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Providing medical support to the local population during a chronic crisis is difficult. The crisis in the Democratic Republic of the Congo (DRC), which is characterized by high excess mortality, ongoing armed violence, mass forced displacement, interference by neighboring countries, resource exploitation, asset stripping, and the virtual absence of the state, has led to great poverty and a dearth of funds for the support of the health system. International nongovernmental organizations (NGOs) have stepped in to address the dire humanitarian situation. This study looks at four organizations that support local health care in the eastern DRC: the International Rescue Committee (IRC), Malteser, Medical Emergency Relief International (Merlin), and the Association Régionale d'Approvisionnement en Médicaments Essentiels (ASRAMES). The study makes a comparison of the management and financing approaches of these four organizations by collecting and comparing qualitative and quantitative data on their interaction with the (remaining) local health providers and the local population. Specific objectives of the study are: 1. To identify which management and financing approaches, including the setting of fees, are used by the four NGOs supporting healthcare in the eastern DRC. 2. To determine how these financing approaches affect utilization rates in the health zones supported by the four NGOs. 3. To assess how these utilization rates compare with donor and humanitarian standards. 4. To determine at what level fees must be set to allow for cost recovery or cost sharing in health facilities. 5. To identify the managerial problems confronting the four NGOs. Many epidemiological and public health studies focus on the interaction between health providers and target groups. Supporting Local Health Care in a Chronic Crisis: Management and Financing Approaches in the Eastern Democratic Republic of the Congo concentrates more on how the relationship between the supporting NGOs and the local health system actually develops. In addition, a common aspect of many of the epidemiological and public health studies is the search for an optimal, or at least appropriate, management and financing approach.
Psychological Crisis Intervention: The SAFER-R Model is designed to provide the reader with a simple set of guidelines for the provision of psychological first aid (PFA). The model of psychological first aid (PFA) for individuals presented in this volume is the SAFER-R model developed by the authors. Arguably it is the most widely used tactical model of crisis intervention in the world with roughly 1 million individuals trained in its operational and derivative guidelines. This model of PFA is not a therapy model nor a substitute for therapy. Rather it is designed to help crisis interventionists stabile and mitigate acute crisis reactions in individuals, as opposed to groups. Guidelines for triage and referrals are also provided. Before plunging into the step-by-step guidelines, a brief history and terminological framework is provided. Lastly, recommendations for addressing specific psychological challenges (suicidal ideation, resistance to seeking professional psychological support, and depression) are provided.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.
The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Humanitarianism as a moral concept and an organized practice has become a major factor in world society. It channels an enormous amount of resources and serves as an argument for different kinds of interference into the "internal affairs" of countries and regions. At the same time, and for these very reasons, it is an ideal testing ground for successful and unsuccessful cooperation across borders. Humanitarianism and the Challenges of Cooperation examines the multiple humanitarianisms of today as a testing ground for new ways of global cooperation. General trends in the contemporary transformation of humanitarianism are studied and individual cases of how humanitarian actors cooperate with others on the ground are investigated. This book offers a highly innovative, empirically informed account of global humanitarianism from the point of view of cooperation research in which internationally renowned contributors analyse broad trends and present case studies based on meticulous fieldwork. This book will be of great interest to students and researchers in the areas of political science, international relations and humanitarianism. It is also a valuable resource for humanitarian aid workers.
With this book, Siegel, an internationally known demographer and gerontologist, has made a unique contribution to the fledgling fields of health demography, and the demography and epidemiology of aging. The book represents a felicitous union of epidemiology, gerontology, and demography, and appears to be the first and only comprehensive text on this subject now available. Drawing on a wide range of sciences in addition to demography, gerontology, and epidemiology, including medical sociology, biostatistics, public policy, bioethics, and molecular biology, the author treats theoretical and applied issues, links methods and findings, covers the material internationally, nationally, and locally, and while focusing on the elderly, treats the entire life course. The methods, materials, and pespectives of demography and epidemiology are brought to bear on such topics as the prospects for future increases in human longevity, the relative contribution of life style, environment, genetics, and chance in human longevity, the measurement of the share of healthy years in total life expectancy, the role of population growth in the rising costs of health care, and the applications of health demography in serving the health needs of local communities. The separate chapters systematically develop the topics of the sources and quality of health data; mortality, life tables, and the measurement of health status; the interrelationships of health, on the one hand, and mortality, fertility, migration, and age structure, on the other; health conditions in the less developed countries; the concepts and theories of aging and projections of the aged population; and local health applications, public health policy, and bioethical issues in health demography. Given its comprehensiveness, clarity, interdisciplinary scope, and authencity, this book appeals to a wide range of users, from students and teachers of medical sociology, the demography of aging, and public health studies to practitioners in these areas, both as a text in health demography and the demography/epidemiology of aging, and as a reference work in these fields.
International responses to the outbreak of SARS, the spread of HIV/AIDS, and the promotion of health as a human right all demonstrate how global politics have a profound effect on the way we think about and respond to major health challenges. Despite a growing interest in the relationship between health and international relations there has yet to be a systematic study of the links between them. Global Politics of Health aims to fill this gap - ultimately showing how world politics can be good, or bad, for your health. This book calls for a more nuanced understanding of the nature of the current global health crisis and the political dilemmas faced by those responsible for the development and implementation of responses to it. By charting these debates and showing how they shape the way actors think about key issues relating to health, such as people movement, infectious disease, the business of health, and the consequences of war, this volume provides an innovative and comprehensive introduction to health and international relations for students of global politics, health studies and related disciplines.
Globally, over 25 million people are displaced within their own countries by conflicts or human rights violations. In Kenya, thousands of families are increasingly being displaced by the effect of inter-ethnic violence, environmental disasters and forced government eviction from forest reserves. The majority of these displaced communities end up squatting in informal settlements in the nearby urban centres or at the fringes of the forest zone where they are exposed to extreme poverty and deprivation. Since almost all the displaced families originate from the rural areas, the act of displacement shatters the family-based rural economy when they seek refuge in towns. Internally displaced children face many risks due to the violence and uncertainty surrounding both their familyis flight and their life in the place of refuge. This report discusses the findings of the Child Exclusion Survey conducted among the internally displaced in Rift Valley and Nyanza provinces between January 2007 and August 2007. The main objective of the study was to examine the extent of child exclusion among IDPs in Kenya in relation to attaining the ideals of the 1989 Convention on the Rights of the Child and the Millennium Development Goals."