Patient safety in Europe: medication errors and hospital-acquired infections

The Report was commissioned by the European Federation of Nurses Associations (EFN) in November 2007 in order to support its policy statements on Patient Safety (June 2004). In that statement the EFN declares its belief that European Union health services should operate within a culture of safety that is based on working towards an open culture and the immediate reporting of mistakes; exchanging best practice and research; and lobbying for the systematic collection of information and dissemination of research findings. This Report adressess specifically the culture of highly reliable organisations using the work of James Reason (2000). Medication errors and hospital-acquired infections are examined in line with the Reprt´s parameters and a range of European studies are used as evidence. An extensive reference list is provided that allows EFN to explore work in greater detail as required

Count every newborn; a measurement improvement roadmap for coverage data.

BACKGROUND: The Every Newborn Action Plan (ENAP), launched in 2014, aims to end preventable newborn deaths and stillbirths, with national targets of ≤12 neonatal deaths per 1000 live births and ≤12 stillbirths per 1000 total births by 2030. This requires ambitious improvement of the data on care at birth and of small and sick newborns, particularly to track coverage, quality and equity. METHODS: In a multistage process, a matrix of 70 indicators were assessed by the Every Newborn steering group. Indicators were graded based on their availability and importance to ENAP, resulting in 10 core and 10 additional indicators. A consultation process was undertaken to assess the status of each ENAP core indicator definition, data availability and measurement feasibility. Coverage indicators for the specific ENAP treatment interventions were assigned task teams and given priority as they were identified as requiring the most technical work. Consultations were held throughout. RESULTS: ENAP published 10 core indicators plus 10 additional indicators. Three core impact indicators (neonatal mortality rate, maternal mortality ratio, stillbirth rate) are well defined, with future efforts needed to focus on improving data quantity and quality. Three core indicators on coverage of care for all mothers and newborns (intrapartum/skilled birth attendance, early postnatal care, essential newborn care) have defined contact points, but gaps exist in measuring content and quality of the interventions. Four core (antenatal corticosteroids, neonatal resuscitation, treatment of serious neonatal infections, kangaroo mother care) and one additional coverage indicator for newborns at risk or with complications (chlorhexidine cord cleansing) lack indicator definitions or data, especially for denominators (population in need). To address these gaps, feasible coverage indicator definitions are presented for validity testing. Measurable process indicators to help monitor health service readiness are also presented. A major measurement gap exists to monitor care of small and sick babies, yet signal functions could be tracked similarly to emergency obstetric care. CONCLUSIONS: The ENAP Measurement Improvement Roadmap (2015-2020) outlines tools to be developed (e.g., improved birth and death registration, audit, and minimum perinatal dataset) and actions to test, validate and institutionalise proposed coverage indicators. The roadmap presents a unique opportunity to strengthen routine health information systems, crosslinking these data with civil registration and vital statistics and population-based surveys. Real measurement change requires intentional transfer of leadership to countries with the greatest disease burden and will be achieved by working with centres of excellence and existing networks

Why and how financial inclusion policy develop? A case study from Indonesia

Financial inclusion policy aims to improve access to mainstream financial products for marginalised groups. It has been promoted onto the global agenda and strategies have been adopted by many nations since 2010, including Indonesia. This study examines the complex development of financial inclusion strategy in Indonesia – including the involvement of international development partners, the intertwined domestic interests, and different beliefs on the role of finance. Using in-depth interviews with 34 critical informants as the primary data source and utilising the Advocacy Coalition Framework (ACF) to guide the analysis, the study shows the development of financial inclusion strategy in Indonesia was produced from the combination of seven critical events, political-symbolic learning, and antagonistic coordination between bankers, regulators, and government. The study found there was little deliberation in the policy-making process and no consultation with consumers as the primary beneficiaries of the policy. As a result, financial inclusion policy developed in ways that potentially benefits those within the financial sector at the expense of the general public. This study also makes a methodological and theoretical contribution to knowledge by tracing ACF’s multiple primary pathways and employing its various concepts for explaining policy change in the financial sector in a developing nation. This study extends our understanding of the role of events and policy actors and proposes the new Policy Learning Spectrum and Collaboration Spectrum as two analytical frameworks to enhance ACF’s explanatory power

Ethnic Violence, Local Security and Return Migration: Enclave communities in Kosovo

Forced migration has become commonplace in the international political landscape. In 2015, 60 million people were displaced by violence, more than ever before recorded (UNHCR, 2015). While we know that violence leads to displacement, we know little about return migration after conflict – who comes back and where they settle. This article seeks to engage and supplement the literature on return migration after conflict, advocating for a broader understanding of the security choices made by displaced people. Emphasized here is the importance of a local understanding of safety and the role played by enclave communities in providing a secure context in which people can enjoy the society of their co-ethnics

Internal Displacement in Europe and Central Asia: A Review of the Literature

This paper reviews the existing scholarship on internal displacement in Europe and Central Asia. It concentrates on research relating to internal displacement in European and Central Asian countries affected by conflict, and the responses to that phenomenon at the national and regional levels. The paper starts by describing the main recent internal displacement trends across those regions, and for particular countries therein. It then reviews how scholarship on internal displacement in Europe and Central Asia has developed, respectively, in the fields of law and policy, other social sciences and humanities, and health and medicine. It ends by offering conclusions on the scope of existing research and directions for future study. This review of the scholarly literature seeks to identify principal trends, gaps and opportunities relating to research on internal displacement. Towards this end, the review concentrates on academic publications, including monographs, chapters in edited volumes and peer-reviewed articles, from the early 1990s until the start of 2020, a period of approximately 30 years. It thus offers not only a critical review of the state of the art in this field of study but also a key point of reference for researchers looking to develop our understanding of internal displacement from the standpoint of a variety of different disciplines and themes. The paper forms part of a series of papers published in this Working Paper Series that review the state of the scholarship on internal displacement at the global level and in particular regions as we enter the decade of the 2020s. This research forms part of the Interdisciplinary Network on Displacement, Conflict and Protection (AH/T005351/1) and Global Engagement on Internal Displacement in sub-Saharan Africa (EP/T003227/1) projects, pilots of which were supported by the UK Research and Innovation (UKRI) Global Challenges Research Fund (GCRF). It should be read in conjunction with the other review papers in this series

The Right to No Longer be a Refugee: The Legal Empowerment of Syrian Refugees in Jordan

The now-protracted Syrian refugee crisis has become the largest global refugee crisis since World War II. Although often discussed in terms of the European migration crisis, this crisis has had a far greater impact on the neighboring host countries, which have been overwhelmed by massive influxes of Syrian refugees since the onset of the crisis in Syria. Moreover, these generous host countries have not received nearly enough support from the international community to cope with the crisis. Consequently, these countries have placed more and more restrictions on Syrian refugees. Syrian refugees in Jordan are marginalized and are not afforded basic rights like the right to work. As humanitarian aid has been consistently underfunded, and Syrian refugees’ savings have dried up, many Syrian refugees are no longer able to cope. Herein I examine the case of the Syrian refugees in Jordan. I focus on legal status of Syrian refugees in Jordan through a human rights lens, bearing in mind the economics and security perspectives. I use the noted observations and interviews with Jordanian nationals, Syrian refugees, and staff from various UN agencies, IGOs and INGOs, and local NGOs obtained during my fieldwork in Jordan in March 2016 in addition to archival material, reports, and other publicly available secondary sources. I conclude that Jordan is obligated to ensure the protection of these Syrian refugees’ human rights (including both civil and political and social, economic, and cultural rights) regardless of how the refugee influx has impacted its economy, infrastructure, and national security. Furthermore, it is in Jordan’s economic and national security interests to integrate the Syrian refugees not just economically but legally by providing them with a pathway to citizenship

Workplace protection for informal workers with reference to waste pickers in the Durban Metro area: an exploration of section 24 of the South African Constitution of 1996.

Masters Degree. University of KwaZulu-Natal, Durban.This thesis explores the extent to which the environmental rights contained in section 24 of the South African Constitution of 1996 are potentially applicable to people who work informally in public spaces, in particular, waste pickers in the Durban Metro area. The extent to which environmental rights may be applicable to these workers is measured by first reviewing the current conditions under which waste pickers in Durban work. The study then argues that, in accordance with section 24(a), all human beings have a fundamental right to an environment that is safe and does not threaten their health or well-being. It concludes that waste pickers ought to enjoy protection in their work environment. The research further highlights deficiencies in waste pickers’ entitlement to have their work environment protected through legislative and other measures as provided for by section 24(b), by reviewing the extent in which current legislation and other measures provide for workplace protection for informal workers; who are the working poor. Finally, it gives recommendations on how these deficiencies could be addressed drawing lessons from foreign case law and international experiences which can be adapted to the South African context

Beyond aid: The continuous struggle to cope with displacement in Myanmar and Thailand

Multi-party elections and the signing of a Nationwide Ceasefire Agreement (NCA) in 2015 raised hopes in the international community of a possible settlement of Myanmar’s protracted conflict and one of the world’s worst protracted displacement situations (PDS) in the near future. Yet conflicts in the border areas and human rights abuses carry on, more than 600,000 Burmese continue to be displaced within Myanmar and three to five million remain in Thailand. This Working Paper examines strategies that displaced persons from Myanmar have developed striving to cope with major challenges of displacement. We observed that strategies go beyond the commonly used three durable solutions. The findings suggest that neither return nor local integration into the society of the host country is necessarily definite or are mutually exclusive. Both are merely two poles of a wide range of displaced persons’ possible coping strategies, encompassing return, cyclical movements, temporary return, de jure local integration and different levels and stages of de facto local integration. In scrutinizing whether the change of governance eradicated the causes of displacement, brought peace and laid the foundation for return, our research revealed significant flaws in Myanmar’s political transition. Notwithstanding impressive achievements, conflicts persist and are likely to cause new waves of displacement. With regard to access to legal, economic, political rights, services, house, land, property and livelihoods, the situation of displaced persons (DPs) remains dire. Still, the international community promotes return and has been reducing assistance for camps in and outside of Myanmar. For internally displaced persons (IDPs) and refugees, this means that options of refuge have diminished, while the causes to flee remain. After decades of displacement, DPs have developed a set of practices such as diversifications of livelihoods, income sources, residences, and others. We argue that it is imperative for any long-term and coherent strategy that addresses protracted displacement to take those micro realities into account