Publications
582 results found
Ahmed F, Ahmed N, Heitmueller A, et al., 2017, Smart cities: health and safety for all, LANCET PUBLIC HEALTH, Vol: 2, Pages: E398-E398, ISSN: 2468-2667
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- Citations: 2
Rockers PC, Tugwell P, Grimshaw J, et al., 2017, Quasi-experimental study designs series-paper 12: strengthening global capacity for evidence synthesis of quasi-experimental health systems research, JOURNAL OF CLINICAL EPIDEMIOLOGY, Vol: 89, Pages: 98-105, ISSN: 0895-4356
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- Citations: 13
Knight GM, Costelloe C, Murray KA, et al., 2017, Addressing the unknowns of antimicrobial resistance: quantifying and mapping the drivers of burden, Clinical Infectious Diseases, Vol: 66, Pages: 612-616, ISSN: 1058-4838
The global threat of antimicrobial resistance (AMR) has arisen through a network of complex interacting factors. Many different sources and transmission pathways contribute to the ever-growing burden of AMR in our clinical settings. The lack of data on these mechanisms and the relative importance of different factors causing the emergence and spread of AMR hampers our global efforts to effectively manage the risks. Importantly, we have little quantitative knowledge on the relative contributions of these sources and are likely to be targeting our interventions suboptimally as a result. Here we propose a systems mapping approach to address the urgent need for reliable and timely data in order to strengthen the response to AMR.
Tudor Car L, Atun R, 2017, eLearning for health system leadership and management capacity building: a protocol for a systematic review, BMJ Open, Vol: 7, ISSN: 2044-6055
Introduction: Health leadership and management capacity are essential for health system strengthening and for attaining universal health coverage by optimizing the existing human, technological, and financial resources. However, in health systems health leadership and management training is not widely available. The use of information technology for education (i.e. eLearning) could help address this training gap by enabling flexible, efficient, and scalable health leadership and management training. We present a protocol for a systematic review on the effectiveness of eLearning for health leadership and management capacity building in improving health system outcomes.Methodology and analysis: We will follow the Cochrane Collaboration methodology. We will search for experimental studies focused on the use of any type of eLearning modality for health management and leadership capacity building in all types of health workforce cadres. The primary outcomes of interest will be health outcomes, financial risk protection and user satisfaction. In addition, secondary outcomes of interest the attainment of health system objectives of improved equity, efficiency, effectiveness and responsiveness. We will search relevant databases of published and grey literature as well as clinical trials registries from 1990 onwards without language restrictions. Two review authors will screen references, extract data and perform risk of bias assessment independently. Contingent on the heterogeneity of the collated literature, we will either perform a meta-analysis or a narrative synthesis of the collated data.Ethics and dissemination: The systematic review will aim to inform policy makers, investors, health professionals, technologists and educators about the existing evidence, potential gaps in literature and the impact of eLearning for health leadership and management capacity building on health system outcomes. We will disseminate the review findings by publishing it as a peer-review jou
Atun R, Davies JI, Gale EAM, et al., 2017, Diabetes in sub-Saharan Africa: from clinical care to health policy, LANCET DIABETES & ENDOCRINOLOGY, Vol: 5, Pages: 622-667, ISSN: 2213-8587
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- Citations: 251
Head MG, Goss S, Gelister Y, et al., 2017, Global funding trends for malaria research in sub-Saharan Africa: a systematic analysis, LANCET GLOBAL HEALTH, Vol: 5, Pages: E772-E781, ISSN: 2214-109X
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- Citations: 29
Atun R, Silva S, Knaul FM, 2017, Innovative financing instruments for global health 2002-15: a systematic analysis, LANCET GLOBAL HEALTH, Vol: 5, Pages: E720-E726, ISSN: 2214-109X
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- Citations: 29
Maruthappu M, Zhou C, Williams C, et al., 2017, Unemployment and HIV mortality in the countries of the Organisation for Economic Co-operation and Development: 1981-2009., JRSM Open, Vol: 8, ISSN: 2054-2704
OBJECTIVES: To determine an association between unemployment rates and human immunodeficiency virus (HIV) mortality in the Organisation for Economic Co-operation and Development (OECD). DESIGN: Multivariate regression analysis. PARTICIPANTS: OECD member states. SETTING: OECD. MAIN OUTCOME MEASURES: World Health Organization HIV mortality. RESULTS: Between 1981 and 2009, a 1% increase in unemployment was associated with an increase in HIV mortality in the OECD (coefficient for men 0.711, 0.334-1.089, p = 0.0003; coefficient for women 0.166, 0.071-0.260, p = 0.0007). Time lag analysis showed a significant increase in HIV mortality for up to two years after rises in unemployment: p = 0.0008 for men and p = 0.0030 for women in year 1, p = 0.0067 for men and p = 0.0403 for women in year 2. CONCLUSIONS: Rises in unemployment are associated with increased HIV mortality. Economic fiscal policy may impact upon population health. Policy discussions should take into consideration potential health outcomes.
Tudor Car L, Papachristou N, Urch C, et al., 2017, Prioritizing medication safety in care of people with cancer: clinicians’ views on main problems and solutions, Journal of Global Health, Vol: 7, ISSN: 2047-2986
Background: Cancer care is liable to medication errors due to the complex nature of cancer treatment, the common presence of comorbidities and the involvement of a number of clinicians in cancer care. While the frequency of medication errors in cancer care has been reported, little is known about their causal factors and effective prevention strategies. With a unique insight into the main safety issues in cancer treatment, frontline staff can help close this gap. In this study, we aimed to identify medication safety priorities in cancer patient care according to clinicians in North West London using PRIORITIZE, a novel priority-setting approach.Methods:The project steering group determined the scope, the context and the criteria for prioritization. We then invited North West London cancer care clinicians to identify and prioritize main causes for, and solutions to, medication errors in cancer care. Forty cancer care providers submitted their suggestions which were thematically synthesized into a composite list of 20 distinct problems and 22 solutions. A group of 26 clinicians from the initial cohort ranked the composite list of suggestions using predetermined criteria. Results: The top ranked problems focused on patients’ poor understanding of treatments due to language or education difficulties, clinicians’ insufficient attention to patients’ psychological distress, and inadequate information sharing among healthcare providers. The top ranked solutions were provision of guidance to patients and their carers on what to do when unwell, pre-chemotherapy work-up for all patients and better staff training. Overall, clinicians considered improved communication between healthcare providers, quality assurance procedures (during prescription and monitoring stages) and patient education as key strategies for improving cancer medication safety. Prescribing stage was identified as the most vulnerable to medication safety threats. The highest ranked suggesti
Li Z, Li M, Fink G, et al., 2017, User-fee-removal improves equity of children's health care utilization and reduces families' financial burden: evidence from Jamaica, JOURNAL OF GLOBAL HEALTH, Vol: 7, ISSN: 2047-2978
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- Citations: 9
Bommer C, Heesemann E, Sagalova V, et al., 2017, The global economic burden of diabetes in adults aged 20-79 years: a cost-of-illness study, LANCET DIABETES & ENDOCRINOLOGY, Vol: 5, Pages: 423-430, ISSN: 2213-8587
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- Citations: 399
Gallien J, Rashkova I, Atun R, et al., 2017, National Drug Stockout Risks and the Global Fund Disbursement Process for Procurement, PRODUCTION AND OPERATIONS MANAGEMENT, Vol: 26, Pages: 997-1014, ISSN: 1059-1478
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- Citations: 28
Nia HA, Atun RA, Rahbarianyazd R, 2017, PERCEPTION BASED METHOD FOR MEASURING THE AESTHETIC QUALITY OF THE URBAN ENVIRONMENT, OPEN HOUSE INTERNATIONAL, Vol: 42, Pages: 11-19, ISSN: 0168-2601
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- Citations: 3
Fukuma S, Ahmed S, Goto R, et al., 2017, Fukushima after the Great East Japan Earthquake: lessons for developing responsive and resilient health systems, JOURNAL OF GLOBAL HEALTH, Vol: 7, ISSN: 2047-2978
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- Citations: 18
Seidman G, Atun R, 2017, Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries, HUMAN RESOURCES FOR HEALTH, Vol: 15, ISSN: 1478-4491
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- Citations: 110
Kyratsis Y, Atun R, Phillips NW, et al., 2017, Health systems in transition: Professional identity work in the context of shifting institutional logics, Academy of Management Journal, Vol: 60, Pages: 610-641, ISSN: 0001-4273
We investigate how established professionals manage their identities in the face of identity threats from a contested shift in the professional logic that characterizes their field. To do so, we draw on interviews with 113 physicians from five European transition countries who faced pressure for change in their professional identities due to a shift in the logic of healthcare from a logic of “narrow specialism” in primary care that characterized the Soviet health system to a new logic of “generalism” that characterizes primary care in the West. We found three important forms of professional identity threats experienced by physicians during this period – professional values conflict, status loss, and social identity conflict. In addition, we identified three forms of identity work – authenticating, reframing, and cultural repositioning – that the professionals who successfully transitioned to the new identity performed in order to reconstruct their professional identities so that they were aligned with the new logic. Based on these findings, we present a model of how established professionals change their professional identities as a result of a contested shift in the professional logic of their field and discuss the underlying mechanisms through which this occurs.
Maruthappu M, Head MG, Zhou CD, et al., 2017, Investments in cancer research awarded to UK institutions and the global burden of cancer 2000-2013: a systematic analysis, BMJ OPEN, Vol: 7, ISSN: 2044-6055
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- Citations: 19
Maruthappu M, Watson RA, Watkins J, et al., 2017, Effects of economic downturns on child mortality: a global economic analysis, 1981-2010, BMJ GLOBAL HEALTH, Vol: 2, ISSN: 2059-7908
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- Citations: 14
Seidman G, Atun R, 2017, Do changes to supply chains and procurement processes yield cost savings and improve availability of pharmaceuticals, vaccines or health products? A systematic review of evidence from low-income and middle-income countries, BMJ GLOBAL HEALTH, Vol: 2, ISSN: 2059-7908
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- Citations: 43
Aknar M, Atun RA, 2017, Predicting movement in architectural space, ARCHITECTURAL SCIENCE REVIEW, Vol: 60, Pages: 78-95, ISSN: 0003-8628
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- Citations: 5
Tudor Car L, El-Khatib M, Perneczky N, et al., 2017, Prioritizing problems in and solutions to homecare safety of people with dementia: supporting carers, streamlining care, BMC Geriatrics, Vol: 17, ISSN: 1471-2318
BackgroundDementia care is predominantly provided by carers in home settings. We aimed to identify the priorities for homecare safety of people with dementia according to dementia health and social care professionals using a novel priority-setting method.MethodsThe project steering group determined the scope, the context and the criteria for prioritization. We then invited 185 North-West London clinicians via an open-ended questionnaire to identify three main problems and solutions relating to homecare safety of people with dementia. 76 clinicians submitted their suggestions which were thematically synthesized into a composite list of 27 distinct problems and 30 solutions. A group of 49 clinicians arbitrarily selected from the initial cohort ranked the composite list of suggestions using predetermined criteria.ResultsInadequate education of carers of people with dementia (both family and professional) is seen as a key problem that needs addressing in addition to challenges of self-neglect, social isolation, medication nonadherence. Seven out of top 10 problems related to patients and/or carers signalling clearly where help and support are needed. The top ranked solutions focused on involvement and education of family carers, their supervision and continuing support. Several suggestions highlighted a need for improvement of recruitment, oversight and working conditions of professional carers and for different home safety-proofing strategies.ConclusionsClinicians identified a range of suggestions for improving homecare safety of people with dementia. Better equipping carers was seen as fundamental for ensuring homecare safety. Many of the identified suggestions are highly challenging and not easily changeable, yet there are also many that are feasible, affordable and could contribute to substantial improvements to dementia homecare safety.
Hone T, Rasella D, Barreto M, et al., 2017, Large reductions In amenable mortality associated with Brazil's primary care expansion and strong health governance, Health Affairs, Vol: 36, Pages: 149-158, ISSN: 0278-2715
Strong health governance is key to universal health coverage. However, the relationship between governance and health system performance is underexplored. We investigated whether expansion of the Brazilian Estratégia de Saúde da Família (ESF; family health strategy), a community-based primary care program, reduced amenable mortality (mortality avoidable with timely and effective health care) and whether this association varied by municipal health governance. Fixed-effects longitudinal regression models were used to identify the relationship between ESF coverage and amenable mortality rates in 1,622 municipalities in Brazil over the period 2000-12. Municipal health governance was measured using indicators from a public administration survey, and the resulting scores were used in interactions. Overall, increasing ESF coverage from 0 percent to 100 percent was associated with a reduction of 6.8 percent in rates of amenable mortality, compared with no increase in ESF coverage. The reductions were 11.0 percent for municipalities with the highest governance scores and 4.3 percent for those with the lowest scores. These findings suggest that strengthening local health governance may be vital for improving health services effectiveness and health outcomes in decentralized health systems.
Jamison DT, Alwan A, Mock CN, et al., 2017, Universal Health Coverage and Intersectoral Action for Health
In 1993, the World Bank published Disease Control Priorities in Developing Countries (DCP1), an attempt to systematically assess value for money (cost-effectiveness) of interventions that would address the major sources of disease burden in low- and middle-income countries (LMICs) (Jamison and others 1993). A major motivation for DCP1 was to identify reasonable responses in highly resource-constrained environments to the growing burden of noncommunicable diseases (NCDs) and of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in LMICs. The World Bank had highlighted the already substantial NCD problem in country studies for Malaysia (Harlan, Harlan, and Oii 1984), for China (Jamison and others 1984), and in a New England Journal of Medicine Shattuck Lecture (Evans, Hall, and Warford 1981). Mexican scholars (Bobadilla and others 1993; Frenk and others 1989) pointed to the rapid growth of NCDs in Mexico and introduced the concept of a protracted epidemiological transition involving a dual burden of NCDs combined with significant lingering problems of infectious disease. The dual burden paradigm remains valid to this day. The World Bank’s first (and so far only) World Development Report (1993) dealing with health drew heavily on findings from DCP1 to conclude that a number of specific interventions against NCDs (including tobacco control and multidrug secondary prevention of vascular disease) were attractive even in environments where substantial burdens of infection and insufficient dietary intake remained policy priorities (World Bank 1993).
Watkins DA, Jamison DT, Mills A, et al., 2017, Universal Health Coverage and Essential Packages of Care
Health systems have several key objectives; the most fundamental is to improve the health of the population. In addition, they are concerned with the distribution of health in the population—for example, with health equity—and they strive to be responsive to the needs of the population and to deliver services efficiently (WHO 2007). Notably, they also seek to provide protection against the financial risks that individuals face when accessing health services. Ideally, this financial risk protection (FRP) is accomplished through mechanisms such as risk pooling and group payment that ensure prepayment of most, if not all, health care costs (Jamison and others 2013). An effective health system is one that meets these objectives by providing equitable access to affordable, high-quality health care—including treatment and curative services as well as health promotion, prevention, and rehabilitation services—to the entire population. Unfortunately, most countries lack health systems that meet this standard. Shortfalls in access, quality, efficiency, and equity have been documented extensively, both in low- and middle-income countries (LMICs) and in some high-income countries (HICs) (WHO 2010). In addition, in many countries, households routinely face catastrophic or impoverishing health expenditure when seeking acute or chronic disease care (Xu and others 2007). These financial risks can result in further health loss and reduced economic prosperity for households and populations (Kruk and others 2009; McIntyre and others 2006). The current universal health coverage (UHC) movement emerged in response to a growing awareness of the worldwide problems of low access to health services, low quality of care, and high levels of financial risk (Ji and Chen 2016). UHC is now a core tenet of United Nations (UN) Sustainable Development Goal (SDG) 3. UHC was preceded by the aspirational notion of a minimum standard of health for all, enshrined in the Universal D
McKee M, Atun R, 2017, Brexit and Health: A Tragedy of Errors, HPHR Journal
<jats:p>In 2015, a new word entered the English language. This was Brexit, short for “British Exit from the European Union”. The Conservative party, then led by David Cameron, had long been divided between those who believed that the United Kingdom’s (UK) future was only secure by remaining part of the by then 28 country European Union (EU) and those who portrayed the EU as some distant dictatorship, staffed by people who spent their days plotting how to damage the UK’s interests. The former view was held by most of the party’s Members of Parliament. The latter view was increasingly prevalent among the diminishing and ageing band of party members but, perhaps more importantly, the British tabloid press, dominated by a few powerful individuals. This split had existed for many years, seriously weakening the party, but the situation was becoming critical as the Conservatives were threatened, electorally, by the growth of the United Kingdom Independence Party. With no consistent, or indeed coherent policies except exiting the EU, it appealed especially to those who had been left behind by the process of globalization, a phenomenon that will be familiar to readers from the United States. Indeed, its leader, Nigel Farage, closely aligned himself with Donald Trump during the latter’s election campaign.</jats:p>
Seidman G, Atun R, 2016, Aligning values and outcomes in priority-setting for health, JOURNAL OF GLOBAL HEALTH, Vol: 6, ISSN: 2047-2978
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- Citations: 6
Ammar W, Kdouh O, Hammoud R, et al., 2016, Health system resilience: Lebanon and the Syrian refugee crisis, JOURNAL OF GLOBAL HEALTH, Vol: 6, ISSN: 2047-2978
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- Citations: 91
Fitchett JRA, Lichtman A, Soyode DT, et al., 2016, Ebola research funding: a systematic analysis, 1997-2015, JOURNAL OF GLOBAL HEALTH, Vol: 6, ISSN: 2047-2978
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- Citations: 19
Atun RA, 2016, ENVELOPMENT: A METHODOLOGICAL APPROACH IN STRUCTURATION OF URBAN DIALECTICS, OPEN HOUSE INTERNATIONAL, Vol: 41, Pages: 82-88, ISSN: 0168-2601
El Koussa M, Atun R, Bowser D, et al., 2016, Factors influencing physicians' choice of workplace: systematic review of drivers of attrition and policy interventions to address them, JOURNAL OF GLOBAL HEALTH, Vol: 6, ISSN: 2047-2978
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- Citations: 19
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