Day 2 :
Professor at Bristol universities in the UK as well as in French at INSERM in Paris.
Before Professor Macdonald came to Western Sydney University in 1996 he had taught Primary Health Care in Manchester and Bristol universities in the UK as well as in French at INSERM in Paris. He worked in Zambia for ten years, and has worked for shorter periods of time in many countries, such as Nicaragua, Chile, India, Pakistan, Bangladesh, Tanzania, Botswana, South Africa and Hong Kong. He has been on three occasions a consultant to the World Health Organisation in Geneva, most recently in January- February of 2016. He was a consultant to the Male Health Policy of Australia (2010). This work is represented in some of the publications listed below.
He is committed to the social determinants of health, applied also to men and boys. He is a leader of men’s health not only in Australia but overseas and has been an invited speaker on men’s health in many countries.
Globally there has been a growth in interest in men’s health in the past two decades. At the time of writing there are three countries with national male health policies: Ireland, Brazil and Australia. The thinking and research on men’s health can (of course in a necessarily oversimplified but nevertheless accurate manner) be seen to revolve around three themes which are to some extent reflected in these policies and other current work on men’s health. These themes are:
- Urological concerns: diseases of the prostate and erectile dysfunction. This strand has considerable support from the medical profession and the pharmaceutical industry
- Men’s behaviour: medical and health sociologists and health promotion professionals draw attention to men’s health threatening behaviour, often ascribed to “masculinity”, seen as a propensity to violence and competition and negative lifestyle choices like smoking and alcohol consumption
- The social determinants of health approach: this strand of thinking draws on the World Health Organization’s promotion of the social determinants of health (the enormous influence of life context on people’s health, like work, the social gradient and social support).
The presentation will overview these approaches to men’s health policies and suggest that the third one (social determinants) can include the other two while providing a way forward, globally, towards an evidence-based approach in the formulation of global men’s health policies.
- Primary Healthcare | Primary Care: Fitness and Wellness
Primary Health Care , Dubai Health authority
Background: Autism spectrum disorder (ASD) is a public health concern in Dubai, Autism is the most common of the Pervasive Developmental Disorders in Dubai .Autism poses a particularly large public health challenge and an inspiring lifelong challenge for many families; it is a lifelong challenge of a different nature, it is a spectrum of neurodevelopment disorder, which often results in an array of motor impairments. These motor impairments often lead to reduced performance in activities of daily living as well as in societal tasks which require specific motor abilities and skills objectives: To study the prevalence’s, determinants and prediction of Autism among Dubai population. To study some associated factors Methodology: Retrospective records review approach has been applied , qualitative methodology (focus groups with mental health experts working at: Al Jalila hospital (AJH), Dubai Autism Centre (DAC), Dubai Rehabilitation Centre for Disabilities, Latifa hospital, Private Sector Healthcare (PSH).) Quantitative methodology through, Prevalence, incidence estimates based on international research (a systematic research review) along with expert interviews has been applied as well. Results: The study showed that 84.9% of the cases were males and 51.9% of the autism cases were females ,30.9% were UAE nationals and 69.1% were expatriate , about 72.4% were diagnosed as Autisim spectrum disorders ,9.2% as ASD features and 9.2% were diagnosed as other disorders when autism diagnostic test applied Dubai Autism Centre estimates it affects 1 in 146 births (0.68%). By apply these estimates to the total number of births in Dubai for 2014, it is predicted there would be approximately 199 children (of which 58, (29.1%) were Nationals and 141, (70.9%) were Non–Nationals) suffering from autism at some stage. About 16.4% of children seek help for ASD assessment (through their families) between the age group 6–18+. It is critical to understand and address factors for seeking late–stage diagnosis, as ASD can be diagnosed much earlier and how many of these later presenters are actually diagnosed with ASD. Families do not consult GPs for early diagnosis for a variety of reasons including cultural reasons. The study reflected future prediction of the cases based on international standards prevalence and the population density as reflected by figure one which reflected the highest prevalence at the age intervals of 25-29 years, 30-34 years and 35-39 years respectively Conclusion: Autism is still ongoing challenging public health issue in Dubai, in terms of raising up prevalence, incidences, trends , cases sorting out and management context of autism is one of actual national health care system gaps . Recommendation: Effective school health strategies is needed and implemented by nurses who are qualified and experienced in identifying children with ASD. Training of GP’s to aid early diagnosis of Autism and increase awareness. There is an urgent need for an adult autism centre for when the children leave the safe environment of the school at 18 years. There is a need for further studies to cover the needs of people with an Autism Spectrum Disorder (ASD).
Ph.D. in Nursing (Health-Promotion) from Michigan State University, College of Nursing, USA
Dr.Panarat Chenchob has cpmplested her Ph.D. in Nursing (Health-Promotion) from Michigan State University, College of Nursing, USA and postdoctoral studies “Method in Community-Based Participatory Research” from The University of Michigan, School of Nursing, USA. She works as the head, the division of Human Recourse Management at Boromarajonani College of Nursing, Buddhachinaraj, Phitsanulok, Thailand. As a researcher, She serves as a facilitator and a mentor in Thailand primary care unit as a principal investigator (PI). Her research studies focus on behavior change in preventing NCDs (The Strengthen Community Nurses’ Competency to Enhance District Health System in Northern, Thailand).
The purpose of this participatory action research was to enhance the community nurses performance and heath care providers in primary health care system and community health networks in order to support and develop District Health System (DHS), This study involved the primary health care and community health network in DHS at the 1st , 2nd, 3rd public health region was carried out during June 2015 - June 2017. The result showed that 12 districts achieved in to develop a community health and promote health-promotion behaviors, including 40 community nurses, 106 participants in 16 interdisciplinary teams and 72 community health networks. The result of this study suggest that the approach to primary care system development and health, community, which contained important elements was 1) the development of the potential of primary care nurses in the participant of health- promotion; 2) the encouragement for health-promotion based on the community context learning; 3) the development process with tools “four main and three sub-components” in order to analyst the problem, foundation and communication of community; 4) the encouragement of the local government and public sector for integration in the common goal; 5) facilitator for sharing and learning in the health care provider between community health networks. This result can inform health care providers and researchers interested in enhancing the community nurses competency. The encouragement for nurses and health care providers and community health networks should be supported based on the context based of community in order to create a sustainable health system.
Dr. Ashish Rambhau Satav,. MAHAN Mahatma Gandhi Tribal Hospital
1. To achieve a recovery rate of 75% in severe acute malnutrition (SAM) children and 35% in severe underweight (SUW) children, in tribal community based management of severe malnutrition.
2. To achieve a case fatality rate of <4% in SAM and SUW children in the above setting.
3. To reduce current prevalence rate of SAM and SUW by at least 35% after 3 years of intervention.
Community-based prospective, single-group intervention study.
Primary and secondary care was given to participants from 14 villages of the tribal area of Melghat.
Severely malnourished children (SMC:734), tribal, male and female of the 6–60 months age group were enrolled and 680 children completed the study over a period of 3 years. Sample size (N = 762) was estimated -considering the prevalence of severe malnutrition (SAM and SUW) in 6–60 months population as 21.5%; design effect was 3.0 and relative precision was 10%, with 95% confidence interval.
LTF (local-therapeutic-food) with MN (micronutrients), treatment of infections and BCC (behaviour change communication) were given for 90 days to SMC by VHW (village health worker).
Rate of recovery, case fatality rate, and reduction in prevalence of SAM and SUW.
Majority of SMC (69.1%) in the 6–24 months age group were SAM, while majority of SMC (65.3%) in the 25–60 months age group were SUW. Recovery rate of SAM is 75.9%, 77.8%, and 79.4% at the end of 8th, 10th, and 12th week, respectively; the recovery rate for SUW is 37.5%, 42.7%, and 45.4%, respectively. Case fatality rate for SAM is 0.6% and for SUW is 0.2% after 8th week. There is significant reduction in prevalence of SAM (p – 0.005) and SUW (p – 0.0001) children at the end of the study.
The study shows efficacy of LTF-MN and effectiveness of our community-based model in acute and chronic malnutrition. Further research is needed for deciding the exact duration of SUW therapy.
The study is registered under Protocol Registration and Results System (PRS) (ClinicalTrials.gov ID: NCT02671786).
SAM, SUW, LTF, MN, BCC
Elmansora-Daqahlia-Egypt AL Azher University
Lactobacillus represent one of the major genera of the intestinal tract of human and animals and are used, as probiotics, in dairy and non-dairy foods to restore the intestinal microflora which confer a health benefit. After an adaptation period for 7 days, the first group was fed on basal diet (80 g- for each rat group /day) and served as control I, while the second group was offered basal diet plus standardized buffalo's milk (40 ml. for each rat group / day) and served as control II. The other groups were fed on 80 grams of basal diet for each rat group / day and 40 ml. / day for each rat group, buffalo's milk plus one of the following Lactobacillus strains respectively L.casei strain AZ1, L.rhamnosus strain AZ1 and L.gasseri strain AZ1. Furthermore, supplementation of diets with fermented milk products cultured with L. casei KY123805 or L. rhamnosus KY123789 resulted in noticeable decreases in Total cholesterol, HDL- cholesterol and triglycerides levels at the end of the experiment (28 days) as compared to dry diet (control I). Species of lactobacilli occurring in intestinal tract deconjugate both taurocholic and glycocholic acids, such serum cholesterol levels when it is considered that deconjugated bile acids function more poorly in supporting adsorption of lipids from the intestinal tract than deconjugated ones, this could result in reduce adsorption of cholesterol from the intestines and thus influence its serum level. Therefore, the main target of the present investigation was to isolate and identify some local isolates belonging to genera Lactobacillus. Also, the isolated strains have been screened in order to define their characteristics that would be as probiotic strains or not. Furthermore, the long-term goal of this work is to registering patent protection for some Lactobacillus spp. isolated from local Egyptian resources to increase the additive values of the Egyptian microbial wealth and well use it in the industrial healthy dairy products and pharmaceutical.
Department of Dairy, faculty of Agricultural Al-Azhar University, Egypt
Bifidobacterium represent one of the major genera of the intestinal tract of human and animals used as probiotics in dairy and nondairy foods for restore the intestinal microflora which confers a health benefit. The identification of Bifidobacterium by phenotypic features is commonly unreliable, time, money, and effort consuming. We sought to improve the Bifidobacterium identification method based on molecular level to identify probiotic bacteria in complex microbial communities. The application of 16S-23S rRNA oligonucleotide primers is the best and most reliable, rapid, and precise species and sub species identification approach. The ribosomal intergenic spacer region (ISR) located between the highly conserved 16S rRNA and 23S rRNA shows a high degree of variation in length and sequence and potential for intra species discrimination and providing the phylogenetic Relationship of the Genus Bifidobacterium spp. Results showed that one of the two primer sets Bflac2-Bflac5 species specific gives positive results differentiating between B. animalis ssp. Lactis isolated from breast fed infants milk of human and that isolated from feces of breast fed infant and detecting reference strain for B. animalis ssp. Lactis DSM10140. DNA sequences of the two strains were submitted to the Genbank NCBI under accession number (KT758845) named as B. animalis ssp. Lactis Egm1 (Egyptian milk) and accession number (KT758846) named as Egf1 Egyptian feces while the second primer give false positive result. Also, we aim to obtain patent protection under Intellectual property rights (IPRs) for B. animalis ssp.Lactis which was isolated from Egyptian resources to be used for a better and healthier food and dairy products.
Professor at Institute of Health Economics, University of Dhaka,
Rafia works with national and international NGOs for around nine years then an academician. Her wishes to increase, ensure health care services by registered trained provider in the countries, with this view this frame work was make. Being a physician, academician and a researches, she fell this model will work for all developing countries.
Statement of the Problem: Worldwide there were 59.8million Health worker. About two third of them (39.5 million) provide health services. Worlds 57 countries were faces an acute shortage
Different countries of the world address the problem with different strategies. None of strategy is establish as accurate solution. The purpose of this study is to describe among the changes if substitution is cope in the mainstream of health systems, people will get services at very low cost. Methodology: A structured questioner was taken for in- depth interviews and focus groups. A hypothetical framework was utilized to focus on the changes, crisis and policy implication. Findings: Manages and community people suggested if service provide at locality; it will ensure the accessibility, availability and continuity of services. Local people were prepare adjusted quality in terms of waiting time and privacy with ensure referral at higher facility. Conclusion & Significance: Non-doctor health care provider having pre-existing medical training, receive top-up training undertake placement for experience and skill. Recommendation is for many diseases an effective, cost-efficient interventions would exist.
Certified Assessor for National Quality Assurance Standards by Ministry of Health and Family Welfare
Syed Fareed Uddin has expertise in the Quality Management of Health Facilities and is a Certified Assessor for National Quality Assurance Standards by Ministry of Health and Family Welfare, Government of India.
He has worked in Health Projects funded by JICA- Reproductive Health in Madhya Pradesh, UKAID-DFID-Madhya Pradesh Health Sector Reforms, World Bank-Uttar Pradesh Health System Strengthening. Presently working with World Bank funded-Nagaland Health Project as Health Planning and Bio Medical Waste Expert and USAID funded-Project on the Health Component with a Smart City Project in Madhya Pradesh.
National Trainer for Bio Medical Waste Management and have trained over 2500 Health Staff and staff of Pollution Control Boards from across India.
He was member of the documentation team for documentation of the Good Practices of JICA-Madhya Pradesh Reproductive Health Project and has authored a no. of publications in National and International Journals.
Statement of the Problem: The large population of India poses big challenge to the Government. Providing Health to a large population in varied geographical areas poses a challenge in India.
Provincial Governments are responsible for providing Health to its population. Primary Healthcare is essential health care based on the principles of Equitable Distribution, Community Participation, Intersectoral Coordination co-ordination using Appropriate Technology
India has a 3-Tier system - Primary, Secondary and Tertiary. Primary Health Centre (PHC) is the first level of contact with the health system to promote health system to promote health, prevent illness, care for common illnesses and cater to the specific needs of the community.
The Basic Elements of Primary Healthcare are - Educating the community about the prevailing health conditions and methods for prevention and control. Promotion of food supply and proper nutrition. Adequate water supply and basic sanitation. Maternal and Child Healthcare with Family Planning. Immunisation against major infectious diseases. Provision of essential drugs.
Rural population in India is close to 70% which makes it a more complex proposition. To benefit the rural population Madhya Pradesh State Government took an innovative step and established the Gram Arogya Kendra at village level within the Anganwadi. Medicine stock for basic illnesses was maintained and the ANM under whose Sub Health Centre (SHC) it falls provides the ANC Services to the Pregnant women of the village and does the Immunisation of women and children and Distributes the medicine. The village community receives the health services almost at their doorstep.
The National Rural Health Mission made provision for Delivery at SHCs for the benefit of the rural population.
More Urban PHCs are being established. Quality norms and Assessment Tools are introduced to ensure Quality Management of the PHCs. Annual monetary award introduced to motivate the staff
Researcher at University of Maryland at College Park, USA
Dr. Chen’s research fields include (1) health care delivery system and policy; (2) health care disparities; (3) behavioral health; and (4) economic evaluation. Her work uses a multidisciplinary perspective and involves collaboration with clinical leaders, community partners, and organizational decision makers. Most recently she has conducted research on patient-centered medical homes, including designing personalized patient activation and empowerment strategies to encourage and sustain patients’ involvement in their treatment. Her research on behavioral health focuses on the integration of health care organizations to promote behavioral health of vulnerable populations.
Mental illness is a major public health concern in the United States. Untreated mental illnesses are associated with high mortality rates; increased risk of developing major chronic diseases, including heart disease, diabetes, asthma, and hypertension; and accelerating progression of coexisting physical illness and amplifying their disability. Sixty-eight percent of adults with a mental illness have one or more chronic physical conditions. A recent study showed that the overall cost of mental illness reached $201 billion in the United States in 2013, topping the list of the most costly conditions. There is an increased awareness of the impact of social determinants of mental health. The need to address healthcare access and underlying social determinants of health will require a multisector integrated mental healthcare system to target “population health.” Public health and health promotion programs became a vital part of hospitals' effort to focus on the primary goal of benefiting the community at large. Research suggests the partnership between hospital systems and public health has the potential to address some of the root causes of poor health.1 Our study shows that the integration of public health system is associated with the 9% reduction of health disparities between racial groups.2 Care coordination models include improving the use of a patient-centered medical home, clinician–patient continuity, team-based approaches, use of community hospital-based support, specialized outpatient programs for high-risk patients, home visits, patient navigation to link primary care and specialty care, and referral tracking systems. Evidence consistently suggests that care coordination is essential to meet the growing demands for mental healthcare access while controlling costs and improving quality of service delivery.3