Factors Influencing Attendees’ Engagement with Group Psychoeducation: A Multi-stakeholder Perspective

Few studies have explored the problem of engagement in relation to group psychoeducation from a multi-site and multi-stakeholder perspective. The aim of the study was to explore the factors influencing service user and family engagement with group psychoeducation programmes. The study design was qualitative descriptive. Data were collected through individual and focus group interviews with key stakeholders (n = 75) involved with the programme within 14 mental health sites in the Republic of Ireland. Enablers and barriers to engagement were identified at participant, provider, programme and organization level. Motivated participants and engaged clinicians, peer co-facilitation and support, and skilled and responsive facilitators were some of the factors which enhanced engagement. Barriers to engagement included readiness among participants, concerns related to stigma and confidentiality, desire to distance oneself from mental health services, a lack of support for programme participation within families, group discomfort, the time and length of the programme, issues with transport, visibility of the programme, and structural supports for clinicians. Findings from the study illustrate the multifaceted nature of engagement as well as provide a greater understanding of the multifactorial influences on engagement. Strategies to enhance engagement should therefore reflect a multipronged approach. At the outset of programme implementation, organizations should address their readiness to engage, conduct local needs assessments to anticipate individuals’ needs and plan accordingly in order to maximize engagement, and bolster facilitators’ engagement skills through the provision of training and mentoring opportunities.

What a Pandemic Has Taught Us About the Potential for Innovation in Rural Health: Commencing an Ethnography in Canada, the United States, Sweden, and Australia

The COVID-19 pandemic coincided with a multi-national federally funded research project examining the potential for health and care services in small rural areas to identify and implement innovations in service delivery. The project has a strong focus on electronic health (eHealth) but covers other areas of innovation as well. The project has been designed as an ethnography to prelude a realist evaluation, asking the question under what conditions can local health and care services take responsibility for designing and implementing new service models that meet local needs? The project had already engaged with several health care practitioners and research students based in Canada, Sweden, Australia, and the United States. Our attention is particularly on rural communities with fewer than 5,000 residents and which are relatively isolated from larger service centres. Between March and September 2020, the project team undertook ethnographic and auto-ethnographic research in their own communities to investigate what the service model responses to the pandemic were, and the extent to which local service managers were able to customize their responses to suit the needs of their communities. An initial program theory drawn from the extant literature suggested that “successful” response to the pandemic would depend on a level of local autonomy, “absorptive capacity,*” strong service-community connections, an “anti-fragile†” approach to implementing change, and a realistic recognition of the historical barriers to implementing eHealth and other innovations in these types of rural communities. The field research in 2020 has refined the theory by focusing even more attention on absorptive capacity and community connections, and by suggesting that some level of ignorance of the barriers to innovation may be beneficial. The research also emphasized the role and power of external actors to the community which had not been well-explored in the literature. This paper will summarize both what the field research revealed about the capacity to respond well to the COVID-19 challenge and highlight the gaps in innovative strategies at a managerial level required for rapid response to system stress.*Absorptive Capacity is defined as the ability of an organization (community, clinic, hospital) to adapt to change. Organizations with flexible capacity can incorporate change in a productive fashion, while those with rigid capacity take longer to adapt, and may do so inappropriately.†Antifragility is defined as an entities' ability to gain stability through stress. Biological examples include building muscle through consistent use, and bones becoming stronger through subtle stress. Antifragility has been used as a guiding principle in programme implementation in the past.

The dynamics of dairy farming development in Belarus

The authors analyze the dynamics of the Belarusian dairy sector development within a period from 2016 to 2020 being one of the major internal and external market suppliers of milk and dairy products. Since 2011, per capita growth has reached 141 kg. Export opportunities are expanding as well. It is noted that provision of milk in this period has been stable, with the gross production reaching 7765 thousand tons of milk by 2020, or 828 kg per capita. With its share of 38,8 to 43,8% in 2016–2020, milk and dairy products were playing a leading role in the agricultural produce export ratio. The number of dairy cattle in the republic amounts to 1485 heads, as of 1st January 2021. National dairy facilities and milk industry capacities in general are being gradually renovated and subjected to technological improvements, which helps with increasing the output ration of the “extra” class milk. The industry’s needs in highly productive dairy cattle and pedigree livestock for export are well secured on account of 32 cattle breeding farms and 6 genetic selection centers. Dairy industry was given specific targets set out in the five-year program for a 2016–2020 period. During the National Programme implementation with regards to the dairy sector development, the goals set by the programme have been achieved by 90,4%.

Religion and Development: An Exploration of the Basis of Wholistic Education in Universal Basic Education Programme in Nigeria

Universal Basic Education (UBE) programme in Nigeria was launched in 1999, with the goal of providing “free, universal and compulsory basic education for every Nigerian child aged 6-15 years”. The scope of UBE among others include the initiation for the acquisition of functional literacy, numeracy and life skill for adults and special programmes of encouragement to all marginalized groups (girls, women, nomads, out-of-school youth and Quranic students). Religion has been destructively criticized largely due to the sufferings and devastating situations humanity has and is passing through over the years in Nigeria and based on these, religion is seen as being pervasive and it continues to weaken the moral fiber of UBE programme implementation. Therefore, any developmental tool that is effective and can drive home development must be such that is particularly viable in tackling the problems of religion. Thus, in a bid to revitalize a society already bedeviled with various degenerating ills, religious education which is wholistic in nature should become everyone’s focus. This paper described the importance, the curriculum and technique for teaching wholistic religion education for religious tolerance and sustainable development in UBE. The paper concluded that no known religion is devoid of moral and ethical principles and religion is a force which has mostly influenced the character of mankind. This paper maintained that development can be enriched by the insights offered by religion, faith, spirituality and values. Based on these, the paper recommended that religion should be carried along in making policies, the study of moral education should be made compulsory in all categories of learning and the National Orientation Agency should also include it in their plans and school curriculum should be more of reflective thinking.

Accessibility Mapping through Linking Land-Use Development Potentials and Planning for Cycling

The transport sector aims to address climate change by reducing emissions, and a key to achieving this goal is to increase uptake of sustainable modes such as walking, cycling, and public transport. Therefore, it is important to determine ways to achieve this goal and to build a portfolio of feasible reduction strategies. This study is based in Norway where the government has a clear policy objective to reduce growth in urban car traffic and assimilate future sustainable transport modes. Cycling has therefore gained importance in both policy discussions and programme implementation through providing dedicated infrastructure to increase its modal share. Ways to increase cycling can be plotted at both macro- and microlevels. At the micro-level, road design and improved conditions for cyclists can lead to an increase in cycling. At the macro-level, land-use planning can be one of the tools to promote cycling. We analyse the issue at a macro-level based on an Integrated Methodology for Land Use prognosis within Transportation Models (INMAP) which estimates the mutual eff ects of land-use plans and increased accessibility by e-bike. We assess the extent to which future growth areas, as earmarked by the strategic master plans of the cities of Oslo and Trondheim, coincide with the areas that have a high job accessibility by bicycle and e-bike. Analyses reveal that on the introduction of e-bikes in Oslo, accessibility to jobs in the city centre increases from 20,000–24,000 to over 28,000 jobs. For Trondheim, in terms of spatial expansion of accessibility for jobs, there is an extension of the catchment area from 6 km2 to 18 km2. Based on the findings, this study strongly recommends integrating the impact of e-bikes with land-use planning processes and decisions. Through active land-use management, municipalities and regional development authorities can take informed decisions to steer urban mobility in a more sustainable direction.

Mixed-methods, descriptive and observational cohort study examining feeding and growth patterns among low birthweight infants in India, Malawi and Tanzania: the LIFE study protocol

IntroductionEnding preventable deaths of newborns and children under 5 will not be possible without evidence-based strategies addressing the health and care of low birthweight (LBW, <2.5 kg) infants. The majority of LBW infants are born in low- and middle-income countries (LMICs) and account for more than 60%–80% of newborn deaths. Feeding promotion tailored to meet the nutritional needs of LBW infants in LMICs may serve a crucial role in curbing newborn mortality rates and promoting growth. The Low Birthweight Infant Feeding Exploration (LIFE) study aims to establish foundational knowledge regarding optimal feeding options for LBW infants in low-resource settings throughout infancy.Methods and analysisLIFE is a formative, multisite, observational cohort study involving 12 study facilities in India, Malawi and Tanzania, and using a convergent parallel, mixed-methods design. We assess feeding patterns, growth indicators, morbidity, mortality, child development and health system inputs that facilitate or hinder care and survival of LBW infants.Ethics and disseminationThis study was approved by 11 ethics committees in India, Malawi, Tanzania and the USA. The results will be disseminated through peer-reviewed publications and presentations targeting the global and local research, clinical, programme implementation and policy communities.Trial registration numbersNCT04002908 and CTRI/2019/02/017475.

Strengthening the national health information system through a capacity-building and mentorship partnership (CBMP) programme: a health system and university partnership initiative in Ethiopia

Background A strong health information system (HIS) is one of the essential building blocks for a resilient health system. The Ministry of Health (MOH) of Ethiopia is working on different initiatives to strengthen the national HIS. Among these is the Capacity-Building and Mentorship Partnership (CBMP) Programme in collaboration with public universities in Ethiopia since November 2017. This study aims to evaluate the outcomes and share experiences of the country in working with universities to strengthen the national HIS. Methods The study employed a mixed-methods approach that included 247 health organizations (health offices and facilities) of CBMP-implementing woredas (districts) and 23 key informant interviews. The programme focused on capacity-building and mentoring facilities and woreda health offices. The status of HIS was measured using a connected woreda checklist before and after the intervention. The checklist consists of items related to HIS infrastructure, data quality and administrative use. The organizations were classified as emerging, candidate or model based on the score. The findings were triangulated with qualitative data collected through key informant interviews. Results The results showed that the overall score of the HIS implementation was 46.3 before and 74.2 after implementation of the programme. The proportion of model organizations increased from 1.2% before to 31.8% after the programme implementation. The health system–university partnership has provided an opportunity for higher education institutions to understand the health system and tune their curricula to address real-world challenges. The partnership brought opportunities to conduct and produce local- and national-level evidence to improve the HIS. Weak ownership, poor responsiveness and poor perceptions of the programme were mentioned as major challenges in programme implementation. Conclusion The overall HIS has shown substantial progress in CBMP implementation woredas. A number of facilities became models in a short period of time after the implementation of the programme. The health system–university partnership was found to be a promising approach to improve the national HIS and to share the on-the-ground experiences with the university academicians. However, weak ownership and poor responsiveness to feedback were the major challenges identified as needing more attention in future programme implementation.

Estimating averted COVID-19 cases, hospitalisations, intensive care unit admissions and deaths by COVID-19 vaccination, Italy, January−September 2021

We assessed the impact of COVID-19 vaccination in Italy, by estimating numbers of averted COVID-19 cases, hospitalisations, ICU admissions and deaths between January and September 2021, by age group and geographical macro areas. Timing and speed of vaccination programme implementation varied slightly between geographical areas, particularly for older adults. We estimated that 445,193 (17% of expected; range: 331,059−616,054) cases, 79,152 (32%; range: 53,209−148,756) hospitalisations, 9,839 ICU admissions (29%; range: 6,434−16,276) and 22,067 (38%; range: 13,571−48,026) deaths were prevented by vaccination.

Perceived determinants of implementation success of the neglected tropical diseases programme in Ghana: a qualitative study among programme officers

Background The importance of health policy implementation cannot be overemphasized in contemporary public health. Neglected Tropical Diseases (NTDs) have negatively impacted society, affect quality of life and make the poor societies poorer. Several policies and strategies have been put in place across the world including the neglected tropical diseases programme in Ghana. Though chalked many successes, the programme continues to lag behind in the full attainment of various objectives. Several factors exist that determine how effective a programme is implemented. Identification of these factors on every programme is essential to determine where more programme resources need to be channelled. This study assessed the determinants of successful implementation of the neglected tropical diseases programme in Ghana. Methods A qualitative approach with the case study design was employed. Purposive and snowball sampling techniques were used to identify key programme officers at the national, regional and district levels of programme implementation. Eighteen (18) Key informant interviews were conducted at all the three levels of the Ghana Health Service NTDs programme. Data were thematically analysed and presented. Results Findings from the study revealed that determinants that influenced the successful implementation of the NTDs programme include donor support, education and training, partnerships, reliability of the health structure, integrative nature of the programme and management commitment. These determining factors cut across the inner settings of the implementing agency and the external environment. Conclusion Neglected tropical diseases continuously affect Ghanaians, especially the poor. It is important for both policy makers and implementers to identify the factors that ensure the success of the programme in the Ghanaian context. Though the factors are independently sufficient, they synergistically lead to improved programme implementation. Empowering all units involved (local to national level) and maximizing the enabling factors identified to would improve upon implementation and ensure sustainability.