Principles of Global Child Health: Education and Research最新文献

{"title":"Global Health Clinical Competencies","authors":"J. Domachowske, Anna M. Stewart-Ibarra, Elizabeth Domachowske, Elizabeth Asiago-Reddy","doi":"10.1542/9781610021906-part02-ch09","DOIUrl":"https://doi.org/10.1542/9781610021906-part02-ch09","url":null,"abstract":"The combined use of interprofessional models for research, education, administration, and clinical practice sets a framework for advancing public health. For the clinician, the pursuit of a career in global health often begins with a desire to establish or enhance patient care in countries or communities considered by many measures to be far less economically stable or technologically advanced than one’s own. Improving the treatment for or identifying novel strategies to prevent a specific disease motivates others. The successful development of the clinical aspects of a global health collaboration depends on adhering to the basic core principles of public health. Faculty practicing in settings outside of their home country need to develop, refine, and practice many of the skills acquired during training and through clinical practice experience but in the new context of understanding the unique aspects of clinical work in a new culture, usually with fewer or different resources than those to which they are accustomed. Competencies for global health faculty are grouped and discussed under 4 categories or domains: values and ethics, roles and responsibilities, communication, and team building and teamwork. Beyond these specific categories, additional special considerations merit discussion.","PeriodicalId":446186,"journal":{"name":"Principles of Global Child Health: Education and Research","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123924732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of Our Understanding of the Concept and Challenges of Global Health Research and Education","authors":"B. Stanton","doi":"10.1542/9781610021906-part01-ch02","DOIUrl":"https://doi.org/10.1542/9781610021906-part01-ch02","url":null,"abstract":"As our understanding of the interdependence of the world’s nations has evolved, greater attention and scrutiny have been focused on the goals of improved national and international health and the processes for achieving these outcomes. The rationales for action in support of health within a country, within a region, and across the globe have changed over the last half century, as has our understanding of the consequences of these approaches. This chapter reviews the evolution over the course of the 20th and 21st centuries of our understanding of international and global health and how this evolution has been reflected in and changed the training of the medical workforce. The chapter describes the emergence of multiple forces and agencies aligned toward the goal of a global perspective on health and well-being with resources and training reflective of this overarching vision. The chapter concludes with a discussion of the critical components of continued progress toward realization of global health, especially as they relate to evidence-based training and research and deployment of the global medical workforce.","PeriodicalId":446186,"journal":{"name":"Principles of Global Child Health: Education and Research","volume":"338 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115884624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing the Agenda for Global Child Health at the American Academy of Pediatrics","authors":"J. Klein, Errol Alden","doi":"10.1542/9781610021906-part04-ch21","DOIUrl":"https://doi.org/10.1542/9781610021906-part04-ch21","url":null,"abstract":"There are challenges in establishing guidelines for care and in implementing evidence-based recommendations and guidelines in many countries. This is a reflection of nationalistic approaches to governance and, more specifically, national choices governing the social strategies that are deemed acceptable to decision-makers. These challenges are not limited to low- and middle-income countries; within the United States and other high-income countries, individual state and community governmental jurisdictions can be resistant to new evidence or to examples of successes that work in neighboring governmental units.1 But despite these nationalistic tendencies, efforts to share successful models for pediatric education have helped spread innovation and quality improvements in care to many countries over the past several decades. This chapter reviews some of the factors that made this spread possible, including the rapid growth and institutionalization of global health training in US residency programs; addresses the future development of competencies and ethical standards within the current framework of the UN Sustainable Development Goals; and provides a perspective on the role of US pediatric associations in setting and supporting the agenda for global child and adolescent health research, practice, and education.","PeriodicalId":446186,"journal":{"name":"Principles of Global Child Health: Education and Research","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122631268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Simulation in Health Education Globally: A Review of the Neonatal Resuscitation Program and Helping Babies Breathe","authors":"B. Kamath-Rayne, Michael K. Visick, S. Berkelhamer","doi":"10.1542/9781610021906-part03-ch13","DOIUrl":"https://doi.org/10.1542/9781610021906-part03-ch13","url":null,"abstract":"In 2010, the Neonatal Resuscitation Program became the first life support resuscitation program to formally incorporate simulation- based training with debriefing as an educational methodology. Concurrently, a simplified simulation-based neonatal resuscitation program called Helping Babies Breathe (HBB) was created, with the goal of providing low-cost, portable programming to teach basic neonatal resuscitation to birth attendants in low- and middle-income countries. Early studies evaluating the efficacy of HBB demonstrated that facility- based implementation has the potential to reduce rates of early (<24 hour) neonatal mortality and stillbirth. Subsequent investigations that have coupled HBB training with quality improvement efforts, ongoing practice, and refresher training have shown even greater effect on neonatal mortality and stillbirth rates. However, the ideal frequency of skills practice and refresher training required to retain resuscitation skills remains poorly defined. Challenges exist in defining optimal practices, as recommendations may vary by the cadre of health care professional, education level, and access to ongoing delivery room experience.\u0000 While simulation-based strategies have been shown to be effective at improving educational and clinical outcomes, the use of simulation in global health settings is challenged by hurdles such as resource limitations (complex equipment, supply chain, and expense), time intensity, dependence on skilled educators, and acceptance of simulation as a teaching strategy.","PeriodicalId":446186,"journal":{"name":"Principles of Global Child Health: Education and Research","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122104999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implication of a Community-Based Participatory Research Model in a Behavioral Intervention Project in China","authors":"Xiaoming Li, S. Qiao","doi":"10.1542/9781610021906-part04-ch16","DOIUrl":"https://doi.org/10.1542/9781610021906-part04-ch16","url":null,"abstract":"Community-based participatory research (CBPR), as a research paradigm emphasizing principles of participation, action, and empowerment, has been widely applied in public health areas to address health needs of local communities and reduce health disparities across ethnic, geographic, socioeconomic, and cultural groups. In this chapter, we briefly introduce the core concepts and main components of the CBPR approach, review its theoretical roots, and highlight its significance in connecting academic scholars and local partners and bridging research and practice. We illustrate the concepts through an adapted CBPR theoretical model with a focus on 4 dimensions—contexts, group dynamics, intervention, and outcomes—considered in developing and implementing a CBPR intervention project. We conclude with a case study of a behavioral intervention project in China to demonstrate how to apply CBPR principles in the context of global health and make several recommendations based on experiences gained from this and other projects.","PeriodicalId":446186,"journal":{"name":"Principles of Global Child Health: Education and Research","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125610869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Health Administrative Competencies","authors":"C. O’Callahan","doi":"10.1542/9781610021906-part02-ch06","DOIUrl":"https://doi.org/10.1542/9781610021906-part02-ch06","url":null,"abstract":"This chapter addresses the knowledge, skills, attitudes, and qualities— the competencies—essential to operate effectively in an administrative role at various levels, from the faculty person to the professional association. These are organized under broad domains.1\u0000 This chapter discusses the operational or administrative attributes of key individuals, the larger entities in which they operate, and how they might demonstrate their competency—what they actually do—as a reflection of their knowledge, skills, and attitudes. Administrative competencies in global health might be manifest as the philosophical principles incorporated into their mission, the goals and objectives within their strategic plan, and the policies and managerial decisions they incorporate in their activities.\u0000 The entities with administrative duties discussed include global health faculty and program directors as well the larger entities of departmental and division structures, the entire health care or university system, and professional societies.\u0000 Competencies imply action, as opposed to simple statements reflecting knowledge or belief, and, thus, need to be measurable to have relevance. Defining basic global health-related competencies increases transparency and induces change toward the ideal. Clear and measurable competency parameters are consumer friendly; the potential undergraduate, resident, or faculty candidate will incorporate these measures into his or her decision-making process when looking for a position. Moreover, and of critical importance, those on the other end of our attentions—the sites to which we send our students, conduct our research, and expand our institutional reach—can monitor and compare how they fare in a particular partnership by comparing it to a transparent and recognized standard. Thus, benchmarking levels of administrative competency at the broader institutional level can be true to the values of partnership and set the stage for bidirectional interaction.","PeriodicalId":446186,"journal":{"name":"Principles of Global Child Health: Education and Research","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131402065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Advocacy Paradigm for Education: The Role of Persistence","authors":"Bron Anders","doi":"10.1542/9781610021906-part03-ch11","DOIUrl":"https://doi.org/10.1542/9781610021906-part03-ch11","url":null,"abstract":"Persistence may be defined as the quality that allows someone to continue doing something or trying to do something even though it is difficult or opposed by other people, or firm or obstinate continuation of advocacy despite difficulty.1 The first definition implies a long-term commitment to a program. It also implies seeing a project through and seeking opportunities to connect others when the time is right. The term “stickiness factor” from Malcom Gladwell’s book, The Tipping Point: How Little Things Can Make a Big Difference, has been brought into the global health discussion by Danielle Laraque-Arena, MD, FAAP, in her presidential speech at the 50th anniversary of the Academic Pediatric Association.2,3 The stickiness factor describes a desire to see programs through to sustainability with a more positive, fanciful lightness, not dogged determination like a bulldozer. As children and youth are given the tools to take ownership of their future with persistence and confidence, there may be no turning back.\u0000 The fierce determination of community health professionals to ensure adequate, reliable, culturally appropriate, and sustainable programs and policies has come, in part, in the United States from the growth of support for such programs from the American Academy of Pediatrics (AAP).\u0000 This chapter will briefly follow through the evolving trends and many key concepts as they helped to frame and guide the work of pediatricians and other health care professionals working with communities in the United States and overseas.\u0000 Several key concepts that helped to support this effort were taken up by the AAP, including the Convention on the Rights of the Child, child-friendly places, concepts of equity and social justice, the Community Access to Child Health program, asset-based community development, the Anne E. Dyson Child Advocacy Award, and the Community Pediatrics Training Initiative, along with the requirement that residents have experiences and opportunities outside the hospital to work with community-based organizations and to learn principals of public health and service learning. The need for persistence will be shown throughout. All these concepts translate easily to overseas work, as we will show with 4 examples. The shared vision of seeking educational successes for all children who can grow up with knowledge of their own languages and stories is taking root across all borders. We are seeing in various countries the importance of spending time with a parent, teacher, or mentor starting at birth surrounded with love and words. The emphasis on the home language spoken freely around the newborn may perhaps mitigate a world fraught with violence, prejudice, and addiction, both in the family and community and in the world at large.","PeriodicalId":446186,"journal":{"name":"Principles of Global Child Health: Education and Research","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122279788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive Strategies in Achieving Health for All Children: An Equity Framework and Its Effect on Research Design and Education","authors":"Renee Sharma, Jai K. Das, Z. Bhutta","doi":"10.1542/9781610021906-part01-ch03","DOIUrl":"https://doi.org/10.1542/9781610021906-part01-ch03","url":null,"abstract":"The United Nations Millennium Development Goals (MDGs) adopted by world leaders in 2000 aimed to address some of the most pressing global issues of our times: extreme poverty, unequal health, and inequities in development. The MDGs, a set of interrelated targets to be met by 2015, catalyzed political commitment toward improving child survival and maternal health. Millennium Development Goals 4 and 5 called for a two-thirds reduction in the younger-than-5 child mortality rate and a three-quarters reduction in the maternal mortality ratio, respectively, from 1990 base figures.1\u0000 Although concerted global efforts have led to substantial reductions in maternal and child mortality over the past 25 years, MDG 4 and 5 targets have not been fully realized. Only 62 of the 195 countries with available estimates achieved the MDG 4 target, of which 24 were low-income and lower-middle–income countries.2 Only 2 regions, East Asia and the Pacific (69% reduction) and Latin America and the Caribbean (67% reduction), met the target at a regional level.2 For MDG 5, of the 95 countries that had a maternal mortality ratio of more than 100 in 1990, only 9 achieved the target for reduction in maternal mortality: Bhutan, Cambodia, Cape Verde, Iran, Laos, Maldives, Mongolia, Rwanda, and Timor-Leste.3 As we celebrate the fact that the global younger-than-5 mortality rate and maternal mortality ratio have fallen by 53% and 43.9%, respectively, since 1990, we also face the sobering reality that high numbers of women and children are still dying every year, largely due to conditions that could have been prevented or treated if existing cost-effective interventions were universally available.2–4 The burden of mortality also remains unevenly distributed, with the largest numbers and highest rates of maternal and younger-than-5 deaths concentrated in countries of sub-Saharan Africa and South Asia, especially in lower-income countries and among fragile states, especially those with ongoing conflict.2,3,5\u0000 2015 marked the end of the MDG era and the beginning of a new global framework, the Sustainable Development Goals (SDGs). This new framework presents an opportunity to leverage the momentum built over recent decades to tackle global inequities in maternal and child health. Of these SDGs, goal 3 also calls for an end to preventable deaths of newborns and children younger than 5 years, as well as a reduction in maternal mortality to less than 70 per 100,000 live births, by 2030.6 Achieving this target would require overcoming barriers and inequities in access to quality health services and, thus, implementing strategies to reach all mothers and children, including those who are most vulnerable, remote, and at risk. In this chapter, we discuss the current burden of younger-than-5 and maternal mortality, barriers contributing to health inequities, and, finally, evidence-based strategies to bridge these gaps.","PeriodicalId":446186,"journal":{"name":"Principles of Global Child Health: Education and Research","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126857860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Purposeful and Mindful Leadership: An Educational Framework for Global Child Health","authors":"S. Ludwig, David G. Nichols","doi":"10.1542/9781610021906-part03-ch10","DOIUrl":"https://doi.org/10.1542/9781610021906-part03-ch10","url":null,"abstract":"Purposeful and mindful leadership for global health incorporates the same principles as any leadership endeavor. Purposeful leadership requires a core dedication to the organizational mission. There cannot be purposeful leadership without authenticity of purpose—a true desire to lead for a reason, not just leadership for the sake of leadership. Mindful leadership requires attention to the many nuances found in a particular setting, culture, and system of care or organizational structure. In global leadership, mindfulness is critical to securing success. All leadership requires the blend of the drive of purpose seasoned with the humility of mindfulness. In the United States, medical education has been shaped by the confluences of accreditation and certification. Accreditation refers to the standardization of training programs. Certification refers to the demonstrated competence of individuals to practice their profession. It is a system of checks and balances that does not exist in many other global settings but one that might serve as an effective framework for others. Central to any leadership position is the ability to promote change. In the context of global health leadership in education, change is not the replication of the US system but the preservation and adaptation of the concepts of programmatic and individual improvement efforts.","PeriodicalId":446186,"journal":{"name":"Principles of Global Child Health: Education and Research","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123380610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appendixes","authors":"","doi":"10.1542/9781610021906-appendixes","DOIUrl":"https://doi.org/10.1542/9781610021906-appendixes","url":null,"abstract":"","PeriodicalId":446186,"journal":{"name":"Principles of Global Child Health: Education and Research","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124448708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}