Context: 72% of deaths in the Dominican Republic result from noncommunicable diseases, mainly cardiovascular diseases, with prevalent risk factors including hypertension, overweight, and obesity. These factors relate to excessive intake of critical nutrients like sodium and fats, recommended for monitoring by the Pan American Health Organization. Updated statistics on sodium and fat consumption in the Dominican Republic are unavailable.

Methods: Exploratory data was collected during the Second National Hypertension Awareness Event (SODHIP 2022), hosted by the Ministry of Public Health across multiple operational points nationwide. Variables analyzed included knowledge, attitudes, and practices regarding sodium intake, as well as fat consumption patterns. A total of 18,742 surveyed adults were included in the analysis.

Results: 89% of participants identified hypertension as a potential consequence of high-sodium diets. 91% perceived excessive sodium intake leading to severe health problems, while 77% deemed reducing salt intake “very important”. Concerning sodium-related practices, 70% incorporate salt, ketchup, or soy sauce just before or after meal preparation more than occasionally. 42% always add salt during meal preparation, and 82% use bouillon cubes (sopitas) and powdered seasoning more than occasionally. 60% sometimes or often consume high-sodium foods like deli meat and bagged snacks. The majority use refined salt in meal preparation. The most common action to reduce salt consumption was limiting processed food intake (71%). Other actions, such as checking sodium content on labels or opting for low-sodium foods, were less common. Regarding fat use, 25% never add oils after meal preparation. 68% use canola and sunflower oil for cooking, while 23% use olive oil. The most common meal preparation method was stewing (48%).

Conclusion: The population has favorable knowledge and attitudes regarding excessive sodium intake implications. A gap exists between positive attitudes towards reducing sodium intake and actual practices. Implementing policies to create healthier food environments is suggested. There is an opportunity to promote olive oil consumption and emphasize culinary practices enhancing flavor without compromising health. Persistent long-term monitoring of sodium and fat consumption is essential.

Background: With the rapid growth of ageing population, the long-term care (LTC) workforce shortage is an increasingly concerning issue in China. The UN Decade of Healthy Ageing: Plan of Action 2021–2030 (2020), Global Strategy and Action Plan on Ageing and Health (2017), and WHO Toolkit for Developing a Multi-Sectoral Action Plan for Non-Communicable Diseases (2022) all emphasize the importance of the use of the multi-sectoral approach that requires strong engagement from diverse sectors (public, private and civil society organizations) and build up collaboration and coordination mechanisms to deliver responsive long-term care to the older people. In the last two decades, many policies have been issued across regions to accelerate the development of LTC workforce as well as encourage private and civil society sectors to engage in the workforce development. This review study aims to describe the current policy guidance on encouraging multisectoral collaboration in the LTC workforce development in China.

Methods: LTC workforce related policy documents issued since 2000 were searched and downloaded from 34 provincial government websites up to Jan 31, 2024. Key information was extracted and summarized.

Results: Seventy-two (of a total of 84) policy documents published since 2015 mentioned multisectoral engagement in LTC workforce development. Developed regions like Shanghai started encouraging multisectoral engagement since 2015 while less-developed regions like Guizhou published related policy until 2020. Current guidance emphasized the different sectors need to involve in the workforce development process with specific roles, including public sector providing financial support and official certifications, private sector mainly responsible for providing training services, and civil society organizations charging for improving professionalism.

Conclusion: there are increasing efforts to engage different sectors in LTC workforce development in China. However, significant disparities exist in policy and guidance development across different regions. Future policies need to provide more detailed guidance on building robust collaboration mechanisms and evaluating the accountability of different sectors.

Background:

“Collaborative practice happens when multiple health workers from different professional backgrounds work together with patients, families, carers, and communities to deliver the highest quality of care.” (WHO 2010). This can contribute to a healthy work environment and better patient outcomes. In Nepal healthcare professionals work in the same setting but collaborative practice is not implemented in the practice setting due to lack of training and understanding of how to practice this concept.

Objective:

The aim of this study is to describe the outcomes of the IPE and IPP workshops in terms of interprofessional competencies of employees and report of the reflection feedback and intent to utilize the knowledge in their practice.

Method:

Participants were separated into interprofessional groups. They were provided with a brief presentation of topics related to IPP including teamwork, collaboration, communication, and conflict resolution. These presentations were followed with group activities.

Participants completed a demographic survey and then a post workshop reflection to evaluate effectiveness of the training in terms of interprofessional competencies (communication, collaboration, conflict management, teamwork and respect for other HC professionals) along with intent of practitioners to utilize what was learned into their practice.

Demographic data were analyzed for frequencies. The qualitative data were collated, coded and analyzed for emerging themes using NVivo. Emergent themes were shared with administration for member checking.

Results:

Evaluations indicated that the workshop promoted effective interprofessional communication (38%), collaboration (26.8%), conflict management skills (16.2%), teamwork (10.3%), respect (5.8%), and an understanding of roles/responsibilities (2.9%). As a result of these workshops, participants were committed to returning to work and working collaboratively to enhance morale among colleagues with the goal of improving patient outcomes.

Conclusion/Implications for Practice:

The data indicate that participants were beginning to appreciate the importance of the different aspects of interprofessional collaboration. Workshops may help them to practice competently within high-functioning healthcare teams and patient centered care. The data also indicate a need for continued reinforcement of the concepts of IPP towards achieving a collaborative healthy work environment and improved patient outcomes. Recommendations include embedding IPE curriculum in future trainings for all hospital staff.

Context

In Ghana, there exists an overreliance among health promotion officers on instructional methodologies for influencing health behavior, stemming from a gap between their training and the demands of their role. In response, an innovative capacity-building initiative was devised to cultivate a foundational group of health promotion officers as Change Agents, dedicated to advocating for positive health behaviors.

Methods

The authors implemented a capacity-strengthening activity that combines practical action learning with taught technical inputs. Through highly interactive sessions augmented with case samples and informal sessions with representatives from the Creative Industry, Health Promotion Researchers, and Development Practitioners, participants are resourced and motivated to take up new opportunities as Change Agents. A complementary competitive small grant provides opportunities for the most innovative participants to put into practice newly acquired skills. Between April 2022 and March 2024, five cohorts of participants (100) have completed the training and are currently leading unique health behavior change activities in their respective districts.

Conclusion

Extensive hands-on practices on explanatory and change theories help health promotion officers better understand the underlying drivers of health behaviors, guiding them to intervene beyond didactic approaches. Knowledge transfer is facilitated when participants have opportunities to immediately put into practice newly acquired skills.

Key words: change agents, capacity strengthening, health promotion officers.

In 2016 the World Health Organization recognized Mycetoma as a neglected tropical disease (NTD). Mycetoma is a chronic, inflammatory disease caused by fungi or bacteria which enters the body through traumatic inoculation and causes tumour-like, granulomatous swellings in subcutaneous tissue. Later stages of the disease can involve bone tissue invasion, necessitating amputation. It affects mostly manual labourers, farmers, and shepherds, causing a high morbidity rate, socioeconomic consequences, and stigma. While researchers know that mycetoma is endemic in tropical and subtropical areas, the true burden of the disease is unknown due to lack of reporting mechanisms and laboratory diagnostic capacity. Additionally, structured mycetoma control and surveillance programs are absent in nearly all countries.

This project aims to utilize a pilot sentinel surveillance program nested within Ethiopia’s existing community health outreach priorities. Partners from the Federal Ministry of Health and Arba Minch University Collaborative Research and Training Center for NTDs (CRTC-NTDs) designated primary care clinics and hospitals as sentinel surveillance sites. They surveyed existing health management information systems (HMIS) in use for reportable skin NTDs, including scabies and lymphatic filariasis, at the community and national levels. Finally, they assessed existing skin NTD case detection and community sensitization efforts to determine the feasibility of integrating mycetoma interventions.

To support these surveillance efforts, our team created training modules for Healthcare Providers (HCPs) and Healthcare Extension Workers (HEWs) in selected facilities within the Southern Nations, Nationalities, and People’s Region (SNNPR). Laboratory personnel will receive training in laboratory processes, including sample collection and transportation. Matching training with capacity building will ensure correct diagnosis, and will support surveillance efforts that would lead to early identification and referral to treatment for patients. As accurate data collection is vital to the processes, HCPs and HEWs will be evaluated on participant learning and learning transfer, with pre- and post-tests measuring knowledge gained and the number of referrals and diagnoses compared. On the community level, population and KAP surveys will be conducted to assess awareness and knowledge.

This multifaceted project with concurrent training, surveillance, data collection, and specimen analysis supports a WHO-CDC collaboration to establish a true global burden of mycetoma.

Introduction: The COVID-19 pandemic has disrupted immunization activities in many countries, causing declines in the delivery of routine doses of antigens, and the postponement of scheduled supplemental immunization activities (SIAs). The disruptions to routine services and the postponement of the SIAs in Ethiopia have increased the risk for measles outbreaks. Based on WHO global guidance and consultation of secretariat of the national COVID 19 pandemic and control ministerial coordination committee, and stakeholders Ethiopia decided to conduct the campaign after 3 month delay with strict implementation of COVID prevention measures..

Objective: To mitigate the imminent threat of measles outbreaks and re-initiate the primary health care service implemented at community level by integrating preventive, curative services. To conduct also community level screening against COVID 19

Method: lesson documentation of process of decision making, planning, and implementation of Ethiopia follow up measles SIAs in the context of COVID 19 in July 2020. Review of reports, documentation of lessons made during the period.

Result: The SIAs reached 14.5 million children 9-59 month aged (97%) administrative coverage nationwide. Significant number of COVID 19 suspected cases screened, re-ignited the community level health extension program activates, community re-gain trust on the health service and seek other essential service during the campaign period.

Conclusion: The strong commitment of the leadership, the coordination role of the national and regional COVID prevention and control taskforces, the engagement of community leaders, the use of multi-channel communication, the timely availability of additional resources and modification of the service delivery approaches contributed to the success of the SIAs.

Background and Objectives

Health systems responsiveness (HSR) is the ability of systems to respond to legitimate non-health expectations of the population. The concept of HSR by WHO includes respect for dignity, individual autonomy, confidentiality, prompt attention to care, availability of basic amenities, choice of provider, access to social support networks and clarity of communication. The WHO tool is globally applied to assess HSR in low, middle, and high-income countries. We have revised the conceptual framework of HSR following a rigorous systematic review and made it specific for L&MICs. This study is designed to (a) run Delphi technique to validate the upgraded conceptual framework of HSR, (b) modify and upgrade the WHO measurement tool for assessing HSR in the context of L&MICs and (c) determine validity of the upgraded HSR measurement tool by pilot testing in Pakistan.

Methods

The survey (objective 3) follows a mixed method study design and will be carried out in primary, secondary and tertiary care hospitals of district Rawalpindi, Pakistan. Delphi technique will be run with global public health experts. The WHO measurement tool, modified after incorporating opinion of subject experts, will be used by the research team in concordance will the conceptual framework. The modified tool will be piloted and administered to 1,128 participants from primary, secondary and tertiary care hospitals of district Rawalpindi, Pakistan. HSR assessment will be substantiated by in-depth interviews with service providers, hospital managers and policymakers (supply side), community representatives (demand side); and observation at health facilities. The study will be carried out over 12 months from Feb 2024 and results presented in the conference.

Implications

This study will provide conceptual understanding of HSR and a corresponding measurement tool specific for L&MICs. It will contribute to global literature on health systems and provide a snapshot of HSR in district Rawalpindi, Pakistan, with concrete action points for policymakers.

The brain drain of well-educated and trained workers is a problem that faces many nations. The pandemic revealed the importance of being ready with all resources, especially the healthcare workers. There are studies showing the migration of many physicians from their home countries to more developed countries, searching for a better life. In Egypt, according to records of the Egyptian medical syndicate, half of the registered physicians in the syndicate are working abroad. In this study, we aimed to understand the relationship between individual satisfaction regarding work or family, his capability factors, and his intention to leave the country to work in another one. We targeted Egyptian physicians who were working in Egypt or outside Egypt and found their consideration to work abroad or return to their home country. The quantitative approach was used by a self-administered online questionnaire. The answers of 146 and 103 physicians who are living in Egypt and abroad respectively were analyzed. The results showed that 66.4% of physicians who are working in Egypt had the intention to leave. The factor that had the highest impact on their decision was work satisfaction, where the less satisfied physicians were 20 times more likely to leave. In addition, the participants with lower economic status were more willing to leave. Also, other factors that can be associated are gender, age, and being financially responsible. On the other hand, only 6.8% of Egyptian physicians who are living abroad were considering going back home and working there. The only factor that showed an association with their intention was their age, as more of the older participants had this intention. It is concluded that the high level of dissatisfaction among physicians with their work environment will lead to significant resource losses for other countries. Factors should be addressed, and intervention strategies are urgently needed for physicians retention in order to achieve Egypt’s Vision 2030 for health and economic growth.

In conflict-affected low- and middle-income countries, the prevalence of undernourishment is significantly higher, with households adopting coping strategies like consuming less nutritious food to mitigate the impact of food insecurity, as evidenced by lower dietary diversity and Food Consumption Score (FCS). This study utilized a serial cross-sectional design analyzing data from 2014, 2016, 2018, and 2020 to examine the impact of location on food consumption scores among Palestinians in Gaza and the West Bank, using a systematically random sampled dataset from the State of Palestine Central Bureau of Statistics. Multivariate linear regression analysis from 23,129 households revealed a median size decrease from 6 to 5 over time, with most household heads being married males with secondary education; about half identified as refugees and worked over 35 hours. Unacceptable food consumption scores increased from 0.8% in 2014 to 4% in 2020, indicating a growing food security issue. Sociodemographic factors in addition to household location were included in the adjusted regression model analysis. The findings underscore a significant and worsening issue of food insecurity in conflict-affected regions, specifically in the occupied Palestinian territories. The observed increase in unacceptable food consumption scores, highlights the exacerbating impact of prolonged conflict and occupation on food accessibility and dietary diversity. This study addresses the gap in research done in conflict-affected settings between geopolitical instability and food insecurity.

Background: Dengue is an arbovirus transmitted to humans by Aedes genus vectors, primarily in regions with tropical and subtropical climates. The increase in dengue cases is attributed to population and climate changes, making it a public health concern. The purpose of this study was to describe the epidemiological and clinical characteristics of patients with dengue in the Dominican Republic during 2023.

Methods: A descriptive, cross-sectional, and retrospective study was conducted with the population of patients from the Dominican Republic confirmed by positive serology for the Dengue Virus, registered in the National Epidemiological Surveillance System (SINAVE), from January to December 2023.

Results: A total of 3,107 confirmed cases of dengue were reported, of which 1,654 were males (53.2%) and 1,453 were females (46.8%). The most common age range was 10 to 19 years (44.5%). 45.7% of dengue cases were diagnosed as dengue without warning signs, 53.4% of cases had dengue with warning signs and 0.9% of patients had severe dengue. The most common symptoms were fever (98.2%) and headache (54.3%). The most frequent complication observed was respiratory difficulty (2.4%).

Conclusions: This study highlights the importance of dengue epidemiological surveillance in the Dominican Republic, as it is one of the countries in the region with a high prevalence of tropical diseases. Furthermore, the results underscore the necessity of multidisciplinary work to mitigate such vector-borne diseases.