A needs assessment for postgraduate training in selected public health disciplines: evidence from health services organisations in Lusaka, Zambia.

Background: As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. This study reports on a needs assessment conducted among health services organisations (HSOs) to understand postgraduate training needs and service gaps for selected public health disciplines - Health Policy and Systems, Health Economics, and Healthcare Management and Planning - at the University of Zambia.

Methods: The study adopted a cross-sectional design, comprising qualitative and quantitative components.

Measuring nurses' health policy participation: WSPPIR instrument development and psychometric evaluation.

Aim: To measure nurses' health policy participation by developing and psychometrically testing the Waddell Spectrum for Policy Participation Influence and Research (WSPPIR) Instrument.

Design: Instrument development; based on a nursing conceptual framework.

Methods: This four-phase study was conducted in 2018 to estimate content validity, construct validity, and internal consistency reliability of the WSPPIR instrument.

Implementation of a pharmacy-focused morbidity, mortality, and improvement conference.

Purpose: Review lessons learned during the development and implementation of a pharmacy-focused Morbidity, Mortality, and Improvement conference at an academic medical center.

Summary: Since the early 1900s, Morbidity and Mortality conferences have provided a forum for clinicians to discuss medical errors and adverse outcomes. Many institutions have now added "improvement" to the conference title to emphasize the goal of approaching these conferences in a systems-oriented manner.

The Quality Enhancement Research Initiative (QUERI) Impact Framework: Measuring the Real-world Impact of Implementation Science.

Background: Measuring the health, economic, and cultural gains generated by scientific investments is crucial to reducing waste and improving quality of care. To date, there is no comprehensive framework for assessing the multi-faceted contributions of implementation and quality improvement sciences towards quality, cost, and patient and provider experiences in health systems.

Objective: We describe the Quality Enhancement Research Initiative (QUERI) Impact Framework and its application to QUERI investments.

Using subdomain-specific item sets affected PROMIS physical function scores differently in cardiology and rheumatology patients.

Objectives: The Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) item bank has been developed to standardize patient-reported PF across medical fields. However, evidence of scoring equivalence across cardiology and rheumatology patients is still missing. Therefore, this study aims to investigate both (1) the extent of disease-related differential item functioning (DIF) and (2) the impact of the disease group on using subdomain-specific item sets for generating PROMIS PF scores in cardiology and rheumatology patients.

Feasibility testing of a community dialogue approach for promoting the uptake of family planning and contraceptive services in Zambia.

Background: Community dialogues have been used in participatory approaches in various health prevention and awareness programs, including family planning interventions, to increase understanding and alignment of particular issues from different peoples' perspectives. The main objective of this paper is to document the feasibility of a community dialogue approach, which aimed to promote dialogue between healthcare providers and community members. The feasibility testing was part of formative-phase research needed to design an intervention, with the ultimate goal of increasing the uptake of family planning and contraception.

COVID-19 pandemic and mitigation strategies: implications for maternal and child health and nutrition.

Coronavirus disease 2019 (COVID-19) continues to ravage health and economic metrics globally, including progress in maternal and child nutrition. Although there has been focus on rising rates of childhood wasting in the short term, maternal and child undernutrition rates are also likely to increase as a consequence of COVID-19 and its impacts on poverty, coverage of essential interventions, and access to appropriate nutritious foods. Key sectors at particular risk of collapse or reduced efficiency in the wake of COVID-19 include food systems, incomes, and social protection, health care services for women and children, and services and access to clean water and sanitation.

Monitoring Mental Healthcare Services Using Business Analytics.

Objectives: Monitoring healthcare activities is the first step for health stakeholders and health professionals to improve the quality and performance of healthcare services. However, monitoring remains a challenge for healthcare facilities, especially in developing countries. Fortunately, advances in business analytics address this need.

Redesigning primary care in an academic medical center: lessons, challenges, and opportunities.

Purpose: To evaluate patient access, provider productivity, and patient satisfaction during a 24-month redesign process of an academic medical center, which requires balance between clinical and educational missions.

Methods: A series of activities were conducted to optimize primary care across 17 attending physicians, 6 Advanced Practice Providers (APPs), and 39 residents. Patient access was defined as the next available appointment for either existing/established patients or new patients.

The central role of provider training in implementing resource-stratified guidelines for palliative care in low-income and middle-income countries: Lessons from the Jamaica Cancer Care and Research Institute in the Caribbean and Universidad Católica in Latin America.

Individuals in low-income and middle-income countries (LMICs) account for approximately two-thirds of cancer deaths worldwide, and the vast majority of these deaths occur without access to essential palliative care (PC). Although resource-stratified guidelines are being developed that take into account the actual resources available within a given country, and several components of PC are available within health care systems, PC will never improve without a trained workforce. The design and implementation of PC provider training programs is the lynchpin for ensuring that all seriously ill patients have access to quality PC services.

European perspectives on efforts to reduce antimicrobial usage in food animal production.

New regulations on veterinary medicines and medicated feed will substantially influence antimicrobial prescribing and usage throughout Europe into the future. These regulations have been informed by a very large body of work, including the substantial progress towards reduced antimicrobial usage in food animal production in a number of member states of the European Union (EU). This paper seeks to summarise European perspectives on efforts to reduce antimicrobial usage in food animal production.

Community and Provider Perspectives on Addressing Unmet Need for Contraception: Key Findings from a Formative Phase Research in Kenya, South Africa and Zambia (2015-2016).

Unmet need for contraception remains a challenge especially in low and middle-income countries. Community participation or the -active involvement of affected populations in all stages of decision-making and implementation of policies, programs, and services‖ is a precondition for attaining the highest standard of health. Participation as a key component of rights and quality of care frameworks could increase met needs.

Development of a Dental School Strategic Plan to Inform Interprofessional Education.

Changes in U.S. health care delivery systems and Commission on Dental Accreditation standards provide impetus for interprofessional education (IPE) and collaborative practice, but roadmaps for engaging dental and dental hygiene faculty to incorporate IPE in a systematic manner are limited.

Surveillance of Opioid Prescribing as a Public Health Intervention: Washington State Bree Collaborative Opioid Metrics.

Context: To address risks associated with prescription opioid medications, guidelines recommend lower dose, shorter duration of use, and avoidance of concurrent sedatives. Monitoring opioid-prescribing practices is critical for assessing guideline impact, comparing populations, and targeting interventions to reduce risks.

Objective: To describe development of Washington (WA) State opioid-prescribing metrics, provide purpose and definitions, and apply metrics to prescription data for WA health care organizations.

Developing a national patient safety plan in Guatemala.

Objective: Patient safety is challenging for health systems around the world, particularly in low-and middleincome countries such as Guatemala. The goal of this report is to summarize a strategic planning process for a national patient safety plan in Guatemala.

Methods: This strategic planning process involved multiple stakeholders, including representatives of the Guatemala Ministry of Health and Social Assistance, medical leadership from across the public health system, and academic experts from Guatemala and the United States of America.

Retention in care as a quality measure for opioid use disorder.

US health care systems are struggling to formulate quality metrics that are patient-centered and describe outcomes rather than processes. Addiction medicine is no exception. Of particular interest is the identification of quality metrics in opioid use disorder (OUD) treatment.

Correction to: Contraception and abortion knowledge, attitudes and practices among adolescents from low and middle-income countries: a systematic review.

In the original publication of this article [1], there are several errors. The original sentences and corrections are listed below.

Proposal of a multidimensional strategic-management dashboard for use in a rehabilitation respiratory unit.

Health information systems are the core support to decision-making in health organizations. Economic and clinical managements often function separately, while a governance system for quality and safety functions with quality checks and performance accountability, could improve efficiency. The aims of this study were, within a respiratory rehabilitation unit (RRU), to: develop a management-strategy dashboard based on key performance areas (KPAs), identify key performance indicators (KPIs) for each KPA which allow multidimensional assessment; estimate the expected results from the implementation of this dashboard using the balanced score card (BSC) method.

Past and future spread of the arbovirus vectors Aedes aegypti and Aedes albopictus.

The global population at risk from mosquito-borne diseases-including dengue, yellow fever, chikungunya and Zika-is expanding in concert with changes in the distribution of two key vectors: Aedes aegypti and Aedes albopictus. The distribution of these species is largely driven by both human movement and the presence of suitable climate. Using statistical mapping techniques, we show that human movement patterns explain the spread of both species in Europe and the United States following their introduction.

Aligning Strategic Interests in an Academic Medical Center: A Framework for Evaluating GME Expansion Requests.

Background: In 2017, the Maine Medical Center Graduate Medical Education Committee received an unprecedented number of requests (n = 18) to start new graduate medical education (GME) programs or expand existing programs. There was no process by which multiple programs could be prioritized to compete for scarce GME resources.

Objective: We developed a framework to strategically assess and prioritize GME program expansion requests to yield the greatest benefits for patients, learners, and the institution as well as to meet regional and societal priorities.

Lean Enterprise Transformation in VA: a national evaluation framework and study protocol.

Background: The goal of Lean Enterprise Transformation (LET) is to go beyond simply using Lean tools and instead embed Lean principles and practices in the system so that it becomes a fundamental, collective mindset of the entire enterprise. The Veterans Engineering Resource Center (VERC) launched the Veterans Affairs (VA) LET pilot program to improve quality, safety, and the Veteran's experience. A national evaluation will examine the pilot program sites' implementation processes, outcomes and impacts, and abilities to improve LET adoption and sustainment.

Contraception and abortion knowledge, attitudes and practices among adolescents from low and middle-income countries: a systematic review.

Background: Adolescents face significant barriers to contraception access and utilization that result in adverse health effects of early pregnancy and childbirth. Unsafe abortions continue to occur partly due to failure to prevent pregnancies, with Sub-Saharan Africa contributing the most significant burden of all unsafe abortions among young people globally, of which a quarter occurs in those aged 15-19 years. We aimed to conduct a systematic review of the contraceptive and abortion knowledge, attitudes and practices of adolescents in low and middle-income countries to increase the understanding of the sexual and reproductive health dynamics that they face.

Health disparities across the counties of Kenya and implications for policy makers, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 provided comprehensive estimates of health loss globally. Decision makers in Kenya can use GBD subnational data to target health interventions and address county-level variation in the burden of disease.

Methods: We used GBD 2016 estimates of life expectancy at birth, healthy life expectancy, all-cause and cause-specific mortality, years of life lost, years lived with disability, disability-adjusted life-years, and risk factors to analyse health by age and sex at the national and county levels in Kenya from 1990 to 2016.

Why do rural women in the most remote and poorest areas of Zambia predominantly attend only one antenatal care visit with a skilled provider? A qualitative inquiry.

Background: While focused antenatal care (ANC) has served as an entry point in the continuum of care for both mothers and children, fewer than a third of pregnant women in the most remote and poorest communities of Zambia achieve the four ANC visits recommended by the World Health Organization. Current evidence suggests that attending ANC provided by a skilled healthcare worker at least once is common and associated with skilled birth attendance. The aim of this study was to explain why one ANC visit with a skilled provider seemed more common than four ANC visits among women in the remote and poorest districts of Zambia.