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Objective:To examine the association between living conditions and physical activity of older adults in Shanghai communities, and to explore the impact of living alone on different types and intensities of physical activity.Methods:Participants included randomly recruited older adults aged 60 and above in the Hongqiao, 2nd Shimen Road and Weifang communities in Shanghai.The Physical Activity Scale for the Elderly(PASE)was used to investigate the physical activity status of participants.The higher the PASE score, the higher the activity level.Results:In terms of physical activity concerning housework and labor and total PASE scores, there were statistically significant differences between those living alone and those not living alone[50.00(35.00)points vs.80.00(55.00)points, 85.80(67.23)points vs.110.80(75.18)points, Z=1.984, 2.102, P=0.047, 0.036]. After adjusting for sex, age, and body mass index, binary Logistic regression analysis showed that living alone was associated with low levels of housework physical activity( OR=2.56, 95% CI: 1.26-5.07, P=0.009). Conclusions:For older adults in Shanghai communities, living alone is associated with lower physical activity levels, especially physical activity involving housework.It is necessary to promote the physical activity level and a positive attitude toward exercise for older adults living alone to maintain a satisfactory level of physical health.
ABSTRACT
Non-governmental organizations ( NGOs) are playing an increasingly significant role in global health governance. This study selected ten key NGOs that play an important role in global health affairs and summarized the tools employed by NGOs participating in global health governance, including nine dimensions:“Generating informa-tion and evidence/intelligence”, “Cooperation ( Partnerships )”, “Participation”, “Consultation”, “Transparen-cy”,“Organizational adequacy/system design”, “Formulating policy / strategic direction”, “Responsibility” and“Regulation”. Four types of NGOs including Operational, Supportive, Advocacy and Integrated ones presented com-monness and their priorities in the selection of tools to participate in global health governance. Meanwhile, China should strive to nurture local NGOs, which should pay attention to“Transparency”,“Participation” and“Cooperation ( Partnerships)”.
ABSTRACT
NGOs play an important role in global health governance, and have become the key partners of World Health Organization ( WHO) , European and American governments. The goal of the sustainable development of the United Nations also proposes to strengthen NGOs as global health governance partners. Taking WHO, the Unit-ed States and Britain as case examples, this study reviewed the NGOs positioning and cooperation in their global health strategies. The results found that these entities explicitly define the roles of NGOs and strengthen cooperation in their global health strategies to expand their influence in the field of global health. Results also found that WHO, US and UK have given NGOs a clear positioning, that is, they have strengthened the mutual cooperation ( partner-ships) in the same way of expanding their influence in the field of global health for China’s global health strategy de-velopment referred to those NGOs. Therefore, China should incorporate NGOs into the global health strategy, estab-lish NGOs management and cooperation mechanism and define their roles and make it an important complement to global health. China should also strictly select international NGOs to cooperate with and strive to nurture and support Chinese NGOs to participate in global health programs set by the Government, formulate the cooperation list and neg-ative list for NGOs, and at the same time strengthen the supervision and audit to avoid possible risks of NGOs.
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The International Foundations have invested large sums of funds to participate in global health gov-ernance and greatly contributed to the promotion of global health. The foundations have extensive experience in the management of global health projects. Based on the nature of the foundation and its structure in the government, this paper compares the management methods of project management, project selection, project planning, project imple-mentation, project follow-up, project evaluation and project completion in two stages of the Gates Foundation and Global Fund. It summarizes the project management features, provided references for China participating in global health governance.
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The global health system is undergoing dramatic reforms, which would further bring about signifi-cant changes in key global health stakeholders. As a key actor and decision maker in global health system, NGO owns extensive experiences in global health governance and can provide a systematic experience for China’s participa-tion in global health decision-making as a reference model. This paper aimed at studying the roles of NGOs in the field of global health, the roles which can be summarized in four aspects of advocacy, implementation, support, and community mobilization. In addition, NGOs also developed some potential risks and unexpected impacts on global health governance. As represented by some typical examples, there occurred conflicts of interests between some NGOs and the local governments. A number of local health systems suffered from a considerable brain drain of health personnel to NGOs, especially the health officials and technical staff, which weakened the country’s health workforce and system. The financing model driven by external donors could weaken the influences and capacity of local govern-ments on health planning. As a key member involved in global health, we that suggested China and Chinese NGOs should strategically and rationally borrow their experiences and try to avoid these risks.
ABSTRACT
The international NGOs have been playing an important role in global health governance, and also represent a channel for countries to exert international influence. However, the Chinese NGOs are not actively in-volved in global health so far. This purpose of this paper is to analyze and show the picture of the social and political context of NGOs in China, to learn from the experience of emerging global health-related NGOs through describing their development, provides a strategy for China to support NGO participation in the global health governance, and to put forward recommendation on how to develop China’s global health NGOs based on experiences from international counterparts. The results of this paper found that China has a better international environment, which is a beneficial opportunity for the country to engage in global health governance. Domestic social NGOs are developing progressive-ly, while they are still being harnessed by political safety considerations, for example being affiliated to public admin-istrative system and policy orientation development. However, this would possibly not obstruct health-related NGOs for its minimal political relevance as it is oriented at professionalism, i. e. specialization, public service attributes and relevance to public governance. Therefore, health-related NGOs can have more support from governments since their number is relatively small, with less foundation ( they are undeveloped) and less participation in international cooper-ation ( they lack international involvement) . International experience indicates that supports from governmental enti-ties represent a backbone of the emerging institutions in the participation into the global health programs. The author suggests that the Chinese government should establish a specific global health development strategy of “prioritizing and improving the whole” and setting up the global development strategy in the county. The government should attach more importance to the government-owned and affiliated and private-capital-supported (social elites) NGOs, guide and subsidize them to the international stage, to engage intensely in global health.
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Objective:About half of Community Health Services ( CHS) in China are not government-owned, forming a multi-ownership situation of CHS .This study aims to examine the effect of “multi-ownership policy” on the development of CHS and put forward suggestions for improving the governance of CHS .Methods:We applied maxi-mum variation sampling to select health workers of different CHS specialties and administrators from local health bu -reaus in District T of Shaanxi province and District X of Shandong province .Inductive thematic analysis was utilized to interpret the development and ramification of multi-ownership policy , and then to formulate substantive theory .Re-sults:The adoption of multi-ownership in two districts was an adaptive strategy based on the limited public finance , institutional restriction of government , and diversity of health resources .This policy promoted the establishment of CHS network , and meanwhile the government's leadership of CHS development was transferred to multiple owners of CHS, which caused the lack of CHS autonomy , fragmented regulation power and deviated development of CHS .Con-clusions:The key problem of multi-ownership situation in CHS development is the problematic partition of governance power.In order to redeem the leadership of CHS development to the local government , it is necessary to strengthen service regulation while to decentralize the facility management power to CHS , to adjust service price ,and to deepen medical insurance coverage of CHS to enhance autonomy of CHS .
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After introduction into Chinese academy, and in the application in health care domain, the usage ofmotivation and related concepts has been changed. The changes were partly due to pragmatic utility, and caused confusion in the application of motivation theory in Chinese human resource for health. Both English and Chinese lit-erature was reviewed and systematic literature review was applied. We analyzed the different definitions of motiva-tion in English, and how they were used and understand in Chinese academia in history. Motivation was divided into three Chinese concepts, representing the process of motivation, inner driver of motivation and psychological state of being motivated. The other usage changes include willful exchange ofincentive andmotivation;motivationbeing used more as a means to motivate than a motivational process;the result of motivation as an aroused psychologi-cal state not seriously defined. Systematic literature review revealed the distribution of various motivation topics in Chinese literature and supported the abovementioned arguments. These changes of usage could cause barriers to re-search of human resource for health in China. It is recommended that usage ofmotivation should be clarified in ac-ademia in China and the process of motivation rather than motivation as a managerial means deserves more attention.