Informed Alaskans Initiative: Public Health Data in Alaska

This article describes the national and state public health data made available online through the Alaska Division of Public Health's Informed Alaskans Initiative.[Introduction] / AK-IBIS / Health Indicators / Indicator Reports / Interactive Health Maps / Help for Website Users / What’s Next / Conclusion / [SIDEBAR:] Public Health Data Resource

Perspectives on financial incentives to health service providers for increasing breast feeding and smoking quit rates during pregnancy: a mixed methods study

Objective: To explore the acceptability, mechanisms and consequences of provider incentives for smoking cessation and breast feeding as part of the Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS) study. Design: Cross-sectional survey and qualitative interviews. Setting: Scotland and North West England. Participants: Early years professionals: 497 survey respondents included 156 doctors; 197 health visitors/maternity staff; 144 other health staff. Qualitative interviews or focus groups were conducted with 68 pregnant/postnatal women/family members; 32 service providers; 22 experts/decision-makers; 63 conference attendees. Methods: Early years professionals were surveyed via email about the acceptability of payments to local health services for reaching smoking cessation in pregnancy and breastfeeding targets. Agreement was measured on a 5-point scale using multivariable ordered logit models. A framework approach was used to analyse free-text survey responses and qualitative data. Results: Health professional net agreement for provider incentives for smoking cessation targets was 52.9% (263/497); net disagreement was 28.6% (142/497). Health visitors/maternity staff were more likely than doctors to agree: OR 2.35 (95% CI 1.51 to 3.64; p<0.001). Net agreement for provider incentives for breastfeeding targets was 44.1% (219/497) and net disagreement was 38.6% (192/497). Agreement was more likely for women (compared with men): OR 1.81 (1.09 to 3.00; p=0.023) and health visitors/maternity staff (compared with doctors): OR 2.54 (95% CI 1.65 to 3.91; p<0.001). Key emergent themes were 'moral tensions around acceptability', 'need for incentives', 'goals', 'collective or divisive action' and 'monitoring and proof'. While provider incentives can focus action and resources, tensions around the impact on relationships raised concerns. Pressure, burden of proof, gaming, box-ticking bureaucracies and health inequalities were counterbalances to potential benefits. Conclusions: Provider incentives are favoured by non-medical staff. Solutions which increase trust and collaboration towards shared goals, without negatively impacting on relationships or increasing bureaucracy are required

Review of the evidence for adolescent and young person specific, community-based health services for NHS managers

Purpose – The purpose of this paper is to provide an overview of the evidence surrounding the design and delivery of adolescent-specific health services for young people aged 14-25. This aims to make recommendations for National Health Service (NHS) senior management teams on the available literature relating to service design for children’s and young people's services within the UK. Design/methodology/approach – This paper presents a mini-review carried out in Spring 2013 using EMBASE, BNI, PSYCHinfo, MEDLINE and Google Scholar to systematically search available published and unpublished research papers. Systematic reviews, meta-analyses and evaluations of service models were included within this review. Adapted “GRADE” criteria were used to appraise the evidence. Findings – Of 70 papers found, 22 met the inclusion criteria. There were five main service designs found within the literature: hospital-based; school-linked or school-based; community based; combination and integrative; and other methods which did not fit into the four other categories. Research limitations/implications – This review is limited to the literature available within the inclusion criteria and search strategy used. It intends to inform management decisions in combination with other parameters and available evidence. Originality/value – There is range of research and evidence syntheses relating to adolescent services, but none of these have been conducted with a focus on the UK NHS and the information needs of managers re-designing services in the current climate within England

Supporting Fathers in Multi-Ethnic Societies: Insights from British Asian Fathers

AbstractThere is concern that current UK policy and intervention aimed at supporting fathers remains primarily informed by dominant White middle-class values and experiences, and therefore fails to respond adequately to the needs of Britain's diverse fathers. This paper contributes to understanding of ethnic diversity in fathering contexts, practices and experiences, by reporting findings from a qualitative study of British Asian fathers, involving in-depth interviews with fifty-nine fathers and thirty-three mothers from Bangladeshi Muslim, Pakistani Muslim, Gujarati Hindu and Punjabi Sikh background, and over eight additional respondents engaged through Key Informant interviews, ethnographic interviews and group discussions. The paper highlights four areas that require greater recognition by policy-makers and practitioners to appropriately meet the needs of fathers from diverse ethnic and socio-economic backgrounds. These are: recognising that fathers and mothers do not necessarily constitute an autonomous unit; appreciating diversity in fathers’ understandings of desirable child outcomes; addressing additional obstacles to achieving similar outcomes for children; and understanding that the boundaries and content of fathering are not universally recognised. Policies that are less normative and more responsive to diversity are essential to ensure that all fathers can be effectively supported.</jats:p

A Practical Guide to Integrating Reproductive Health and HIV/AIDS into Grant Proposals to the Global Fund

Integrating RH and HIV can greatly contribute to mitigating the AIDS pandemic by reducing unintended pregnancy; preventing perinatal transmission; expanding to more target groups; reducing gender based violence; meeting the needs of people living with HIV and providing our youth with the knowledge and services they need. Whether to integrate, how to integrate and exactly what to integrate will depend on a country's epidemiological profile, policies and program structures.Experience with implementation of integration initiatives in countries around the world shows that scale up and sustainability requires attention to policy and program operations issues. This document, with links to a range of resources, will help CCMs, civil society organizations and others developing proposals for the Global Fund that contribute to preventing HIV and mitigating the effects of the AIDS pandemic through programs that link and integrate RH and HIV/AIDS

The Adolescent Girls Empowerment Program: Lessons learned from the pilot test program

This document presents an evaluation of the Adolescent Girls Empowerment Program (AGEP), which is comprised of three major components: 1) safe spaces groups in which girls meet once a week over the course of two years for training on sexual and reproductive health, life skills and financial education. Groups are facilitated by a mentor, a young female from the same community as the girls; 2) a health voucher that girls can use at contracted private and public facilities for general wellness and sexual and reproductive health services; and 3) a saving account that has been designed to be girl-friendly. A randomized control trial (RCT) using a cluster design is being used to evaluate the impact of AGEP. The research aims to identify the impact of the intervention on the following key indicators: HIV prevalence, HSV-2 prevalence, age at first sex, age at first birth, contraceptive use, experience of gender-based violence, and educational attainment

Adolescent Sexual and Reproductive Health:Report on an Assessment and Review of Training Materials

Young people in Tanzania face a range of serious reproductive health risks – from early unwanted pregnancy and unsafe abortion to sexually transmitted infections, including HIV/AIDS. These reproductive health problems do not only have an immediate impact on the lives and well being of young people, but also contribute to long-term pattern of high fertility, poverty, dependency and poor socio-economic development. In recognition of the extent of adolescent health problems, the Government of Tanzania has initiated an effort to address young people’s needs for reproductive health information, counseling and services. To guide improved adolescent sexual and reproductive health programming, the Reproductive and Child Health Section (RCHS) of the Ministry of Health, with technical assistance from Family Care International (FCI) and financial assistance from the United Nations Population Fund (UNFPA), launched an effort to assess and review training curricula and related resource materials that are available in Ta nzania and internationally. Specific objectives of the Assessment were: To provide an overview of adolescent sexual and reproductive health (ASRH) training curricula that is available in Tanzania and at the international level. To identify priorities for curriculum development in Tanzania. To recommend training materials that could be used as models for developing national training curricula for various target audiences. Through interviews with key ASRH stakeholders in Tanzania and literature reviews, a \ud range of training materials were identified and reviewed. Materials were analyzed by target user and audience as well as by content and depth of coverage. The Assessment and Review served to illuminate critical ASRH issues that need to be addressed through training programmes for those working with youth. In addition, the Assessment highlighted key gaps in available curricula. Based on the Assessment findings, priorities for curriculum development include. An in-service training curriculum for orienting health service providers. The Assessment revealed that there are few materials for orienting service providers to youth friendly service delivery. Therefore, a standardized curriculum is needed to guide in-service training of facility-based health staff, as well as school-based health workers, outreach workers, lay counselors and other community-based providers in adolescent sexual and reproductive health counseling and service delivery. A comprehensive peer education training manual. Many organizations working with peer educators have developed training curricula, and there is considerable variety in the content and quality of these resources. To ensure the content and quality of peer education programmes for youth, it is recommended that a comprehensive peer education manual be developed, which could be used for training various types of peer educators and youth counselors (i.e. those working with in-school adolescents, those working with out-of-school adolescents, etc). Curricula and teaching aids for primary and secondary schools. Although the Ministry of Education and Culture has begun developing syllabi to guide implementation of the Family Life Education Programme in primary and secondary schools, teachers need more detailed curricula, reference materials and teaching aids to successfully carry out this important education programme. In developing the above curricula, it is recommended that special emphasis be placed on designing training resources comprised of separate training modules – modules that can be used either separately or together, depending on the specific training needs of various audiences. For example, the curriculum for service providers should include separate modules on adolescent sexual and reproductive health, information and counseling, and service provision to young people. While all tree modules would be used in training service providers, select modules could be used to train lay counselors and outreach workers. Similarly, the comprehensive training manual for peer educators should include separate modules on topics, such as adolescent sexual and reproductive health, facilitation and peer education skills, and working with different target audiences – in school adolescents, out-of-school youth, and parents and other adults – to ensure that peer education programmes could use the specific modules that are appropriate to their outreach efforts.The Assessment revealed that a large number of training curricula and related materials exist to support adolescent sexual and reproductive health initiatives in Tanzania. Although none of these resources is precisely suited to meet the above-mentioned gaps,many of the existing materials contain excellent content, which should be used as the basis for developing standardized national curricula