major outputs of InfAct. Results: The InfAct sustainability plan was organized in three main sections: a proposal of a new research infrastructure on population health (the DIPoH), new health information tools and innovative proposals for HIS, and a comprehensive capacity building programme. These activities were carried out in InfAct and are being further developed in the Population Health Information Research Infrastructure (PHIRI). PHIRI is a practical rollout of DIPoH facilitating and generating the best available evidence for research on health and wellbeing of populations ...
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