Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Development Policy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,351 records · Page 75Linked to original sources
PubMed1993

The continuum of care revisited: a rural perspective.

This study examines resource data for a variety of services in North Carolina's continuum of care for older adults. It qualifies the widespread contention that older adults in urban areas receive a greater number and more varied services than their rural counterparts. It also demonstrates that one of the most important differences between these communities is the greater variability of services among rural compared to urban counties. The comparative findings on urban and rural variations in the continuum of care for older adults have implications for further research and future policy development.

Aged↗
PubMed2000

Experiences of breastfeeding and vulnerability among a group of HIV-positive women in Durban, South Africa.

While international guidelines are currently being drawn up about HIV and infant feeding practices, and national and regional guidelines are under discussion in South Africa, there have been remarkably few studies that have sought to elicit HIV-positive mothers' experiences of breastfeeding and of paediatric infection. There is an urgent need to document this 'grass roots' knowledge in different sites, and for this data to be used to inform policy development, and for advocacy and counselling purposes. This qualitative investigation reports on the experiences and decisions taken around breastfeeding by a peer support group of 13 HIV-positive mothers meeting at King Edward VIII Hospital, Durban. In this study, the particular focus of information-giving and decision-making as to breast or formula feed is concerned with the impact on individual HIV-positive women and their babies. The most significant finding is that at no stage during their pregnancy were any of these mothers given information about the risks of HIV transmission through breastmilk. The study data were elicited in an in-depth group discussion, and individual women were invited to re-enact their stories in a follow-up discussion for clarification purposes. The women also discussed how they dealt with problems surrounding confidentiality in cases where few have been able to disclose their status to the extended family. There have been renewed calls for further investment in counsellors, with an enhanced role for community activists as peer educators. While there are severe resource constraints and low morale among many overworked nurses, one of the general problems in hospital settings remains the vertical health paradigm. This does not accommodate women's experiences, preferences, social networks and lay knowledge, and inhibits many women from becoming full participants in decisions affecting their own and their family's health.

Adult↗
PubMed2005

The Ghana community-based health planning and services initiative for scaling up service delivery innovation.

Research projects demonstrating ways to improve health services often fail to have an impact on what national health programmes actually do. An approach to evidence-based policy development has been launched in Ghana which bridges the gap between research and programme implementation. After nearly two decades of national debate and investigation into appropriate strategies for service delivery at the periphery, the Community-based Health Planning and Services (CHPS) Initiative has employed strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteerism, resources and cultural institutions for supporting community-based primary health care. Over a 2-year period, 104 out of the 110 districts in Ghana started CHPS. This paper reviews the development of the CHPS initiative, describes the processes of implementation and relates the initiative to the principles of scaling up organizational change which it embraces. Evidence from the national monitoring and evaluation programme provides insights into CHPS' success and identifies constraints on future progress.

Community Health Planning↗
PubMed1980

Euthanasia: a social work perspective.

As one of the many bioethical issues arising from new scientific and medical control over the processes of life and death, euthanasia raises some of the most difficult dilemmas to confront social workers in health care. In addition to exploring these dilemmas, this article points out the need to involve social workers in developing policy to address them.

Bioethics↗
PubMed1983

Social work in dentistry.

This article describes social work in a nontraditional area. The author uses two case vignettes to present intervention at the micro level and then outlines change strategies in the institutional and cultural context of dental care. The author discusses active case finding, dynamics of the interdisciplinary team, consultation, and implications for policy development.

Aged↗
PubMed1998

A survey of the effectiveness of the assessment of the welfare of the child in UK in-vitro fertilization units.

Seventy-one clinics in the UK offering in-vitro fertilization (IVF) treatment were surveyed for their protocols on the assessment of the welfare of the children produced. A total of 44 (62%) responded. Of these, five (12%) did not have operational protocols, seven (16%) declined to provide their protocols, and 32 (73%) provided information used in the survey. The information was in the form of a protocol for only 16 (50%) of these clinics. The remaining clinics submitted as their 'protocols' letters to general practitioners, patient information, patient questionnaires and/or a copy of their policy on the assessment of child welfare. From the submitted material, it was possible to determine that 94% of clinics seek information on aspects of child welfare assessment, 78% have a procedure for making further enquiries where there is any cause for concern, 44 % include counselling opportunities explicitly in protocols, 30-38% of clinics see a full medical and social history from each prospective parent as part of the child welfare assessment, 16% include explicit consideration of the impact of multiple births on the welfare of the child, and 3% include consideration of the issue of disclosure of the mode of conception of the child on its welfare. Most clinics did not have clearly defined procedures on how to reach a decision on whether or not to treat. Eight clinics (25%) made explicit in their protocols any exclusion criteria. It is concluded that clinics are not currently producing completely effective protocols. Two possible reasons for this are considered: lack of technical knowledge about what constitutes an effective protocol, and lack of clear policy development and propagation underlying protocols within clinics. Possible approaches to improving the situation are considered.

Adult↗
PubMed1994

Intravenous administration among heroin users having treatment in Spain.

BACKGROUND: Of critical importance to AIDS control in Spain is the analysis of geographical variation and trend over time in the prevalence of intravenous administration in heroin users, as well as the factors associated with the use of this route. METHODS: We carried out a cross-sectional study of 27,655 people admitted to outpatient treatment for heroin dependence in 15 of the 17 Autonomous Communities of Spain during 1991, using data provided by the State Information System on Drug Abuse (SEIT). To assess the association of some factors with use of the intravenous route crude and logistic analysis was performed. RESULTS: The prevalence of intravenous administration in this population was 64.4% with regional differences ranging between 33% and 90%. Crude and logistic analysis demonstrated a strong association with two factors in addition to geography: the year of first use and the age at first use (the earlier the first use, the greater the strength of the association). CONCLUSIONS: These findings are of paramount importance for the control of the HIV epidemic in Spain and further study in this area could help to guide policy development.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Quality of care of modern health services as perceived by users and non-users in Burkina Faso.

OBJECTIVE: Only one-fifth of the population in rural Burkina Faso uses modern health services. This article aims to identify barriers to increased use, which may help decision makers to develop policies to remove them. DESIGN: This article compares perceived quality of care of 853 pairs of users and non-users of modern health services. Non-users were matched to users on age, sex, occupation of the head of the household and distance to health post. Questions were structured according to four dimensions of quality of care. SETTING: Nouna health care district, Burkina Faso. RESULTS: Both users and non-users were relatively favourable about health personnel practices and conduct (77% versus 70% of the maximum attainable score), and about health care delivery (77% versus 74%). They were less favourable about adequacy of resources and services (51% versus 46%), and financial and physical accessibility of care (57% versus 51%). Both groups were very negative regarding the availability of drugs (33% versus 27%). Users were more favourable than non-users overall (66% versus 61%), and especially regarding payment arrangements (51% versus 43%) and costs (50% versus 40%). Observed differences were generally significant. CONCLUSION: To remove barriers to increase utilization, policy makers may do good to target their attention to improve financial accessibility of modern health services and improve drugs availability. These factors seem most persistent in decisions of ill people to stay with home-based care and/or traditional medicine, or go to consult modern health services.

Adolescent↗
PubMed2004

The expanding role of the antibiotic pharmacist.

Widespread inappropriate prescribing of antibiotics in UK hospitals has led to the introduction of specialist antibiotic pharmacists. Their role is to monitor antibiotic use, advise clinicians, educate all grades of healthcare workers and help to develop policy. Antibiotic pharmacists have been shown to be effective in many situations. As these practitioners become more accomplished it will be possible to expand their role to include direct intervention in patient treatment. Simple measures, such as modification of intravenous treatment to oral and automatic stop orders, could greatly enhance patient care.

Anti-Bacterial Agents↗
PubMed2001

Nutrition among older adults in Africa: the situation at the beginning of the millenium.

Most Africans enter old age after a lifetime of poverty and deprivation, poor access to health care and a diet that is usually inadequate in quantity and quality. However, nutrition interventions in African countries are directed primarily toward infants and young children, as well as pregnant and lactating women. This situational analysis focuses on two key areas to identify priorities for future research and policy development: the nutritional status of older Africans and determinants of undernutrition. Based on the scant evidence available, the prevalence of undernutrition is high in older African men (9.5-36.1%) and women (13.1-27%); however, in some urban areas there is evidence that older adults are experiencing the nutrition transition. Information on micronutrient status is sparse, yet it appears that anemia related to suboptimal folate status is a particular problem. Important determinants of poor nutritional status in the elderly in the African context include inadequate household food security, war and famine, and the indirect impact of HIV infection and AIDS. The rapidly increasing size of the older population, combined with their increased burden of care-giving responsibilities and severe socioeconomic hardship, indicates an urgent need for increased attention to this group, including applied research on nutrition problems and the development and evaluation of nutrition interventions.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Building a research consortium of large health systems: the Cancer Research Network.

Critical questions about cancer prevention, care, and outcomes increasingly require research involving large patient populations and their care delivery organizations. The Cancer Research Network (CRN) includes 11 integrated health systems funded by the National Cancer Institute (NCI) to conduct collaborative cancer research. This article describes the challenges of constructing a productive consortium of large health systems, and explores the CRN's responses. The CRN was initially funded through an NCI cooperative agreement in 1999 and has since received a second 4-year grant. Leadership and policy development are provided through a steering committee, subcommittees, and an external advisory committee. The CRN includes integral and affiliated research projects supported by a Scientific and Data Resources Core. Three characteristics of the CRN intensified the general challenges of consortium research: 1) its members are large health systems with legitimate concerns about confidentiality of data about enrollees, providers, and the organization; 2) CRN research projects often generate highly sensitive data about quality of care; and therefore 3) each participating organization wants a strong voice in CRN direction. CRN experience to date confirms that a consortium of health systems with internal research capacity can address a range of important cancer research questions that would be difficult to study in other venues. The advantages and challenges of consortium research are explored, with suggestions for the development, execution, and management of multisystem population laboratories.

Biomedical Research↗
PubMed2001

Partnering with communities to improve health: the New York City Turning Point experience.

Concurrent with the New York City Department of Health's reorganization efforts, the Robert Wood Johnson and W.K. Kellogg Foundations launched Turning Point, a national initiative designed to strengthen the nation's public health system. The Turning Point initiative has emphasized broad-based partnership building and planning as key prerequisites for improving public health practice. In response to the foundations' request for proposals, the department formed a New York City Public Health Partnership, which in turn applied for and was granted a Turning Point planning grant. This funding allowed New York City Turning Point to initiate a public health planning process, part of which involved convening forums in each of the five boroughs. With over 1,100 community participants, these forums provided both a starting point for establishing public health priorities and an interactive setting for sharing health and demographic data. Included among the issues that emerged as priorities were: access to care, environmental health, mental health, housing, asthma, education, and dietary issues. Building on the forum outcomes, the New York City Public Health Partnership developed a public health system improvement plan. The goals delineated in this plan are: (1) to create and support public health partnerships at the community, borough, and citywide levels; (2) to identify community health concerns and develop strategies responsive to these concerns; and (3) to develop policies to support and sustain a community health approach to improve health status. This article also discusses possible roles for local health departments in promoting a community health approach to address public health concerns.

Community Health Planning↗
PubMed1998

Euthanasia and assisted suicide: a survey of registered social workers in British Columbia.

This anonymous postal survey explores the attitudes and experiences concerning voluntary euthanasia (VE) and assisted suicide (AS) held by professionally registered members of the British Columbia Association of Social Workers. Social workers determine only a minor moral distinction between VE and AS and a large majority believe both acts should be legal, in certain circumstances (VE 75.9 per cent; AS 78.2 per cent). Approximately 80.0 per cent feel that social workers should be involved in social policy development concerning VE and AS, and, if such acts were to be legal, 70.0 per cent believe social workers should be involved in the decision making process with clients. Over 21.0 per cent of all social workers and nearly 40.0 per cent of social workers with medical employers have been consulted by a patient about VE or AS. Six respondents (1.1 per cent) reported assisting the death of a patient by VE. None had involvement in AS. Further research and education is required to better inform social work practice in this ethical area. Given the unique position of social workers in health care, they should, for the benefit of patients, families, and physicians, actively participate in the discussion concerning end of life decisions.

Attitude of Health Personnel↗
PubMedDate not supplied

Reducing firearm injuries: the role of local public health departments.

OBJECTIVE: The purpose of this study was to gather data regarding local public health departments' involvement in activities to prevent firearm-related morbidity and mortality. METHODS: A questionnaire was sent to local public health departments serving cities with populations > or =60,000 to assess their perceptions of the magnitude of the firearm injury problem in their jurisdictions and the activities in which they were engaged to reduce firearm-related injuries. RESULTS: Almost half (49.7%) of respondents said that their departments had not seriously thought about being involved in activities to reduce firearm-related injuries, and fewer than one in five (17.8%) reported that their departments were involved in such activities. Respondents identified three barriers to involvement in activities to reduce firearm injuries: limited financial resources (62.7% of respondents), lack of expertise (50.8%), and not enough time (47%). CONCLUSIONS: Despite the extent of firearm injuries in the US, systematic collection of local data on firearm morbidity and mortality to help guide policy development is lacking.

Female↗
PubMed2005

Mode of questionnaire administration can have serious effects on data quality.

BACKGROUND: One of the main primary data collection instruments in social, health and epidemiological research is the survey questionnaire. Modes of data collection by questionnaire differ in several ways, including the method of contacting respondents, the medium of delivering the questionnaire to respondents, and the administration of the questions. These are likely to have different effects on the quality of the data collected. METHODS: This paper is based on a narrative review of systematic and non-systematic searches of the literature on the effects of mode of questionnaire administration on data quality. RESULTS: Within different modes of questionnaire administration, there were many documented potential, biasing influences on the responses obtained. These were greatest between different types of mode (e.g. self-administered versus interview modes), rather than within modes. It can be difficult to separate out the effects of the different influences, at different levels. CONCLUSIONS: The biasing effects of mode of questionnaire administration has important implications for research methodology, the validity of the results of research, and for the soundness of public policy developed from evidence using questionnaire-based research. All users of questionnaires need to be aware of these potential effects on their data.

Bias↗
PubMed2000

Use and support of multicultural and antiracist education: research-informed interdisciplinary social work practice.

Multicultural education (MCE) and antiracist education (ARE) are the primary curricula through which school educators are combating the effects of racism and bigotry. To assist in the efforts of the educators, social workers need an understanding of MCE and ARE objectives, assumptions, and current research to guide their practice. This article discusses the differences between MCE and ARE and presents the findings of a study conducted in five northwestern United States school districts. It examines curricula, policies, and practices used to address racism and bigotry among elementary, middle, and high school students; attempts to discover underlying barriers to implementing antiracist and antibigotry curricula; and reveals the perspectives of teachers, administrators, counselors, and social workers. Implications for social work practice, policy development, and research are discussed.

Adult↗
PubMed2004

Health coverage instability for mothers in working families.

Using data from the National Longitudinal Survey of Youth, the authors examined the health insurance coverage stability of 1,667 women in working families over a three-year period (1995-1997). Findings revealed that coverage instability is common. Nearly one-half of low-income women experienced health coverage instability over the three-year study period, and low-income women with poor education, single marital status, low work hours, and frequent job changes were at even greater risk of coverage instability. The findings also imply that women affected by recent welfare reforms are likely to experience widespread health coverage problems. The implications for health care policy development, social work administration, and social work practice are discussed.

Demography↗
PubMed1997

Empowering initiatives to improve a community's health status.

The rapid growth of managed care in this country has contributed to major and ongoing changes that affect how consumers receive care and how providers deliver it. No longer are the terms managed care and capitation limited to the vernacular of policy developers and fiduciary entities. Consumers quickly are becoming informed, and this is leading to greater regulation of the managed care industry. Managed care, too, is evolving to another level as communities of consumers find that their health maintenance plans are not what they expected, needed, or desired. Empowered consumers are assuming the driver's seat and negotiating changes in services provided to them. To counter the power of well-organized managed care entities, partnerships comprising concerned consumers are rapidly springing up across the 50 states. They are starting to hold managed care organizations accountable, demanding information about the health outcomes of enrollees in relation to costs. The article examines partnerships that are using the data-driven community health assessment process to improve a community's health and ensure that providers deliver quality services that are appropriate for those consumers.

Community Health Planning↗