Perceptions of Private Practitioners Regarding Revised National Tuberculosis Control Program- A Cross-sectional Study in Sonepat, Haryana

Background: A substantial proportion of tuberculosis patients either take treatment from private care providers or first-time visit private hospitals to diagnose tuberculosis. Hence the role of private providers is too essential to ignore to realize the ambition of tuberculosis elimination in India. Aim and Objectives: To understand the perception of private practitioners of Sonepat district of Haryana state regarding. Setting and Design: A cross-sectional study was done among the private practitioners of the Sonepat district of Haryana Methods and Material: 78 randomly selected practitioners from the list provided by the district health authority were interviewed using a pretested semi-structured questionnaire. The ethics committee of the study institute approved the study. Statistical analysis used: Descriptive analysis in terms of proportion and percentages was conducted. Results: One-third of the study participants were in the age group of 30-40 years. Half of the practitioners were reportedly practicing medicine for less than twenty years. A significant proportion agreed that the government could not single-handedly eliminate tuberculosis without collaborating with private providers. Mostly agreed on the effectiveness of Tuberculosis regimens under the program; however, over-relying on the sputum examination was perceived as a negative component of the program. Conclusions: Private providers understand their pivotal role in tuberculosis-related programs. However, their full participation has not been realized in the program.

Recursos Públicos na Esfera Privada: Política de Educação Especial em um Município Paulista de Grande Porte / Public Resources in the Private Sphere: Special Education Policy in a Large Municipality of São Paulo

RESUMO: A Educação Especial brasileira tem marcas históricas da privatização, uma delas é focalizada neste artigo, que tem por objetivo analisar o repasse de recursos financeiros públicos da educação para a esfera privada em um município paulista de grande porte, entre 2012 e 2017. Adotando abordagem qualitativa, são analisados os valores liquidados em favor da Educação Especial direcionados à esfera privada a partir de fontes documentais, abrangendo contratos com empresas terceirizadas, termos de colaboração e aditamento, relatórios de remuneração de profissionais da Educação Especial e documentos de repasse de recursos à esfera privada. Os resultados indicam aumento dos recursos destinados a essa modalidade na esfera privada em decorrência, principalmente, da necessidade de contratação de cuidadoras(es), até aquele momento sem provimento de cargo nessa rede de ensino. Também expressam que a inclusão escolar reproduz modos de financiamento que marcam a história da Educação Especial no Brasil. A parceria com instituições privadas sem fins lucrativos e a contratação de empresas terceirizadas vão ao encontro da perspectiva gerencial da administração pública. No caso analisado, por um lado, a política de inclusão escolar terceirizou a manutenção dos serviços a partir da concessão para a esfera privada; por outro lado, houve crescente aumento do financiamento do setor público municipal.

ABSTRACT: Brazilian Special Education has historical marks of privatization, one of which is focused on this article, which aims to analyze the transfer of public financial resources from education to the private sphere in a large municipality in São Paulo, between 2012 and 2017. Adopting a qualitative approach, the amounts settled in favor of Special Education directed to the private sphere are analyzed based on documentary sources, covering contracts with outsourced companies, terms of collaboration and additions, reports on remuneration of Special Education professionals and documents for the transfer of funds to the private sphere. The results indicate an increase in resources allocated to this modality in the private sphere, mainly due to the need to hire caregivers, until that moment without filling a position in this teaching network. They also express that school inclusion reproduces funding modes that mark the history of Special Education in Brazil. The partnership with non-profit private institutions and the contracting of outsourced companies are in line with the managerial perspective of public administration. On the one hand, in the analyzed case, the school inclusion policy outsourced the maintenance of services from the concession to the private sphere, on the other hand, there was a growing increase in funding from the municipal public sector.

Primary health care­family partnership for better diabetes outcomes of patients: a systematic review

Background: Diabetes mellitus is a lifelong disease requiring daily self-care activities for better outcomes. Although most of these self-care activities for outpatients are taught in primary health care, their actual practice occurs at home where patients stay. Family dynamics or established cultures impact the management of the disease, hence a need for primary health care­family partnership to empower both families and patients with ways to manage the disease. This systematic review aims to describe the primary health care­family partnership. Methods: The literature was sourced using Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The Scopus/ Elsevier, ScienceDirect and PubMed databases were used to source literature written in English and published between January 1, 2010 and July 31, 2022. Studies were included if focused on self-care activities, management and family-centred care (FCC); participants were diabetes patients and non-diabetic family members; and primary health care diabetes intervention. Results: A total of 62 publications that met inclusion criteria were used in this review. The included studies include quantitative, qualitative and mixed-method studies, including reports. The process of including these publications involved identification, screening and re-screening in line with set eligibility. The key search strategies resulted in the following sub-headings: diabetes self-care, diabetes self-management education and support (DSMES), family-centred care, and primary health care. Conclusion: Evidence from existing literature shows that primary health care is the source of information, yet actual diabetes management occurs at home. This review recommends the adoption of DSMES and FCC modalities to set the foundation for workable primary health care­family partnerships. The adoption of these joint modalities for partnerships will outline the dos and don'ts in managing diabetes at home. The literature further indicates that family support is critical, therefore primary health care­families partnership may lead to improved adherence to self-care activities and better outcomes

Government-Industry-Academia Alliance: A multisectoral collaboration for improved nutrition of children and well-being of mothers

@#Introduction: Consistent with the Sustainable Development Goal 17 highlighting partnership to achieve development, this study demonstrated the convergence among government, industry and academe in carrying out a nutrition intervention to improve the nutritional status, knowledge, attitude and behaviour of school community (school children and mothers). Methods: A school-based intervention study comprising of school lunch feeding and nutrition lessons was conducted. Quasi-experimental design was used in the intervention research. Data were analysed using Stata 12.0. Descriptive statistics were generated using the survey module (svy) of Stata. The food and nutrition intervention mix composed of the governmentpartner School Feeding Programme (SFP) and the nutrition education campaign. The government-partner SFP involved lunch feeding of 7 to 9 years old students based on the standardised Pinggang Pinoy® recipes. The government-partner nutrition education component involved teaching of the developed modules to students and their mothers. Results: The intervention resulted in improvements in nutritional status, knowledge, attitude and behaviour of students. Investing an average of Php 15.00 or USD 0.29 (as of 2017) in a school feeding programme following the government-partner food and nutrition intervention mix improved nutritional status and shifted the number of underweight children to normal nutritional status by 25.3% after 120 feeding days. This intervention was implemented through a multisectoral collaboration during the pre-implementation, implementation, and post-implementation phases of the study. Conclusion: Partnerships among stakeholders provided the context towards healthier children as demonstrated by improved nutritional status, knowledge, attitude and behaviour of participants.

Application and effect of partnership plan competition in the recruitment of apheresis platelet donation / 中国输血杂志

【Objective】 To analyze the demographic characteristics of apheresis platelet donors who participated in the Partnership Plan Competition(PPC) of Beijing Red Cross Blood Center, and to analyze the effect of publicity and recruitment of apheresis platelet donors, so as to provide reference for formulating recruitment strategy of apheresis platelet donation. 【Methods】 Apheresis blood donors who participated in PPC from March 18, 2021 to May 18, 2021 were selected as research subjects, and their demographic data in terms of gender, age, occupation and education, and relevant blood donation data within 12 months such as the number of blood donations, whether they were regular blood donors were collected. The demographic characteristics of PPC donors and promising groups were analyzed. 【Results】 There were 58 recruiters participating in the PPC, and a total of 170 people were recruited; 53.53%(91/170) successfully participated in the donation of apheresis platelets, and 35.16%(32/91) became regular blood donors. Those 18-30 years old college male students were promising group in the PPC, and were more willing to participate in the recruitment and donation of apheresis platelets. 【Conclusion】 The PPC has significant effect on the promotion and recruitment of apheresis platelets donation. Measures such as setting the types of souvenirs according to the preferences of promising groups, strengthening publicity of PPC, encouraging non-blood donors to participate and expanding targeted recruitment can be taken in the future to increase the success rate of blood donation of the recruitment.

Management of Severe Acute Malnutrition in Day Care Settings : Findings fromInnovative Public Private Partnership at Devbhumi Dwarka District, Gujarat

Introduction :Severe Acute Malnutrition (SAM) is a major public health concern that is linked to a high mortality rate in children under the age of five. Government of Gujarat has expanded treatment network from government facilities to private institutions and non-governmental organizations through various initiative in an effort to address the issue of SAM. To assess the treatment outcome among SAMObjective: children (0-5 years) admitted at Niramay Bal Poshan Kendra, Jam Khambhalia, Devbhumi Dwarka District of Gujarat. A longitudinal study was conducted among SAM children admitted at he Niramay BalMethod: t Poshan Kendra (Public Private Partnership model under Bal Poshan Yojana) which is a day care center providing treatment to SAM children for 14 days according to the protocol of NRC (Nutrition Rehabilitation Centre). Under Bal Poshan Yojana, RBSK medical officers screen children for SAM and refer them for treatment at empanelled NGO/Private institution. Total 1557 under five children were screened by them between 6 September 2021 and 5 February 2022. Out of them 121 SAM children were identified, 95th th children could be mobilized at the study site (Niramay Bal Poshan Kendra). Out of 95 children, 76 SAM children completed the treatment along with all three follow up at the study site. The data of these 76 Children was analyzed. Among 76 children, average weight gain was 566 grams at the time ofResults: discharge and 1000 grams at the time of third follow-up. An average weight gain for the cohort is 5.2 gram/kg/day. At the end of treatment, 92% children moved out of the SAM category at the completion of three follow-up, 55% moved to Moderate Acute Malnutrition and 37% to normal weight category. Conclusion: An average weight gain among the study population was satisfactory. Day care treatment model provides advantage of improved treatment completion rate and higher follow-up com

Kidney health for all: bridging the gap in kidney health education and literacy / Saúde dos rins para todos: preenchendo a lacuna de educação e conhecimento sobre a saúde renal

Abstract The high burden of kidney disease, global disparities in kidney care, and the poor outcomes of kidney failure place a growing burden on affected individuals and their families, caregivers, and the community at large. Health literacy is the degree to which individuals and organizations have, or equitably enable individuals to have, the ability to find, understand, and use information and services to make informed health-related decisions and actions for themselves and others. Rather than viewing health literacy as a patient deficit, improving health literacy lies primarily with health care providers communicating and educating effectively in codesigned partnership with those with kidney disease. For kidney policy makers, health literacy is a prerequisite for organizations to transition to a culture that places the person at the center of health care. The growing capability of and access to technology provides new opportunities to enhance education and awareness of kidney disease for all stakeholders. Advances in telecommunication, including social media platforms, can be leveraged to enhance persons' and providers' education. The World Kidney Day declares 2022 as the year of "Kidney Health for All" to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney organizations should work toward shifting the patient-deficit health literacy narrative to that of being the responsibility of health care providers and health policy makers. By engaging in and supporting kidney health-centered policy making, community health planning, and health literacy approaches for all, the kidney communities strive to prevent kidney diseases and enable living well with kidney disease.

Resumo A elevada carga da doença renal, disparidades globais no cuidado renal e desfechos ruins da insuficiência renal impõem uma sobrecarga crescente aos indivíduos afetados e suas famílias, cuidadores e a própria comunidade geral. Educação em saúde é o grau em que indivíduos e organizações têm, ou que igualmente permitem que indivíduos tenham, capacidade de encontrar, compreender e utilizar informações e serviços para tomar decisões e ações conscientes relacionadas à saúde para si e outros. Mais do que enxergar educação em saúde como um problema dos pacientes, a melhoria dessa educação depende principalmente da comunicação e educação efetiva dos profissionais em parceria com aqueles que apresentam doença renal. Para formuladores de políticas renais, educação em saúde é pré-requisito para que organizações migrem para uma cultura que coloque a pessoa no centro dos cuidados. A crescente capacidade e acesso à tecnologia oferecem novas oportunidades para melhorar educação e conscientização sobre doença renal para todas as partes interessadas. Avanços nas telecomunicações, incluindo redes sociais, podem ajudar a melhorar a educação de pessoas e provedores. O Dia Mundial do Rim declara 2022 como o ano da "Saúde dos Rins para Todos" promovendo trabalho em equipe global no avanço de estratégias para preencher a lacuna na educação e conhecimento em saúde renal. Organizações renais devem trabalhar para mudar a narrativa da educação em saúde como um problema de pacientes, para sendo responsabilidade dos profissionais e formuladores de políticas. Ao engajar-se e apoiar formulação de políticas centradas na saúde renal, planejamento de saúde comunitária e abordagens de educação em saúde para todos, comunidades renais esforçam-se para prevenir doenças renais e permitir viver bem com elas.

A case of transient ischemic attack during acupuncture therapy / 全日本鍼灸学会雑誌

[Objective] We report a case in which we unexpectedly encountered a patient with a transient ischemic attack (TIA) caused by severe stenosis of the left middle cerebral artery (MCA) during the course of acupuncture treatment.Patient: A 79-year-old man suffered from bilateral shoulder pain. He was diagnosed with a frozen shoulder at the orthopedic department and was referred to the acupuncture department.[Results] During the course of acupuncture treatment, the subject occasionally exhibited subtle behavioral features, such as difficulty in speech, holding incoherent conversations, and forgetting where he put things. The symptoms were observed repeatedly during treatment, so the acupuncturist referred the patient to the neurosurgical department for a consultation. Magnetic resonance imaging (MRI) of the brain showed an old cerebral infarction in the watershed area in the left paraventricular region, and MR angiography (MRA) revealed left middle cerebral artery stenosis. Single photon emission computed tomography showed decreased blood flow in the left MCA area. The symptoms could be considered TIA with motor and sensory aphasia. The administration of aspirin was started, and the symptoms disappeared.[Discussion and Conclusion] The acupuncturist has more opportunities to obtain information about the patient due to the longer time spent in acupuncture therapy compared to general outpatient treatment. Acupuncture can play an important role in medical partnership. It is also important that the acupuncturist has sufficient medical knowledge.

Parceria público-privada na gestão hospitalar no Sistema Único de Saúde da Bahia, Brasil / Public-private partnerships in hospital administration in the Brazilian Unified National Health System in Bahia State, Brazil / Colaboración público-privada en la gestión hospitalaria en el Sistema Único de Salud de Bahía, Brasil

Resumo: O processo de construção do Sistema Único de Saúde (SUS) tem sido, desde o início, espaço de disputa entre as forças políticas que defendem a ampliação da participação do setor privado na assistência e gestão dos serviços, e os defensores do fortalecimento da gestão pública. No contexto do subfinanciamento do SUS, associado às restrições impostas pela Lei de Responsabilidade Fiscal, novos modelos de gestão têm sido adotados, especialmente na área de gestão hospitalar, a exemplo da parceria público-privada (PPP). Considerando a relevância de investigar os processos de decisão relativos à adoção desses modelos pelas Secretarias Estaduais de Saúde, este trabalho tem por objetivo analisar os processos de tomada de decisão e incorporação desse modelo de gestão hospitalar no Estado da Bahia, Brasil, primeira concessão administrativa no setor de saúde do Brasil. Trata-se de um estudo de caso que tomou como referencial teórico a teoria do jogo social, elaborada por Carlos Matus, articulada ao modelo analítico do Ciclo de Políticas Públicas. Os dados foram produzidos a partir de pesquisa documental e entrevistas semiestruturadas com informantes-chave que participaram dos momentos de pré-decisão e decisão acerca do modelo PPP. O artigo apresenta o jogo político em torno da escolha dessa alternativa entre outros modelos para gestão hospitalar, além de debater vantagens e desvantagens dos modelos segundo atores-chave entrevistados, e conclui que determinantes não apenas financeiros, mas também políticos e ideológicos marcaram o processo de decisão pelo modelo PPP na Bahia, que teve como fomentador e consultor o braço direito do Banco Mundial, a Corporação Financeira Internacional.

Abstract: The process of building Brazil´s Unified Health System has always been a space of dispute between the political forces that defend greater private sector participation in patient care and administration of services and those who defend strengthening public administration. In the context of underfinancing of the Brazilian Unified National Health System (SUS), associated with the restrictions imposed by the so-called Fiscal Responsibility Law, new management models have been adopted in hospital administration, including public-private partnerships (PPPs). Considering the relevance of investigating decision-making processes pertaining to the adoption of these models by State Health Departments, this study aims to analyze the decision-making processes and incorporation of this hospital administration model in the State of Bahia, Brazil, the first administrative concession in Brazil´s health sector. This is a case study in which the theoretical reference was Social Game Theory elaborated by Carlos Matus, linked to the Public Policy Cycle analytical model. The data were produced with document research and semi-structured interviews with key informants who participated in the pre-decision and decision-making stages of the PPP model. The article presents the political game involved in the choice of this alternative among other hospital administration models, besides debating the models´ advantages and disadvantages according to the key actors and concludes that determinants (not only financial, but also political and ideological) marked the decision-making process for the PPP model in Bahia, in which the driving factor and source of consultancy was the International Finance Corporation, an arm of the World Bank.

Resumen: El proceso de construcción del Sistema Único de Salud ha sido, desde el comienzo, un espacio de disputa entre las fuerzas políticas que defienden la ampliación de la participación del sector privado en la asistencia y gestión de los servicios, y los defensores del fortalecimiento de la gestión pública. En el contexto de la subfinanciación del SUS, asociado a las restricciones impuestas por la Ley de responsabilidad fiscal, se han adoptado nuevos modelos de gestión, especialmente en el área de gestión hospitalaria, como por ejemplo la colaboración público-privada (PPP por sus siglas en portugués). Considerando la relevancia de investigar los procesos de decisión, relativos a la adopción de esos modelos por parte de las Secretarías Estatales de Salud, este trabajo tiene como objetivo analizar los procesos de toma de decisión e incorporación de este modelo de gestión hospitalaria en el Estado de Bahía, Brasil, primera concesión administrativa en el sector de salud de Brasil. Se trata de un estudio de caso, que tomó como marco de referencia teórico la Teoría de Juego Social, elaborada por Carlos Matus, coordinada con el modelo analítico del Ciclo de Políticas Públicas. Los datos fueron producidos a partir de una investigación documental y entrevistas semiestructuradas con informantes-clave que participaron en los momentos de pre-decisión y decisión acerca del modelo PPP. El artículo presenta el juego político en torno de la elección de esa alternativa entre otros modelos para gestión hospitalaria, además de debatir ventajas y desventajas de los modelos, según actores-claves entrevistados, y concluye que determinantes no solo financieros, sino políticos e ideológicos marcaron el proceso de decisión del modelo PPP en Bahía, que tuvo como fomentador y consultor al brazo derecho del Banco Mundial, la Corporación Financiera Internacional.

Assessment of public hospital drug supply financing through the public-private partnership: pharmacists' perspectives

In Nigeria, drug financing by the public has been challenged by financial constraints through public fund due to a limited fund available to the government to meet all its demands. The objectives of this study were to determine the variability of the hospital patient prices of same drugs under the PublicPrivate Partnership (PPP) and in Private Retail Community Pharmacy (PRCP), and to investigate the perceived efficiency and effectiveness of the PPP by comparing it with the Drug Revolving Fund (DRF) model in drug supply financing. This study was conducted in Nigeria utilizing a mixed method. Mann-Whitney U test analysis was used to compare the median drug price of the two facilities. The majority (76.19%) of the drugs were sold at a cheaper rate in the hospital than what was obtained in the PRCP with no significance difference (p > 0.05). Dominant responses from the focused group discussions supported the PPP model. This study shows that the median patient price of the basket of matched pairs of same drugs in the hospital under the PPP and in the PRCP was identical. Overall, the participants were of the opinion that the PPP model was more efficient and effective than DRFin the financing drug supply

A plateform for management of atrial fibrillation based on internet and medical concortium / 中华全科医师杂志

In order to provide efficient medical care to atrial fibrillation patients in the community, the Huamu Community Health Service Center in association with its medical consortium, Renji Hospital have developed a novel atrial fibrillation management system. With the collaboration of general practitioners and specialist team from the tertiary hospital, a special clinic for atrial fibrillation has been set up in the community health service center, which is based on the internet technology and the medical consortium platform. This article introduces the development of this novel system and the initial outcome of the measures, to provide a reference for the management of atrial fibrillation patients in the community.

A Longitudinal Faculty Development Program Nurturing Leaders in Residency Education in Okinawa / 医学教育

The Hawaii-Okinawa Medical Education Fellowship is a longitudinal FD program developed and administered by the John A. Burns School of Medicine at the University of Hawaii and Okinawa Prefecture to train young clinical teachers who will play a central role in residency education. The program also supports the building of networks among clinical teachers. Each year, around six participants learn the skills required of clinical teachers through monthly seminar participation and a year-round curriculum development project. To date, about 60 physicians have completed the fellowship, and many of them are active as clinical teachers at medical institutions in Okinawa. The community of practice consisting of the graduates of this fellowship is gradually expanding. It is expected to contribute more and more to the enhancement of clinical education in Okinawa.

Construction and Effect of Partnership Model of Rehabilitation for Patients with COVID-2019 in Critical Wards Using International Health Classifications Framework / 中国康复理论与实践

Objective:To construct a teamwork model, Partnership Rehabilitation Therapy (PRT), for therapists in critical wards for patients with Corona Virus Disease 2019 (COVID-19), and observe its effect. Methods:PRT had been developed, in which one therapist (main) implementing therapy and another (assistant) monitoring and supporting in the treatment. Eleven COVID-19 patients from infectious critical ward were treated with PRT. The behavior safety of therapists was recorded during the treatment, and the patients were assessed with Borg Index, Cough Score, Miller Sputum Grading and World Health Organization Disability Assessment Schedule (WHODAS) 2.0 before and after treatment. Results:No physiotherapist was infected by COVID-19. Seven times of infection risks were recorded and avoided, and six times of treatment risks were corrected instantly. All the patients improved in Borg Index (P < 0.01), Cough Score (P < 0.05), Miller Sputum Grading (P = 0.02) and WHODAS 2.0 (P < 0.01) after a 1-week physical therapy. Conclusion:Based on the Family International Classifications, a teamwork model is established, which provides a safe and practicable way for rehabilitation for COVID-19 patients in critical wards.

Fostering partnerships between the academe-government and community in the COVID-19 pandemic response in the Philippines

@#This paper describes the COVID-19 response efforts through strategic partnerships of a nursing school in the Philippines. The roles of the academe through teaching as well as continuing education and community extension services programs were particularly harnessed. Existing academe-government-community partnerships were leveraged, and personal networks mobilized to provide support on risk communication, community engagement, and capacity building. Challenges and limitations encountered serve as points for improving the academe's strategies and activities. The lessons from this undertaking highlight the crucial role of nursing schools as relevant resources in COVID-19 pandemic response initiatives. Partnerships and networks built prior to the pandemic are instrumental in providing the space and opportunities for faculty and student nurses to aid in strengthening the local response. Recommendations are outlined to enhance current roles, strategies, and activities of the academe in the COVID-19 pandemic and lay future directions for Philippine nursing schools given the increasing incidence and severity of disasters in the country.

A relação público-privado e a gestão do trabalho nas fundações estatais de saúde / The public-private relationship and the management of work in state health foundations / La relación público-privado y la gestión del trabajo en las fundaciones estatales de salud

Resumo As discussões sobre a relação público-privado atentam para a necessidade de imprimir à gestão pública maior autonomia, agilidade e flexibilidade gerenciais e administrativas em setores estratégicos do sistema de saúde. A pesquisa qualitativa que deu origem a este artigo objetivou analisar a gestão do trabalho na Fundação Estatal de Saúde da Família da Bahia e na Fundação Estadual de Saúde de Sergipe, usando técnica de triangulação de dados e análise hermenêutica-dialética. Participaram gestores, trabalhadores e usuários dos dois estados, totalizando vinte entrevistas semiestruturadas. Os fatores contextuais e os atores foram analisados utilizando-se um modelo que enfatizou as dimensões do macro e do microcontexto. O desempenho satisfatório relativo à gestão do trabalho pode ser atribuído à variedade e complexidade de fatores enfrentados pela administração direta. A inter-relação do microcontexto com subdimensões do macrocontexto contribuiu favoravelmente para a implementação das fundações. Como contribuição aos gestores, construiu-se um quadro contendo indicadores para o monitoramento das atribuições da gestão do trabalho nas fundações estatais. Os resultados e potencialidades dessas experiências podem auxiliar no enfrentamento dos desafios à gestão em saúde, dotando-a de maior efetividade, celeridade e resolubilidade na atenção à saúde e na gestão do trabalho no Sistema Único de Saúde.

Abstract The discussions on the public-private relationship highlight the need to provide public management with more managerial and administrative autonomy, agility and flexibility in strategic sectors of the health care system. The qualitative research that was the origin of the present article had the aim of analyzing the work management at the State-Owned Family Health Foundation of Bahia (Fundação Estatal de Saúde da Família da Bahia, in Portuguese) and at the State Health Foundation of Sergipe (Fundação Estadual de Saúde de Sergipe, in Portuguese), using the technique of data triangulation and hermeneutic-dialectical analysis. Managers, workers and users from both states took part in the study, totaling twenty semi-structured interviews. The contextual factors and the actors were analyzed using a model that emphasized the dimensions of the macro- and microcontexts. The satisfactory performance regarding work management may be attributed to the variety and complexity of the factors faced by the direct administration. The interrelationship of the microcontext with subdimensions of the macrocontext contributed favorably to the implementation of the foundations. As contributions to the managers, we developed a table containing indicators for the monitoring of the attributions of the work management at the state-owned foundations. The results and potentialities of these experiences may help face the challenges to management in health, providing it with more efficacy, speed and solvability in health care and work management in the Brazilian Unified Health System.

Resumen Las discusiones sobre la relación público-privado enfatizan la necesidad de imprimir a la gestión pública más autonomía, agilidad y flexibilidad gerenciales y administrativas en sectores estratégicos del sistema de salud. La pesquisa cualitativa que dio origen a este artículo tuvo el objetivo de analizar la gestión del trabajo en la Fundación Estatal de Salud de la Familia de Bahia (Fundação Estatal de Saúde da Família da Bahia, en portugués) y en la Fundación Provincial de Salud de Sergipe (Fundação Estadual de Saúde de Sergipe, en portugués), usando la técnica de triangulación de datos y análisis hermenéutica-dialéctica. Participaron gestores, trabajadores y usuarios de los dos estados, totalizando veinte entrevistas semiestructuradas. Los factores contextuales y los actores han sido analizados utilizando un modelo que enfatizó las dimensiones del macro y del microcontexto. El desempeño satisfactorio relativo a la gestión del trabajo se puede atribuir a la variedad y complejidad de factores enfrentados por la administración directa. La interrelación del microcontexto con subdimensiones del macrocontexto contribuyó favorablemente para la implementación de las fundaciones. Como contribución a los gestores, se construyó un cuadro conteniendo indicadores para el monitoreo de las atribuciones da gestión del trabajo en las fundaciones estatales. Los resultados y potencialidades de esas experiencias pueden ayudar en el enfrentamiento de los desafíos a la gestión en salud, dotándola de más efectividad, celeridad y resolubilidad en la atención a la salud y en la gestión del trabajo en el Sistema Único de Salud de Brasil.

Experts' perspectives on the application of public-private partnership policy in prevention of road traffic injuries / 中华创伤杂志(英文版)

PURPOSE@#Successful application experiences on public-private partnership (PPP) in different countries, suggest that PPP could be an option in road traffic injury (RTI) prevention. The present study aims at investigating the applicability of PPP policy in RTI prevention in Iran based on the experts' perspectives.@*METHODS@#This is a qualitative study with grounded theory approach which has been conducted in Tabriz University of Medical Sciences, Iran in 2018. The participants were 22 experts in the field of RTIs selected using purposive sampling method. Data were collected by semi-structured interviews and analyzed with content-analysis method.@*RESULTS@#The results were classified under 5 main themes (applicability, scopes and services, challenges, advantages, and strategies) for applying PPP policy and 37 sub-themes. Due to the prevalence of RTIs, the present challenges in public sector, existence of qualified private sector, and successful experiences in other areas, there are opportunities for private sector partnership in prevention of RTIs. Private sector could participate in different scopes and services regarding RTI prevention, including road construction and maintenance, maintenance and provision of vehicles safety and public education. The main challenges including legislation issues, ambiguities in collaboration, political and organizational unsustainability, government's financial hardship and lack of experienced experts in the field of RTI. However, there are significant advantages including high efficiency in program implementation, covering the weaknesses of public sector, effective and efficient management on application of PPP in RTI prevention. The strategies include identifying and prioritizing the assignable activities, identifying the qualified private sector, developing PPP policies and legal frameworks, creating a common language between public and private parties, trying to meet the expectations of the private sector by public sector, developing a comprehensive and sound contract, and cultivating public culture to accept private sector in the field of RTI prevention.@*CONCLUSION@#This study sought to determine whether PPP could be used as strategy to reduce the burden of RTIs in Iran. But it requires a lot of preliminary studies to provide the context and conditions for applying this policy.

Accelerating research evidence translation through dyadic engagement: A developing model for evidence-based practice implementation

@#Evidence-based practice (EBP) has been regarded as the gold standard of clinical practice in the health profession. However, even though the importance of EBP is well documented in the nursing literature, in developing countries, its implementation remains a challenge. In addition to individual and organizational barriers to EBP implementation, the existence of the academician-clinician divide is a critical concern. This seeming disconnect has significantly hampered the translation of knowledge into practice. Hence, collaborative dyadic engagements between the academician and clinicians have to be nurtured. The Accelerating Research evidence translation through Dyadic Engagement (ARDE) Model, a pragmatic way of facilitating the enculturation of EBP, is proposed and collaborative efforts in solving clinically relevant nursing issues will pave the way for EBP to become an integral part of clinical practice.

Knowledge, attitude and practice among private medical professionals enrolled in public private partnership program for prevention of mother to child transmission of human immunodeficiency virus in three districts of Karnataka

Background: Human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS), is one of the world’s most serious public health challenges. Nearly all young children newly infected with HIV are infected through mother-to-child transmission. Only about half of the HIV infected mothers received ART and quarter of the babies born through HIV infected mothers receive ARV prophylaxis. This low coverage due to a high proportion of women delivering in private health facilities. Lack of policy for the private sector, inadequate knowledge and fear of occupational exposure are some barriers.Methods: A cross sectional study conducted among private practitioners enrolled in parent to child transmission (PPTCT) program in three districts of Karnataka. 175 obstetricians and pediatricians engaged in giving care to HIV infected mother and children were selected randomly and were interviewed using a pre tested semi structured questionnaire and the scores were graded.Results: Mean age of the participants was 38.95 years with SD of 9.12 years. The mean years of experience was found to be 14.36 years with SD of 6.45 years. The knowledge was average scoring 66.56%. The attitude and practice were 69.21% and 64.21% respectively. The mean score for KAP was 28.89 (9.56) out of 43 questions. There was significant association between age of the participants, specialization and years of experience with scoring.Conclusions: The knowledge, attitude and practice among private practitioners were average. To enhance the coverage of PMTCT, there is a need for strengthening private sector with strong political will thus reducing morbidity and mortality of the disease.

An Assessment of Home-Based Newborn Care Plus Innovation in Six districts of Rajasthan: A Cross Sectional Comparative Analysis

Background: To improve coverage of key child health community practices, Home Based Infant Care (HBNC+) was implemented with support of Norway India Partnership Initiative (NIPI) in 4 States of Rajasthan, Madhya Pradesh, Bihar and Odisha. The innovation aimed at improving coverage of key child health interventions through home visits by community health worker, Accredited Social Health Activist (ASHA). Aims & Objective: This paper elucidates the results from the assessment of implementation in intervention versus control districts of Rajasthan. Material & Methods: A cross-sectional intervention-control design with a sample size of 3211 mothers of children in age group 0 to 23 months was adopted. Results: 85 percent of the children (aged 3-23 months) received at least one infant care home visit in the intervention districts in comparison to 32 percent in control. Significant improvements were found in terms of exclusive breastfeeding, weighing and Iron Folic Acid (IFA) consumption and availability of ORS and Iron Syrup in intervention districts. 15 percent additional children had weight plotted in growth charts and 24 percent more consumed IFA syrup bi-weekly in intervention districts. Conclusion: Home visits in infancy is a scalable model and can lead to improvement of community child health practices.

A glance on public private partnership: an opportunity for developing nations to achieve universal health coverage

The government of India has joined hands with the rest of the world aiming at universal health coverage (UHC) and has set the target for 2022. The huge population, the difficult land terrain, unequal distribution of health care system, socio-economic and cultural factors are posing serious challenges. Public private partnership (PPP) even though not exactly a novel concept, some innovations can tackle these challenges to an extent and give us a smooth track towards UHC. In the past, PPP models were utilized to some extent for development and refurbishment of health infrastructure. But expanding the partnership between the two sectors to human resource, service delivery and financial management with supervision and monitoring by the government may bring out the needed significant difference.