# ent

id: cord-012040-24112w2j
type: FAC
entity:
  Epidemic Republique Democratique du Congo Evaluation des Presentations des Services de souns de Sante EPSS


id: cord-258570-3n7jp0l0
type: ORG
entity:
  World Health Organization Task Force for Scaling Up Education and Training for Health Workers Global Health Workforce Alliance


id: cord-258570-3n7jp0l0
type: ORG
entity:
  Frontline Health Workers Coalition A Commitment to Community Health Workers Improving Data for Decision


id: cord-285027-40ciukd7
type: DISEASE
entity:
  influenza A H1N1 pandemic 13 14 15 16 17 18 19 20 21 22 The mental health impact of other emergencies such as bioterrorism have also been documented among survivors 23 Psychological distress anxiety depression


id: cord-343881-0i3rfpvd
type: DNA
entity:
  WHO regions African region 612 40 American region 279 18 Eastern Mediterranean region 32 2 European region 460 30 South East Asia region 87 6 Western Pacific region 58 4 Participants


id: cord-329016-w95typ7k
type: CHEMICAL
entity:
  captopril enalapril ramipril metoprolol atenolol amlodipine hydrochlorothiazide simvastatin atorvastatin


# bib

id: cord-011855-0vetk6jd
author: Shayo, Elizabeth
date: 2020-07-06
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342469/
doi: 10.1136/bmjgh-2019-002193
abstract: nan
title:
  Ethical issues in intervention studies on the prevention and management of diabetes and hypertension in sub-Saharan Africa


id: cord-011992-jgw3nat2
author: Srinivas, Prashanth Nuggehalli
date: 2020-07-23
txt: ./txt/cord-011992-jgw3nat2.txt
cache: ./cache/cord-011992-jgw3nat2.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7380710/
doi: 10.1136/bmjgh-2020-003015
abstract: nan
summary:
  The EV4GH programme deliberately selects a cohort of 30-40 early career researchers in health systems, living or working in lowincome and middle-income countries and with an interest to engage critically on global health issues that have local relevance within their country/local health systems. The collective engagement every 2 years during the biennial global health systems symposia enables community-building and several EV4GH alumni have taken on leadership roles within our network and within the broader HPSR community and beyond. Some have become elected members of the HSG board, and others have taken the lead in managing other thematic working groups within HSG, and many others participate actively in other regional and global events while coordinating with fellow EV4GH alumni in such fora, leveraging the membership in the network to seek wider change in the health systems and global health community.

title:
  “Together we move a mountain”: celebrating a decade of the Emerging Voices for Global Health network


id: cord-012040-24112w2j
author: Hung, Yuen W
date: 2020-07-27
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7389747/
doi: 10.1136/bmjgh-2019-002119
title:
  Impact of a free care policy on the utilisation of health services during an Ebola outbreak in the Democratic Republic of Congo: an interrupted time-series analysis

abstract:
  BACKGROUND: During past outbreaks of Ebola virus disease (EVD) and other infectious diseases, health service utilisation declined among the general public, delaying health seeking behaviour and affecting population health. From May to July 2018, the Democratic Republic of Congo experienced an outbreak of EVD in Equateur province. The Ministry of Public Health introduced a free care policy (FCP) in both affected and neighbouring health zones. We evaluated the impact of this policy on health service utilisation. METHODS: Using monthly data from the national Health Management Information System from January 2017 to January 2019, we examined rates of the use of nine health services at primary health facilities: total visits; first and fourth antenatal care visits; institutional deliveries; postnatal care visits; diphtheria, pertussis and tetanus (DTP) vaccinations and visits for uncomplicated malaria, pneumonia and diarrhoea. We used controlled interrupted time series analysis with a mixed effects model to estimate changes in the rates of services use during the policy (June–September 2018) and afterwards. FINDINGS: Overall, use of most services increased compared to control health zones, including EVD affected areas. Total visits and visits for pneumonia and diarrhoea initially increased more than two-fold relative to the control areas (p<0.001), while institutional deliveries and first antenatal care increased between 20% and 50% (p<0.01). Visits for DTP, fourth antenatal care visits and postnatal care visits were not significantly affected. During the FCP period, visit rates followed a downward trend. Most increases did not persist after the policy ended. INTERPRETATION: The FCP was effective at rapidly increasing the use of some health services both EVD affected and not affected health zones, but this effect was not sustained post FCP. Such policies may mitigate the adverse impact of infectious disease outbreaks on population health.


id: cord-252843-vd81pftu
title: Building back from the ground up: the vital role of communities
author: Doherty, Tanya
date: 2020-10-07
txt: ./txt/cord-252843-vd81pftu.txt
cache: ./cache/cord-252843-vd81pftu.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33028703/
doi: 10.1136/bmjgh-2020-003928
abstract: nan
summary:
  Governments in low-and middle-income countries (LMICs) followed the approaches adopted by the Global North and advocated by international bodies such as the WHO, and instituted varying degrees of nationwide stay at home orders (lockdowns) from strict restrictions (such as in South Africa, India and Zimbabwe) to weakly enforced lockdown as in Brazil. ► Investing in community cadres and organisations has the potential to build social solidarity, mitigate the impact of COVID-19 and strengthen intersectoral collaboration and safety nets for future crises. While LMIC governments have focussed almost exclusively on reducing COVID-19 case numbers, many communities organised themselves with ''ground-up'' mitigation measures to address the worsening unintended effects. The intense lockdown periods and burden of COVID-19-related illness have revealed the inadequacies of strained, under-resourced public health facilities, and in some instances inept LMIC governments'' responses to crises; and the critical role of resilient, mobilised community structures.


id: cord-257765-ljt9rn8z
title: Predicted COVID-19 fatality rates based on age, sex, comorbidities and health system capacity
author: Ghisolfi, Selene
date: 2020-09-09
url: https://doi.org/10.1136/bmjgh-2020-003094
doi: 10.1136/bmjgh-2020-003094
abstract:
  Early reports suggest the fatality rate from COVID-19 varies greatly across countries, but non-random testing and incomplete vital registration systems render it impossible to directly estimate the infection fatality rate (IFR) in many low- and middle-income countries. To fill this gap, we estimate the adjustments required to extrapolate estimates of the IFR from high-income to lower-income regions. Accounting for differences in the distribution of age, sex and relevant comorbidities yields substantial differences in the predicted IFR across 21 world regions, ranging from 0.11% in Western Sub-Saharan Africa to 1.07% for high-income Asia Pacific. However, these predictions must be treated as lower bounds in low- and middle-income countries as they are grounded in fatality rates from countries with advanced health systems. To adjust for health system capacity, we incorporate regional differences in the relative odds of infection fatality from childhood respiratory syncytial virus. This adjustment greatly diminishes but does not entirely erase the demography-based advantage predicted in the lowest income settings, with regional estimates of the predicted COVID-19 IFR ranging from 0.37% in Western Sub-Saharan Africa to 1.45% for Eastern Europe.


id: cord-258570-3n7jp0l0
title: Community health workers in Ghana: the need for greater policy attention
author: Baatiema, Leonard
date: 2016-12-02
txt: ./txt/cord-258570-3n7jp0l0.txt
cache: ./cache/cord-258570-3n7jp0l0.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2016-000141
doi: 10.1136/bmjgh-2016-000141
summary:
  We argue that CHWs have played critical roles in improving health service delivery and outcomes, including guinea worm eradication, expanded immunisation coverage, maternal and child health, and HIV/AIDS treatment and management. Despite the general consensus about the importance of CHWs among the global health community, health policy interventions to recognise and support optimal delivery of healthcare by CHWs are lacking, especially in LMICs. In Ghana, although a number of studies and reports have highlighted CHWs'' activities, 16 19 20 there is inadequate health policy support for them. Ambiguity further abounds in the mainstream literature on the characterisation of CHWs. 21 However, during the recent United States Agency for International Development (USAID) CHW Evidence Summit, there was some consensus that a CHW is "A health worker who receives standardized training outside the formal nursing or medical curricula to deliver a range of basic health, promotional, educational, and mobilization services and has a defined role within the community system and larger health system".

abstract:
  From the 1970s to the 1990s, the WHO, United Nations and other agencies mooted the idea of formally training and recognising community health workers (CHWs) to complement efforts to improve primary healthcare delivery in low and middle income countries. Recently, CHWs have been recognised as important players in the achievement of the health-related Millennium Development Goals (MDGs). Despite this recognition, little understanding exists in Ghana about the activities of CHWs: who they are; how they are recruited; what they do; level of health policy support; contribution to healthcare delivery and the challenges they face. Based on a rapid scoping review of the existing literature, and our experience working in Ghana, this paper reflects on the role of CHWs in healthcare delivery in Ghana. We argue that CHWs have played critical roles in improving health service delivery and outcomes, including guinea worm eradication, expanded immunisation coverage, maternal and child health, and HIV/AIDS treatment and management. However, these achievements notwithstanding, CHWs face challenges which prevent them from being optimally productive, including capacity problems, neglect by the healthcare system, high attrition rates and inadequate supervision. Policymakers in Ghana therefore need to give increased attention to CHWs, provide remuneration for their activities, create career opportunities and other means of motivations to boost their productivity and sustain gains associated with their activities.


id: cord-260985-ria9v2p6
author: McDarby, Geraldine
date: 2019-07-29
txt: ./txt/cord-260985-ria9v2p6.txt
cache: ./cache/cord-260985-ria9v2p6.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/31406594/
doi: 10.1136/bmjgh-2019-001687
summary:
  Given the important implications health services resilience has for the protection and improvement of human life, this scoping review was undertaken to determine how the publicly available body of existing global SimEx materials considers health systems, together with health security functions in the event of disruptive emergencies. Given the important implications health services resilience has for the protection and improvement of human life, this scoping review was undertaken to determine how the publicly available body of existing global SimEx materials considers health systems, together with health security functions in the event of disruptive emergencies. SimEx are also an ideal opportunity to test preparedness of the various functions of the health system, particularly health service delivery, in response to PHEs. This would contribute to the development of strong linkages between health systems and health security sectors supporting an integrated approach towards building resilient health systems.

title:
  The global pool of simulation exercise materials in health emergency preparedness and response: a scoping review with a health system perspective

abstract:
  Simulation Exercises (SimEx) are an established tool in defence and allied security sectors, applied extensively in health security initiatives under national or international legislative requirements, particularly the International Health Regulations (2005). There is, however, a paucity of information on SimEx application to test the functionality of health systems alongside emergency preparedness, response and recovery. Given the important implications health services resilience has for the protection and improvement of human life, this scoping review was undertaken to determine how the publicly available body of existing global SimEx materials considers health systems, together with health security functions in the event of disruptive emergencies. The global review identified 668 articles from literature and 73 products from institutional sources. Relevant screening identified 51 materials suitable to examine from a health system lens using the six health system building blocks as per the WHO Health System Framework. Eight materials were identified for further examination of their ability to test health system functionality from a resilience perspective. SimEx are an effective approach used extensively within health security and emergency response sectors but is not yet adequately used to test health system resilience. Currently available SimEx materials lack an integrated health system perspective and have a limited focus on the quality of services delivered within the context of response to a public health emergency. The materials do not focus on the ability of systems to effectively maintain core services during response. Without adjustment of the scope and focus, currently available SimEx materials do not have the capacity to test health systems to support the development of resilient health systems. Dedicated SimEx materials are urgently needed to fill this gap and harness their potential as an operational tool to contribute to improvements in health systems. They can act as effective global goods to allow testing of different functional aspects of health systems and service delivery alongside emergency preparedness and response. The work was conducted within the scope of the Tackling Deadly Diseases in Africa Programme, funded by the UK Department for International Development, which seeks to strengthen collaboration between the health system and health security clusters to promote health security and build resilient health systems.


id: cord-266780-dwmfayaz
title: The Al Hol camp in Northeast Syria: health and humanitarian challenges
author: Saad, Neil J.
date: 2020-07-21
txt: ./txt/cord-266780-dwmfayaz.txt
cache: ./cache/cord-266780-dwmfayaz.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32694220/
doi: 10.1136/bmjgh-2020-002491
abstract: nan
summary:
  1 2 In the Northwest of the country, in the Idlib and Northern Aleppo governorates, four million people, of which two-thirds are displaced from other parts of Syria, are currently in the midst of a humanitarian crisis due to a military campaign by Syrian and Russian government forces. The Al Hol camp, close to the Syria-Iraq border, was initially set up by the United Nations High Commissioner for Refugees during the 1991 Gulf war for approximately 15 000 people and it expanded further during the US invasion of Iraq in the early 2000s. 9 10 Generally, newcomers first stay at a reception area and remain there until allocated a shelter and being Summary box ► Al Hol camp is the largest refugee/internally displaced people camp in Northeast Syria. In the harsh conditions of the Al Hol camp, international NGOs, United Nations agencies and local authorities worked towards improving people''s living conditions and supporting their basic needs.


id: cord-268279-umlqh0q4
title: Cuba y seguridad sanitaria mundial: Cuba’s role in global health security
author: Wenham, Clare
date: 2020-05-13
txt: ./txt/cord-268279-umlqh0q4.txt
cache: ./cache/cord-268279-umlqh0q4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32409329/
doi: 10.1136/bmjgh-2019-002227
summary:
  These concern Cuba''s visibility and participation in the broader global health security architecture, the social controls exercised by the state in managing disease threats in Cuban territory, and the resource constraints facing the island—in particular, the effects of the US embargo. These concern Cuba''s visibility and participation in the broader global health security architecture, the social controls exercised by the state in managing disease threats in Cuban territory, and the resource constraints facing the island-in particular, the effects of the US embargo. We consider this to be the most apparent embodiment of Cuban health security activities internationally, where the state appears to be supporting response efforts for emerging pathogens by providing human resources and technical expertise within outbreak response, and health systems capacity-building elsewhere in the world, such as the training of international medical professionals.

abstract:
  Cuba has been largely absent in academic and policy discourse on global health security, yet Cuba’s history of medical internationalism and its domestic health system have much to offer contemporary global health security debates. In this paper, we examine what we identify as key traits of Cuban health security, as they play out on both international and domestic fronts. We argue that Cuba demonstrates a strong health security capacity, both in terms of its health systems support and crisis response activities internationally, and its domestic disease control activities rooted in an integrated health system with a focus on universal healthcare. Health security in Cuba, however, also faces challenges. These concern Cuba’s visibility and participation in the broader global health security architecture, the social controls exercised by the state in managing disease threats in Cuban territory, and the resource constraints facing the island—in particular, the effects of the US embargo. While Cuba does not frame its disease control activities within the discourse of health security, we argue that the Cuban case demonstrates that it is possible to make strides to improve capacity for health security in resource-constrained settings. The successes and challenges facing health security in Cuba, moreover, provide points of reflection relevant to the pursuit of health security globally and are thus worth further consideration in broader health security discussions.


id: cord-272195-c4xypzdx
title: COVID-19 stressors on migrant workers in Kuwait: cumulative risk considerations
author: Alahmad, Barrak
date: 2020-07-08
txt: ./txt/cord-272195-c4xypzdx.txt
cache: ./cache/cord-272195-c4xypzdx.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-002995
doi: 10.1136/bmjgh-2020-002995
summary:
  Local authorities and employers must act quickly to stop the spread, ensure easy access to testing and treatment, provide adequate housing and clear communication, encourage wide social support, safeguard financial protection and mental well-being and continuously re-evaluate the situation as more data are collected. 1 In many countries, migrant workers are recognised as one of the most vulnerable subpopulations, as they: (1) often are excluded from protections provided by public policies; (2) frequently take precarious jobs with less pay and longer hours; (3) often work in unsafe working conditions with little occupational safety and health (OSH) training; and (4) grapple with major cultural and language barriers. 5 6 This work investigates the multiple stressors associated with the COVID-19 pandemic on migrant workers by applying a holistic CRA framework, using Kuwait as an example. Migrant workers who are in non-essential businesses that remain closed could Figure 1 A cumulative risk assessment framework for occupational health and safety with four overlapping domains described by Fox et al.

abstract:
  As a marginalised subpopulation, migrant workers often fall short from protection by public policies, they take precarious jobs with unsafe working and living conditions and they grapple with cultural and linguistic barriers. In light of the current COVID-19 pandemic, migrant workers are now exposed to additional stressors of the virus and related responses. We applied a comprehensive qualitative cumulative risk assessment framework for migrant workers living in Kuwait. This pandemic could be one of the few examples where the stressors overlap all domains of migrant workers’ lives. No single intervention can solve all the problems; there must be a set of interventions to address all domains. Local authorities and employers must act quickly to stop the spread, ensure easy access to testing and treatment, provide adequate housing and clear communication, encourage wide social support, safeguard financial protection and mental well-being and continuously re-evaluate the situation as more data are collected.


id: cord-272965-l0d7rgt0
title: Global health is more than just ‘Public Health Somewhere Else’
author: Turcotte-Tremblay, Anne-Marie
date: 2020-05-07
txt: ./txt/cord-272965-l0d7rgt0.txt
cache: ./cache/cord-272965-l0d7rgt0.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-002545
doi: 10.1136/bmjgh-2020-002545
abstract: nan
summary:
  ► King and Koski''s definition of global health may exacerbate inequities by reserving the right to call oneself a global health researcher to those who are privileged and have access to funding that enables them to travel to other settings. Moreover, King and Koski''s 1 definition is not adequate because some global health initiatives are aimed at finding solutions to domestic problems, whether it be in a high, middle or low-income country. 6 7 There are examples of global health research and interventions where countries and communities have worked collaboratively and shared expertise, cultural knowledge and other resources to develop appropriate and effective solutions. 6 11 12 Recognising global health as a field in its own right is crucial to ensure there are dedicated resources for training and forums where the global health community can exchange and share knowledge, so that best practices can be further promoted, especially among students and emerging researchers and practitioners.


id: cord-272991-opvs2ejd
author: Masiira, Ben
date: 2020-10-13
url: https://www.ncbi.nlm.nih.gov/pubmed/33051282/
doi: 10.1136/bmjgh-2020-002874
title:
  Building a new platform to support public health emergency response in Africa: the AFENET Corps of Disease Detectives, 2018–2019

abstract:
  Public health emergency (PHE) response in sub-Saharan Africa is constrained by inadequate skilled public health workforce and underfunding. Since 2005, the African Field Epidemiology Network (AFENET) has been supporting field epidemiology capacity development and innovative strategies are required to use this workforce. In 2018, AFENET launched a continental rapid response team: the AFENET Corps of Disease Detectives (ACoDD). ACoDD comprises field epidemiology graduates and residents and was established to support PHE response. Since 2018, AFENET has deployed the ACoDD to support response to several PHEs. The main challenges faced during ACoDD deployments were financing of operations, ACoDD safety and security, resistance to interventions and distrust of the responders by some communities. Our experience during these deployments showed that it was feasible to mobilise and deploy ACoDD within 48 hours. However, the sustainability of deployments will depend on establishing strong linkages with the employers of ACoDD members. PHEs are effectively controlled when there is a fast deployment and strong linkages between the stakeholders. There are ongoing efforts to strengthen PHE preparedness and response in sub-Saharan Africa. ACoDD members are a competent workforce that can effectively augment PHE response. ACoDD teams mentored front-line health workers and community health workers who are critical in PHE response. Public health emergence response in sub-Saharan Africa is constrained by inadequacies in a skilled workforce and underfunding. ACoDD can be utilised to overcome the challenges of accessing a skilled public health workforce. To improve health security in sub-Saharan Africa, more financing of PHE response is needed.


id: cord-274895-rw5keyos
title: Towards universal health coverage: lessons from 10 years of healthcare reform in China
author: Tao, Wenjuan
date: 2020-03-19
txt: ./txt/cord-274895-rw5keyos.txt
cache: ./cache/cord-274895-rw5keyos.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32257400/
doi: 10.1136/bmjgh-2019-002086
summary:
  However, much of the early research focused solely on the first 3-year reform after 2009 in China, summary box ► Continued political support is the most important enabling condition for achieving universal health coverage (UHC). 42 43 Under the goal of achieving UHC, China concentrated on establishing the four systems (ie, public health service system, medical service system, health insurance system, and drug supply and security system), based on the eight functional mechanisms that could provide essential supports. There were five reform priorities: (1) accelerating the establishment of a basic health insurance system; (2) establishing a preliminary national essential drug system; (3) improving the primary care delivery system to provide basic healthcare; (4) making basic public health services (BPHS) available and equal for all; and (5) piloting public hospital reforms.

abstract:
  Universal health coverage (UHC) is driving the global health agenda. Many countries have embarked on national policy reforms towards this goal, including China. In 2009, the Chinese government launched a new round of healthcare reform towards UHC, aiming to provide universal coverage of basic healthcare by the end of 2020. The year of 2019 marks the 10th anniversary of China’s most recent healthcare reform. Sharing China’s experience is especially timely for other countries pursuing reforms to achieve UHC. This study describes the social, economic and health context in China, and then reviews the overall progress of healthcare reform (1949 to present), with a focus on the most recent (2009) round of healthcare reform. The study comprehensively analyses key reform initiatives and major achievements according to four aspects: health insurance system, drug supply and security system, medical service system and public health service system. Lessons learnt from China may have important implications for other nations, including continued political support, increased health financing and a strong primary healthcare system as basis.


id: cord-281543-ivhr2no3
title: Pandemicity, COVID-19 and the limits of public health ‘science’
author: Richardson, Eugene T
date: 2020-04-17
txt: ./txt/cord-281543-ivhr2no3.txt
cache: ./cache/cord-281543-ivhr2no3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32469327/
doi: 10.1136/bmjgh-2020-002571
abstract: nan
summary:
  17 In the case of Ebola outbreak in West Africa, epidemiologists attributed amplified transmission to local populations'' beliefs in misinformation or their ''strange'' funerary practices-in essence, diverting the public''s gaze from legacies of the transatlantic slave trade (or Maafa), 18 colonialism, 19 indirect rule, 20 structural adjustment 21 and extractive foreign companies as determinants. 40 As they start to sift back through the determinative web of human rights abuses-that is, the pathologies of power 41that set the stage for these health inequalities, they may begin to see that they contribute a great deal to the production and reproduction of structural injustice because of the social position they occupy and the violence that has been committed in their names. Mathematical modeling of the West Africa Ebola epidemic


id: cord-283485-xit6najq
title: The COVID-19 pandemic: diverse contexts; different epidemics—how and why?
author: Van Damme, Wim
date: 2020-07-27
txt: ./txt/cord-283485-xit6najq.txt
cache: ./cache/cord-283485-xit6najq.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-003098
doi: 10.1136/bmjgh-2020-003098
summary:
  Since its emergence in Wuhan, China, in late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, has spread to nearly all countries of the world in only a few months. 4 It was soon discovered that the virus is easily transmitted, can cause Summary box ► Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, has spread to nearly all countries of the world in only a few months. 88 Box 2 On the use of mathematical models during epidemics A dominant way of studying the transmission dynamics of an infectious disease such as COVID-19, and predicting the amplitude and peak of the epidemic in a population (city, province, country) and analysing the effect of control measures is using mathematical models.

abstract:
  It is very exceptional that a new disease becomes a true pandemic. Since its emergence in Wuhan, China, in late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, has spread to nearly all countries of the world in only a few months. However, in different countries, the COVID-19 epidemic takes variable shapes and forms in how it affects communities. Until now, the insights gained on COVID-19 have been largely dominated by the COVID-19 epidemics and the lockdowns in China, Europe and the USA. But this variety of global trajectories is little described, analysed or understood. In only a few months, an enormous amount of scientific evidence on SARS-CoV-2 and COVID-19 has been uncovered (knowns). But important knowledge gaps remain (unknowns). Learning from the variety of ways the COVID-19 epidemic is unfolding across the globe can potentially contribute to solving the COVID-19 puzzle. This paper tries to make sense of this variability—by exploring the important role that context plays in these different COVID-19 epidemics; by comparing COVID-19 epidemics with other respiratory diseases, including other coronaviruses that circulate continuously; and by highlighting the critical unknowns and uncertainties that remain. These unknowns and uncertainties require a deeper understanding of the variable trajectories of COVID-19. Unravelling them will be important for discerning potential future scenarios, such as the first wave in virgin territories still untouched by COVID-19 and for future waves elsewhere.


id: cord-283555-pgel6i3y
title: Universal masking for COVID-19: evidence, ethics and recommendations
author: Chan, Tak Kwong
date: 2020-05-26
txt: ./txt/cord-283555-pgel6i3y.txt
cache: ./cache/cord-283555-pgel6i3y.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-002819
doi: 10.1136/bmjgh-2020-002819
abstract: nan
summary:
  ► There is no shortage of mechanistic evidence and observational studies that affirmed the benefits of wearing a face mask in the community, which should drive urgent public health policy while we await the results of further research. 1 There is limited clinical evidence that wearing a disposable face mask, enhancing hand hygiene practice or social distancing can reduce transmission of respiratory viral infections in the community, 2 3 although there is mechanistic basis for these measures to work. I aim to provide further clarification of the evidence and ethics on this issue (which can provide grounds alternative and/or supplementary to the precautionary principle applied by Greenhalgh et al) and make a plea to the World Health Organisation (WHO) and policy makers to reformulate current recommendations with a view to enhancing the practice of wearing a face mask in the community. While social distancing and hand washing form the main recommendations, there is no shortage of mechanistic evidence and observational studies that affirmed the benefits of wearing a face mask in the community.


id: cord-285027-40ciukd7
title: Impact of Ebola experiences and risk perceptions on mental health in Sierra Leone, July 2015
author: Jalloh, Mohamed F
date: 2018-03-17
txt: ./txt/cord-285027-40ciukd7.txt
cache: ./cache/cord-285027-40ciukd7.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/29607096/
doi: 10.1136/bmjgh-2017-000471
summary:
  We assessed symptoms of anxiety, depression and post-traumatic stress disorder (PTSD) in the general population in Sierra Leone after over a year of outbreak response. ► To the best of our knowledge, the assessment was the first national survey that examined the impact of the devastating Ebola epidemic on populationlevel mental health using globally validated scales, and conducted after more than a year of ongoing transmission of Ebola in the country. 25 26 Known risk factors for anxiety, depression and PTSDincluding experience with ill individuals, perceptions of threat, high levels of mortality, food and resource insecurity, stigma and discrimination, and intolerance of uncertainty-may have been experienced by people in Sierra Leone during the Ebola epidemic. Table 4 presents multivariate analyses of the associations between Ebola experience and perceived Ebola threat and symptoms of anxiety and depression and PTSD, adjusting for gender, age, region and education levels.

abstract:
  BACKGROUND: The mental health impact of the 2014–2016 Ebola epidemic has been described among survivors, family members and healthcare workers, but little is known about its impact on the general population of affected countries. We assessed symptoms of anxiety, depression and post-traumatic stress disorder (PTSD) in the general population in Sierra Leone after over a year of outbreak response. METHODS: We administered a cross-sectional survey in July 2015 to a national sample of 3564 consenting participants selected through multistaged cluster sampling. Symptoms of anxiety and depression were measured by Patient Health Questionnaire-4. PTSD symptoms were measured by six items from the Impact of Events Scale-revised. Relationships among Ebola experience, perceived Ebola threat and mental health symptoms were examined through binary logistic regression. RESULTS: Prevalence of any anxiety-depression symptom was 48% (95% CI 46.8% to 50.0%), and of any PTSD symptom 76% (95% CI 75.0% to 77.8%). In addition, 6% (95% CI 5.4% to 7.0%) met the clinical cut-off for anxiety-depression, 27% (95% CI 25.8% to 28.8%) met levels of clinical concern for PTSD and 16% (95% CI 14.7% to 17.1%) met levels of probable PTSD diagnosis. Factors associated with higher reporting of any symptoms in bivariate analysis included region of residence, experiences with Ebola and perceived Ebola threat. Knowing someone quarantined for Ebola was independently associated with anxiety-depression (adjusted OR (AOR) 2.3, 95% CI 1.7 to 2.9) and PTSD (AOR 2.095% CI 1.5 to 2.8) symptoms. Perceiving Ebola as a threat was independently associated with anxiety-depression (AOR 1.69 95% CI 1.44 to 1.98) and PTSD (AOR 1.86 95% CI 1.56 to 2.21) symptoms. CONCLUSION: Symptoms of PTSD and anxiety-depression were common after one year of Ebola response; psychosocial support may be needed for people with Ebola-related experiences. Preventing, detecting, and responding to mental health conditions should be an important component of global health security efforts.


id: cord-285083-nkrw2sad
title: Global health and human rights for a postpandemic world
author: Khosla, Rajat
date: 2020-08-20
txt: ./txt/cord-285083-nkrw2sad.txt
cache: ./cache/cord-285083-nkrw2sad.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-003548
doi: 10.1136/bmjgh-2020-003548
abstract: nan
summary:
  For we, those working on health and human rights in global spaces and beyond, need to reflect on our values, our standards, our institutions, our mechanisms, and ask if we are fit for purpose. 9 Failing to explicitly address human rights concerns not only continues to jeopardise the response to this pandemic, but the future of global health. 10 Many scholarly writings, reflecting on the determinants of the current pandemic, point to our failure to approach global health as ''commons'' as the beginning of our collective descent. In the words of Jonathan Mann, ''time is now for us to come together as "equal partners in the belief that the world can change".'' 15 Twitter Pascale Allotey @PascaleAllotey Contributors The manuscript is a result of discussions towards foundational work on the future of human rights in health.


id: cord-290067-fa0mxvc3
title: Global health degrees: at what cost?
author: Svadzian, Anita
date: 2020-08-05
txt: ./txt/cord-290067-fa0mxvc3.txt
cache: ./cache/cord-290067-fa0mxvc3.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-003310
doi: 10.1136/bmjgh-2020-003310
abstract: nan
summary:
  Results for average tuition fees for Master''s degrees in global or international health are displayed in table 2. The data presented suggest that there may be a disconnect between where global health training is needed most versus where the degree programmes are currently offered. This would vary a lot, depending on the country and cost of living and what financial aid or fellowships To this extent, we hope global health degree programmes will be transparent about diversity in their student body and provide information on what proportion of their LMIC students receive tuition waivers or fellowships. We also need data on what proportion of the LMIC students in these degrees get full tuition fee waivers. Fee waivers may also represent a form of reparation, given the colonial and extractive origins of many HIC universities and global/ public health schools. It is disappointing that distance education global health degrees still cost about US$20 000 for international students.


id: cord-295450-ca7ll1tt
author: Jia, Peng
date: 2020-10-26
txt: ./txt/cord-295450-ca7ll1tt.txt
cache: ./cache/cord-295450-ca7ll1tt.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33106238/
doi: 10.1136/bmjgh-2020-002925
abstract: nan
summary:
  The outbreak of the COVID-19 has further advanced the demand for an intelligent disease reporting system, also known as the national intelligent syndromic surveillance system (NISSS), 1 which would be able to analyse these suspected cases on the basis of prior knowledge and real-time information before a disease is confirmed clinically and in the laboratory. ► Literature databases containing valuable research findings and knowledge and internet activity data reflecting cyber user awareness should be incorporated into the NISSS in a real-time way for warning or fighting the epidemic. ► The International Institute of Spatial Lifecourse Epidemiology (ISLE), a global health collaborative research network, has committed to working with multiple stakeholders to codevelop the NISSS in China. Such data-sharing mechanisms and infrastructures would also facilitate timely spatial epidemiological research on the basis of individual-level infected cases linked with respective location data from mobile service providers and/or smartphone-based apps without violating confidentiality requirements.

title:
  Early warning of epidemics: towards a national intelligent syndromic surveillance system (NISSS) in China


id: cord-306184-wfvc35l5
author: Perrin, Christophe
date: 2020-07-26
url: https://doi.org/10.1136/bmjgh-2020-003283
doi: 10.1136/bmjgh-2020-003283
abstract: nan
title:
  Europe should lead in coordinated procurement of quality-assured medicines for programmes in low-income and middle-income countries


id: cord-314699-5b4toeik
author: Wishnia, Jodi
date: 2020-10-29
url: https://doi.org/10.1136/bmjgh-2020-003524
doi: 10.1136/bmjgh-2020-003524
title:
  Impact of financial management centralisation in a health system under austerity: a qualitative study from South Africa

abstract:
  INTRODUCTION: International calls for universal health coverage (UHC) have led many countries to implement health sector reforms, however, since the 2008 global recession, economic growth has slowed in many lower-income and middle-income countries. In a renewed interest in public financial management (PFM), international organisations have emphasised the importance of giving spending control to those responsible for healthcare. However, centralisation is a common response when there is a need to cut expenditure due to a reduced budget; yet failure to decentralise often hampers the achievement of important goals. This paper examines the effect of centralising financial decision-making on the functioning of the South African health system. METHODS: We used a case study design with an ethnographic approach. Primary data collection was conducted through participant-observation and semistructured interviews, over 1 year. Member checking was conducted. RESULTS: New management implemented centralisation due to a reduced budget, a history of financial mismanagement, the punitive regulatory environment financial managers face, and their fear of poor audit outcomes. The reform, together with an authoritarian management style to ensure compliance, created a large power distance between financial and clinical managers. District managers felt that there was poor communication about the reform and that decision-making was opaque. This lowered commitment to the reform, even for those who thought it was necessary. It also reduced communal action, creating an individualistic environment. The authoritarian management style, and the impact of centralisation on service delivery, negatively affected planning and decision making, impairing organisational functioning. CONCLUSION: As public health systems become even more financially constrained, recognising how PFM reforms can influence organisational culture, and how the negative effects can be mitigated, is of international importance. We highlight the importance of a participatory culture that encourages shared decision making and coproduction, particularly as countries grapple with how to achieve UHC with limited funds.


id: cord-315744-nr0fu2qb
author: Wang, Yu
date: 2020-05-28
url: https://doi.org/10.1136/bmjgh-2020-002794
doi: 10.1136/bmjgh-2020-002794
title:
  Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: a cohort study in Beijing, China

abstract:
  INTRODUCTION: Transmission of COVID-19 within families and close contacts accounts for the majority of epidemic growth. Community mask wearing, hand washing and social distancing are thought to be effective but there is little evidence to inform or support community members on COVID-19 risk reduction within families. METHODS: A retrospective cohort study of 335 people in 124 families and with at least one laboratory confirmed COVID-19 case was conducted from 28 February to 27 March 2020, in Beijing, China. The outcome of interest was secondary transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within the family. Characteristics and practices of primary cases, of well family contacts and household hygiene practices were analysed as predictors of secondary transmission. RESULTS: The secondary attack rate in families was 23.0% (77/335). Face mask use by the primary case and family contacts before the primary case developed symptoms was 79% effective in reducing transmission (OR=0.21, 95% CI 0.06 to 0.79). Daily use of chlorine or ethanol based disinfectant in households was 77% effective (OR=0.23, 95% CI 0.07 to 0.84). Wearing a mask after illness onset of the primary case was not significantly protective. The risk of household transmission was 18 times higher with frequent daily close contact with the primary case (OR=18.26, 95% CI 3.93 to 84.79), and four times higher if the primary case had diarrhoea (OR=4.10, 95% CI 1.08 to 15.60). Household crowding was not significant. CONCLUSION: The study confirms the highest risk of transmission prior to symptom onset, and provides the first evidence of the effectiveness of mask use, disinfection and social distancing in preventing COVID-19. We also found evidence of faecal transmission. This can inform guidelines for community prevention in settings of intense COVID-19 epidemics.


id: cord-316855-4ua7ohkq
author: Druetz, Thomas
date: 2020-09-25
txt: ./txt/cord-316855-4ua7ohkq.txt
cache: ./cache/cord-316855-4ua7ohkq.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32978211/
doi: 10.1136/bmjgh-2020-002879
summary:
  title: Effects of terrorist attacks on access to maternal healthcare services: a national longitudinal study in Burkina Faso Negative binomial regression models were fitted with fixed effects to isolate the immediate and long-term effects of terrorist attacks on three outcomes (antenatal care visits, of facility deliveries and of cesarean sections). A quasi-experimental study was therefore designed to (1) assess the immediate effects of terrorist attacks on access to maternal healthcare in Burkina Faso and (2) evaluate the longitudinal effects in communes affected by incremental levels of insecurity, defined here by the cumulative frequency of attacks. This is a longitudinal quasi-experimental study that used multiple (pooled) interrupted time-series analysis BMJ Global Health to evaluate the effects of terrorist attacks on access to maternal healthcare services at the level of the lowest administrative unit (ie, the commune).

title:
  Effects of terrorist attacks on access to maternal healthcare services: a national longitudinal study in Burkina Faso

abstract:
  INTRODUCTION: Most of the literature on terrorist attacks’ health impacts has focused on direct victims rather than on distal consequences in the overall population. There is limited knowledge on how terrorist attacks can be detrimental to access to healthcare services. The objective of this study is to assess the impact of terrorist attacks on the utilisation of maternal healthcare services by examining the case of Burkina Faso. METHODS: This longitudinal quasi-experimental study uses multiple interrupted time series analysis. Utilisation of healthcare services data was extracted from the National Health Information System in Burkina Faso. Data span the period of January 2013–December 2018 and include all public primary healthcare centres and district hospitals. Terrorist attack data were extracted from the Armed Conflict Location and Event Data project. Negative binomial regression models were fitted with fixed effects to isolate the immediate and long-term effects of terrorist attacks on three outcomes (antenatal care visits, of facility deliveries and of cesarean sections). RESULTS: During the next month of an attack, the incidence of assisted deliveries in healthcare facilities is significantly reduced by 3.8% (95% CI 1.3 to 6.3). Multiple attacks have immediate effects more pronounced than single attacks. Longitudinal analysis show that the incremental number of terrorist attacks is associated with a decrease of the three outcomes. For every additional attack in a commune, the incidence of cesarean sections is reduced by 7.7% (95% CI 4.7 to 10.7) while, for assisted deliveries, it is reduced by 2.5% (95% CI 1.9 to 3.1) and, for antenatal care visits, by 1.8% (95% CI 1.2 to 2.5). CONCLUSION: Terrorist attacks constitute a new barrier to access of maternal healthcare in Burkina Faso. The exponential increase in terrorist activities in West Africa is expected to have negative effects on maternal health in the entire region.


id: cord-320127-55h4hhm3
title: Mitigating the impact of COVID-19 on children''s surgery in Africa
author: Mazingi, Dennis
date: 2020-06-10
txt: ./txt/cord-320127-55h4hhm3.txt
cache: ./cache/cord-320127-55h4hhm3.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-003016
doi: 10.1136/bmjgh-2020-003016
abstract: nan
summary:
  13 The COVID-19 pandemic has placed unprecedented strain on health services around the world, and paediatric surgical services are no exception. During the 2003 severe acute respiratory syndrome-related coronavirus (SARS-CoV)-1 outbreak in Toronto, stringent restrictions on non-essential surgical services were thought to have aggravated precipitous declines in surgical volume, with only small increases in surge capacity for the outbreak. 42 Paediatric care in Africa is typically characterised by significant involvement by guardians and other family members who support the child during hospital admission, assist the overburdened healthcare workforce and act as care advocates. A recent global review of paediatric surgical workforce density showed that a minimum of four paediatric surgeons per million children under 15 years of age would be required to achieve a survival of >80% for a group of four bellwether paediatric surgical conditions. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents: a systematic review


id: cord-321299-h6pcatvx
author: Hanson, Claudia
date: 2020-10-14
txt: ./txt/cord-321299-h6pcatvx.txt
cache: ./cache/cord-321299-h6pcatvx.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-003748
doi: 10.1136/bmjgh-2020-003748
abstract: nan
summary:
  2 The authors suggest that all childbirth care services should be moved to hospitals in all countries, combined with improvements in (1) the quality of care provided in these facilities; (2) transportation from home to hospital; and (3) continuity of care through hub-and-spoke arrangements. First, Roder-DeWan and colleagues propose that the present strategy of promoting childbirth care in primary health facilities may be the primary reason for improvements in maternal and newborn survival being less than anticipated. 19 However, midwifery-led birthing facilities equipped with functioning ambulance able to make transfers to a hospital with caesarean section services may be a less BMJ Global Health complex and more flexible approach; more responsive to the needs of women and their families. Maternal and perinatal outcomes by planned place of birth among women with low-risk pregnancies in high-income countries: a systematic review and meta-analysis

title:
  Health system redesign for equity in maternal and newborn health must be codesigned, country led, adapted to context and fit for purpose


id: cord-325474-iikfjqz5
title: Malaria vector control in sub-Saharan Africa in the time of COVID-19: no room for complacency
author: Guerra, Carlos A
date: 2020-09-16
txt: ./txt/cord-325474-iikfjqz5.txt
cache: ./cache/cord-325474-iikfjqz5.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-003880
doi: 10.1136/bmjgh-2020-003880
abstract: nan
summary:
  Perhaps most importantly, the increasing demand for resources to curb COVID-19 and the curtailment of economic activities driven by the pandemic could lead to substantial reductions in government revenues, 3 undermining their ability to finance essential social services, including life-saving malaria vector control interventions. The scaling-up of vector control, chiefly insecticide-treated nets (ITN) and indoor residual spraying (IRS), was the main driver for the significant reductions of malaria burden in SSA in the past two decades. ► In sub-Saharan Africa (SSA), the COVID-19 pandemic could cause major disruptions to the delivery of malaria vector control interventions. For instance, in Nigeria, the SSA country with the highest population at risk of malaria (>200 million people), only 11.1% of the 22.7 million nets in the Box 1 Strategies required for sustaining malaria vector control interventions during the COVID-19 pandemic ► Ensure that funding for malaria control activities remains in place considering increased demand of additional resources to carry out activities.


id: cord-328115-tjxt88vd
title: Tailored support for national NCD policy and programme implementation: an over-looked priority
author: Jackson-Morris, Angela
date: 2020-08-25
txt: ./txt/cord-328115-tjxt88vd.txt
cache: ./cache/cord-328115-tjxt88vd.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-002598
doi: 10.1136/bmjgh-2020-002598
summary:
  ► Tailored technical support can empower national stakeholders to put investment cases into operation by partnering local expertise with specialist guidance for specific policies and programmes, using implementation science to surmount implementation obstacles and building national NCD capacity. Thus, a country may use an investment case to review and reprioritise an existing strategy; some countries may have stronger NCD stakeholder capacity and may not need to address this; some may have sustainable funding mechanisms under development yet can beneficially align these to the newly identified priority interventions and revised strategy. 21 Thus, an investment case may identify a specific intervention as a cost-effective priority based on national data; implementation research can then indicate how this may impact population groups differently and suggest ways BMJ Global Health that the implementation process and supporting actions should be tailored.

abstract:
  Many low-income and middle-income countries (LMICs) are unlikely to achieve Sustainable Development Goal 3.4 to reduce premature deaths from non-communicable diseases (NCDs) by one-third by 2030. For some, the prospect is receding: between 2010 and 2020, the decline in premature deaths for the major NCDs slowed compared with the prior decade. Barriers to implementing effective strategies are well known, yet the value of tailored technical support to countries has been overlooked and downplayed. Tailored technical support is specialist guidance for country-specific application of technical tools, and capacity enhancement when needed, that enables an LMIC to advance its NCD priorities and plans. We present a model identifying pivotal junctures where tailored technical support can help surmount implementation obstacles. We draw on our experience preparing NCD investment cases with health ministries, development partners and technical agencies. National investment cases produce evidence based, locally tailored and costed packages of NCD interventions and policies appropriate to national needs and circumstances. They can include analysis of financing needs and point towards sustainable funding mechanisms. Enhancing the NCD-specific knowledge of government and Civil Society Organization leads can capitalise on existing expertise, aid integrative health system developments and unlock capabilities to use global tools and guidance. Investment cases form a platform to develop or review NCD plans and (re)prioritise action, then apply implementation science to trouble-shoot obstacles. Partnering national stakeholders with technical support in this process is critical to develop and implement effective NCD strategies.


id: cord-329016-w95typ7k
author: Chow, Clara Kayei
date: 2020-11-03
txt: ./txt/cord-329016-w95typ7k.txt
cache: ./cache/cord-329016-w95typ7k.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-002640
doi: 10.1136/bmjgh-2020-002640
summary:
  OBJECTIVES: We aimed to examine the relationship between access to medicine for cardiovascular disease (CVD) and major adverse cardiovascular events (MACEs) among people at high risk of CVD in high-income countries (HICs), upper and lower middle-income countries (UMICs, LMICs) and low-income countries (LICs) participating in the Prospective Urban Rural Epidemiology (PURE) study. 8 PURE recruited participants from different HICs, middle-income countries and LICs, making it possible to investigate the impact of availability and affordability of CVD medicines on adverse health outcomes across communities at varying economic levels. The medicines studied in this paper have been shown to be effective in primary and secondary prevention of CVD events and to reduce mortality, and are recommended in most clinical guidelines but were unavailable in a large proportion of communities in LICs and middle-income countries and even when available they were not always affordable. Availability and affordability of cardiovascular disease medicines and their effect on use in highincome, middle-income, and low-income countries: an analysis of the pure study data

title:
  Availability and affordability of medicines and cardiovascular outcomes in 21 high-income, middle-income and low-income countries

abstract:
  OBJECTIVES: We aimed to examine the relationship between access to medicine for cardiovascular disease (CVD) and major adverse cardiovascular events (MACEs) among people at high risk of CVD in high-income countries (HICs), upper and lower middle-income countries (UMICs, LMICs) and low-income countries (LICs) participating in the Prospective Urban Rural Epidemiology (PURE) study. METHODS: We defined high CVD risk as the presence of any of the following: hypertension, coronary artery disease, stroke, smoker, diabetes or age >55 years. Availability and affordability of blood pressure lowering drugs, antiplatelets and statins were obtained from pharmacies. Participants were categorised: group 1—all three drug types were available and affordable, group 2—all three drugs were available but not affordable and group 3—all three drugs were not available. We used multivariable Cox proportional hazard models with nested clustering at country and community levels, adjusting for comorbidities, sociodemographic and economic factors. RESULTS: Of 163 466 participants, there were 93 200 with high CVD risk from 21 countries (mean age 54.7, 49% female). Of these, 44.9% were from group 1, 29.4% from group 2 and 25.7% from group 3. Compared with participants from group 1, the risk of MACEs was higher among participants in group 2 (HR 1.19, 95% CI 1.07 to 1.31), and among participants from group 3 (HR 1.25, 95% CI 1.08 to 1.50). CONCLUSION: Lower availability and affordability of essential CVD medicines were associated with higher risk of MACEs and mortality. Improving access to CVD medicines should be a key part of the strategy to lower CVD globally.


id: cord-330343-p7a8chn4
title: An updated roadmap for MERS-CoV research and product development: focus on diagnostics
author: Kelly-Cirino, Cassandra
date: 2019-02-01
txt: ./txt/cord-330343-p7a8chn4.txt
cache: ./cache/cord-330343-p7a8chn4.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2018-001105
doi: 10.1136/bmjgh-2018-001105
summary:
  ► Diagnostic research and development (R&D) needs to include point-of-care testing options, syndromic panels for differential diagnosis, a greater understanding of viral and antibody kinetics, improved access to clinical specimens, and establishment of international reference standards. Diagnostics play a central role in the early detection and control of outbreaks and can enable a more nuanced understanding of the disease kinetics and risk factors for the Middle East respiratory syndrome-coronavirus (MERS-CoV), one of the high-priority pathogens identified by the WHO. Diagnostics play a central role in the early detection and control of outbreaks and can enable a more nuanced understanding of the disease kinetics and risk factors for the Middle East respiratory syndrome-coronavirus (MERS-CoV), one of the high-priority pathogens identified by the WHO. In this review we identified sources for molecular and serological diagnostic tests used in MERS-CoV detection, case management and outbreak investigations, as well as surveillance for humans and animals (camels), and summarised the performance of currently available tests, diagnostic needs, and associated challenges for diagnostic test development and implementation.

abstract:
  Diagnostics play a central role in the early detection and control of outbreaks and can enable a more nuanced understanding of the disease kinetics and risk factors for the Middle East respiratory syndrome-coronavirus (MERS-CoV), one of the high-priority pathogens identified by the WHO. In this review we identified sources for molecular and serological diagnostic tests used in MERS-CoV detection, case management and outbreak investigations, as well as surveillance for humans and animals (camels), and summarised the performance of currently available tests, diagnostic needs, and associated challenges for diagnostic test development and implementation. A more detailed understanding of the kinetics of infection of MERS-CoV is needed in order to optimise the use of existing assays. Notably, MERS-CoV point-of-care tests are needed in order to optimise supportive care and to minimise transmission risk. However, for new test development, sourcing clinical material continues to be a major challenge to achieving assay validation. Harmonisation and standardisation of laboratory methods are essential for surveillance and for a rapid and effective international response to emerging diseases. Routine external quality assessment, along with well-characterised and up-to-date proficiency panels, would provide insight into MERS-CoV diagnostic performance worldwide. A defined set of Target Product Profiles for diagnostic technologies will be developed by WHO to address these gaps in MERS-CoV outbreak management.


id: cord-335004-vw6up31u
author: McDiarmid, Melissa
date: 2019-08-31
txt: ./txt/cord-335004-vw6up31u.txt
cache: ./cache/cord-335004-vw6up31u.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/31543992/
doi: 10.1136/bmjgh-2019-001593
abstract: nan
summary:
  ► Médecins Sans Frontières (MSF) health workers had a much lower incidence rate of 4.3/1000, explained as the result of MSF''s ''duty of care'' toward staff safety. ► Adopting and consistently enforcing these broader, duty of care safety policies in deployed teams augments and fortifies standard infection prevention practices, creating a more protective, comprehensive safety programme. analySeS oF HealTH rISkS relaTed To THe job propoSed Months before the WHO declared the Ebola outbreak an international public health emergency in August 2014, MSF teams were already deployed to multiple sites in the affected West Africa region, providing patient care, contact tracing, community outreach and logistical support to the Ebola response. The briefings and training for prospective international Ebola staff emphasise specific sanitation and infection prevention and control (IPC) work practices, which limit exposure to infectious body fluids or objects. provIdIng FolloW-up For any IllneSS or Work-relaTed Injury Staff illness, including suspected Ebola cases, are managed by the team-based health focal point (Action 4).

title:
  Duty of care and health worker protections in the age of Ebola: lessons from Médecins Sans Frontières


id: cord-335373-17tcikxl
title: COVID-19: time for paradigm shift in the nexus between local, national and global health
author: Paul, Elisabeth
date: 2020-04-20
txt: ./txt/cord-335373-17tcikxl.txt
cache: ./cache/cord-335373-17tcikxl.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-002622
doi: 10.1136/bmjgh-2020-002622
abstract: nan
summary:
  ► The COVID-19 pandemic has triggered unprecedented measures worldwide, which have often been adopted in an ''emergency'' mode and are largely reactionary ► Alternatively, COVID-19 needs to be appraised as part of a much bigger health picture, adopting a "systems approach" that enables interactions with other acknowledged and preventable health conditions, which often receive disproportionately low attention ► To do so requires a paradigm shift in global health governance, from a specific reactional paradigm to a systemic, coordinated and preventive paradigm ► It is necessary to adopt a holistic approach to health reflecting both a security approach and a health development approach, tackling upstream causes and determinants, aimed at helping populations reduce their individual risk factors and augment their natural immunity ► Such preventive health policies must be tailored to local specificities and local environments, and health systems must be strengthened at the local level so as to be able to respond to population needs and expectations ► The current crisis calls for a paradigm shift in public and global health policies; and in the in the nexus between local, national and global health policies and systems


id: cord-339121-w16e8lw1
title: COVID-19 as social disability: the opportunity of social empathy for empowerment
author: Ebuenyi, Ikenna D
date: 2020-08-23
txt: ./txt/cord-339121-w16e8lw1.txt
cache: ./cache/cord-339121-w16e8lw1.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-003039
doi: 10.1136/bmjgh-2020-003039
abstract: nan
summary:
  4 6 The COVID-19 experience may offer contextual experience of the prepandemic lives of persons with disabilities and in doing so foster greater social responsibility and opportunities for change and a more inclusive society. Summary box ► COVID-19 has conferred new experiential knowledge on society and a rare opportunity to better understand the social model of disability and to improve the lives of persons with disabilities. ► The COVID-19 experience may offer contextual knowledge of the prepandemic lives of persons with disabilities and foster greater social awareness, responsibility and opportunities for change towards a more inclusive society. ► We have learnt from COVID-19 that inclusive healthcare and universal access should be the new normal, that its provision as a social good is both unifying and empowering for society as a whole. We have a rare opportunity to understand and better the lives of persons with disabilities for whom some aspects of the COVID-19 experience are enduring.


id: cord-343881-0i3rfpvd
author: Norton, Alice
date: 2020-07-29
url: https://doi.org/10.1136/bmjgh-2020-003306
doi: 10.1136/bmjgh-2020-003306
title:
  The remaining unknowns: a mixed methods study of the current and global health research priorities for COVID-19

abstract:
  INTRODUCTION: In March 2020, the WHO released a Global Research Roadmap in an effort to coordinate and accelerate the global research response to combat COVID-19 based on deliberations of 400 experts across the world. Three months on, the disease and our understanding have both evolved significantly. As we now tackle a pandemic in very different contexts and with increased knowledge, we sought to build on the work of the WHO to gain a more current and global perspective on these initial priorities. METHODS: We undertook a mixed methods study seeking the views of the global research community to (1) assess which of the early WHO roadmap priorities are still most pressing; (2) understand whether they are still valid in different settings, regions or countries; and (3) identify any new emerging priorities. RESULTS: Thematic analysis of the significant body of combined data shows the WHO roadmap is globally relevant; however, new important priorities have emerged, in particular, pertinent to low and lower middle-income countries (less resourced countries), where health systems are under significant competing pressures. We also found a shift from prioritising vaccine and therapeutic development towards a focus on assessing the effectiveness, risks, benefits and trust in the variety of public health interventions and measures. Our findings also provide insight into temporal nature of these research priorities, highlighting the urgency of research that can only be undertaken within the period of virus transmission, as well as other important research questions but which can be answered outside the transmission period. Both types of studies are key to help combat this pandemic but also importantly to ensure we are better prepared for the future. CONCLUSION: We hope these findings will help guide decision-making across the broad research system including the multilateral partners, research funders, public health practitioners, clinicians and civil society.


id: cord-351083-3oy7zuy9
title: Towards a socially just model: balancing hunger and response to the COVID-19 pandemic in Bangladesh
author: Rashid, Sabina Faiz
date: 2020-06-01
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url: https://doi.org/10.1136/bmjgh-2020-002715
doi: 10.1136/bmjgh-2020-002715
abstract: nan
summary:
  ► Responsive and timely research is needed to better understand the challenges faced by poor and vulnerable populations to inform immediate interventions and policies to address this unprecedented COVID-19 modern-day pandemic. ► In the context of COVID-19, the lockdown model is being imported from a different context (western or developed economies) with stronger economic bases and better social safety nets for those in need, but is there a better way forward for low resource contexts? While there is no easy solution or strategy, for Bangladesh and its high proportion of vulnerable populations, continuation of the shutdown has to be accompanied with strong political resolve to ensure that people do not go without food BMJ Global Health and have basic health information and support, given the grounded realities of their lives.


id: cord-355523-zol0k94p
title: Advancing Planetary Health in Australia: focus on emerging infections and antimicrobial resistance
author: Hill-Cawthorne, Grant
date: 2019-04-22
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url: https://www.ncbi.nlm.nih.gov/pubmed/31139446/
doi: 10.1136/bmjgh-2018-001283
summary:
  To clarify and advance the Planetary Health agenda within Australia, specifically in relation to emerging infectious diseases (EID) and antimicrobial resistance (AMR), national experts and key stakeholders were invited to a facilitated workshop. To clarify and advance the Planetary Health agenda within Australia, specifically in relation to emerging infectious diseases (EID) and antimicrobial resistance (AMR), national experts and key stakeholders were invited to a facilitated workshop. 7 However, a national summary box ► The emergence and spread of infectious diseases, including antimicrobial-resistant infections, pose a major health security threat. 34 The Australian National Antimicrobial Resistance Strategy 2015-2019, jointly developed by the Departments of Health and Agriculture and Water Resources, represents an example of how these silos can be linked, 35 but implementation remains challenging. Australian doctors prescribe more than twice the amount (in defined daily doses per 1000 population per day) of antibiotics compared with their counterparts in the BMJ Global Health Table 3 Responses to open-ended questions on antimicrobial resistance (AMR)

abstract:
  With rising population numbers, anthropogenic changes to our environment and unprecedented global connectivity, the World Economic Forum ranks the spread of infectious diseases second only to water crises in terms of potential global impact. Addressing the diverse challenges to human health and well-being in the 21st century requires an overarching focus on ‘Planetary Health’, with input from all sectors of government, non-governmental organisations, academic institutions and industry. To clarify and advance the Planetary Health agenda within Australia, specifically in relation to emerging infectious diseases (EID) and antimicrobial resistance (AMR), national experts and key stakeholders were invited to a facilitated workshop. EID themes identified included animal reservoirs, targeted surveillance, mechanisms of emergence and the role of unrecognised human vectors (the ‘invisible man’) in the spread of infection. Themes related to AMR included antimicrobial use in production and companion animals, antimicrobial stewardship, novel treatment approaches and education of professionals, politicians and the general public. Effective infection control strategies are important in both EID and AMR. We provide an overview of key discussion points, as well as important barriers identified and solutions proposed.


id: cord-355919-e8fhlo37
author: Semaan, Aline
date: 2020-06-24
url: https://doi.org/10.1136/bmjgh-2020-002967
doi: 10.1136/bmjgh-2020-002967
title:
  Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic

abstract:
  INTRODUCTION: The COVID-19 pandemic has substantially impacted maternity care provision worldwide. Studies based on modelling estimated large indirect effects of the pandemic on services and health outcomes. The objective of this study was to prospectively document experiences of frontline maternal and newborn healthcare providers. METHODS: We conducted a global, cross-sectional study of maternal and newborn health professionals via an online survey disseminated through professional networks and social media in 12 languages. Information was collected between 24 March and 10 April 2020 on respondents’ background, preparedness for and response to COVID-19 and their experience during the pandemic. An optional module sought information on adaptations to 17 care processes. Descriptive statistics and qualitative thematic analysis were used to analyse responses, disaggregating by low-income and middle-income countries (LMICs) and high-income countries (HICs). RESULTS: We analysed responses from 714 maternal and newborn health professionals. Only one-third received training on COVID-19 from their health facility and nearly all searched for information themselves. Half of respondents in LMICs received updated guidelines for care provision compared with 82% in HICs. Overall, 47% of participants in LMICs and 69% in HICs felt mostly or completely knowledgeable in how to care for COVID-19 maternity patients. Facility-level responses to COVID-19 (signage, screening, testing and isolation rooms) were more common in HICs than LMICs. Globally, 90% of respondents reported somewhat or substantially higher levels of stress. There was a widespread perception of reduced use of routine maternity care services, and of modification in care processes, some of which were not evidence-based practices. CONCLUSIONS: Substantial knowledge gaps exist in guidance on management of maternity cases with or without COVID-19. Formal information-sharing channels for providers must be established and mental health support provided. Surveys of maternity care providers can help track the situation, capture innovations and support rapid development of effective responses.


