Oxford graduates' perceptions of a global health master's degree: a case study

<p>Abstract</p> <p>Introduction</p> <p>Low and middle-income countries suffer an ongoing deficit of trained public health workers, yet optimizing postgraduate education to best address these training needs remains a challenge. Much international public health education literature has focused on global capacity building and/or the description of innovative programmes, but less on quality and appropriateness.</p> <p>Case description</p> <p>The MSc in Global Health Science at the University of Oxford is a relatively new, full-time one year master's degree in international public health. The programme is intended for individuals with significant evidence of commitment to health in low and middle income countries. The intake is small, with only about 25 students each year, but they are from diverse professional and geographical backgrounds. Given the diversity of their backgrounds, we wanted to determine the extent to which student background influenced their perceptions of the quality of their learning experience and their learning outcomes. We conducted virtual or face-to-face semi-structured individual interviews with students who had graduated from the course at least one year previously. Of the 2005 to 2007 intake years, 52 of 63 graduates (83%) were interviewed. We used thematic analysis to analyze the data, then linked results to student characteristics.</p> <p>Discussion</p> <p>The findings from the evaluation suggested that all MSc GHS graduates who spoke with us, irrespective of background, appreciated the curriculum structure drawing on the strengths of a small, diverse student group, and the contribution the programme had made to their breadth of understanding and their careers. This evaluation also demonstrated the feasibility of an educational evaluation conducted several years after programme completion and when graduates were 'in the field'. This is important in ensuring international public health programmes are relevant to the day-to-day work of public health practitioners and researchers in low and middle-income countries.</p> <p>Conclusions</p> <p>Feedback from students, when they had either resumed their positions 'in the field' or pursued further training, was useful in identifying valuable and positive aspects of the programme and also in identifying areas for further action and development by the programme's management and by individual teaching staff.</p

Changes in health-related quality of life following imprisonment in 92 women in England: a three month follow-up study

<p>Abstract</p> <p>Background</p> <p>Despite the considerable changes in the provision of health care to prisoners in the UK there is little published literature that attempts to examine broader aspects of health and the impact of imprisonment on these, focusing instead on disease specific areas. This is surprising given that one of the main drivers behind the changes was the need for improvements in the quality of care; examining changes in health outcomes should be an important part of monitoring service developments. This study assessed the health-related quality of life of women on entry into prison and examined changes during a period of three months imprisonment.</p> <p>Methods</p> <p>This was a prospective longitudinal study involving 505 women prisoners in England. The SF-36 was contained within a questionnaire designed to examine many aspects of imprisoned women's health. Participants completed this questionnaire within 72 hours of entering prison. The researchers followed up all participants who were still imprisoned three months later.</p> <p>Results</p> <p>The study achieved good response rates: 82% of women agreed to participate initially (n = 505), and 93% of those still imprisoned participating three months later (n = 112). At prison entry, women prisoners have lower mental component summary score (MCS) and physical component summary score (PCS) compared to women within the general population. The mental well-being of those 112 women still imprisoned after three months improved over this period of imprisonment, although remained poorer than that of the general population. The PCS did not improve significantly and remained significantly lower than that of the general population. Multivariate analyses showed that the only independent predictor of change in component score was the score at baseline.</p> <p>Conclusions</p> <p>The results highlight the poor health-related quality of life of women prisoners and highlight the scale of the challenge faced by those providing health care to prisoners. They also draw attention to the major health disadvantages of women offenders compared to women in general. While recent reforms may improve health services for prisoners, broader inequalities in the health of women are a more complex challenge.</p

A systematic review of how researchers characterize the school environment in determining its effect on student obesity

BACKGROUND: Obesity in early childhood is a robust predictor of obesity later in life. Schools provide unparalleled access to children and have subsequently become major intervention sites. However, empirical evidence supporting the effectiveness of school-based interventions against childhood obesity is of limited scope and unknown quality. The aim of this systematic review is to critically assess how researchers have characterized the school environment in determining its effect on childhood weight status in order to improve the quality and consistency of research in this area. We conducted a narrative review with a systematic search of the literature in line with PRISMA guidelines (2009). Original peer-reviewed research articles in English were searched from Medline, EMBASE, CENTRAL, CINAHL and PsycINFO databases from earliest record to January 2014. We included empirical research that reported at least one measure of the primary/elementary school environment and its relationship with at least one objective adiposity-related variable for students aged 4-12 years. Two authors independently extracted data on study design, school-level factors, student weight status, type of analysis and effect. RESULTS: Five studies met the inclusion criteria. Each study targeted different parts of the school environment and findings across the studies were not comparable. The instruments used to collect school-level data report no validity or reliability testing. CONCLUSIONS: Our review shows that researchers have used instruments of unknown quality to test if the school environment is a determinant of childhood obesity, which raises broader questions about the impact that schools can play in obesity prevention

Determinants of Appropriate Child Health and Nutrition Practices among Women in Rural Gambia

Health education and awareness involves providing knowledge about causes of illness and choices to promote a change in individual behaviour and, thus, improves survival of individuals. Studies have, however, shown that improved knowledge and awareness is not always translated into appropriate actions. This study aimed at exploring the factors determining mothers’ choices of appropriate child health and nutrition practices in the Gambia. Eight focus-group discussions (FGDs) were held with 63 women whose children had been seen at the Keneba MRC Clinic within the 12 months preceding the study. The FGDs were analyzed using a thematic framework. Gender inequality, presence or absence of support networks, alternative explanatory models of malnutrition, and poverty were identified as the main factors that would determine the ability of a mother to practise what she knows about child health and nutrition. The findings highlight the need to consider the broader social, cultural and economic factors, including the value of involving men in childcare, when designing nutritional interventions

Delivering primary care in prison: the need to improve health information

Background Electronic patient records and access to electronic information resources are the cornerstones of delivery of modern primary care, and they will be necessary to deliver effective evidence-based patient care, provide needs-driven health care, assist research and improve quality of services. However, prison health needs assessments carried out in the South East region suggested that modern information technology was lacking in prison primary care. This is despite the fact that the principle of 'equivalence of care' has been guiding the recent prison healthcare reforms in response to concerns about quality of prison healthcare services. Methods We visited all four male adult prisons in the Thames Valley area and conducted one-to-one semi-structured interviews with healthcare staff to investigate the information available to them, the quality and uses of the data, and their current information systems. We also ran a workshop with prison healthcare managers and other healthcare staff from prisons in the Thames Valley area. Results Primary care staff in prisons record almost all clinical data on paper and do not have access to electronic clinical records nor to the internet. The main perceived barriers to implementing health information technology in prisons were concerns about potential breaches of security and discipline in prisons, anxiety about data security and a culture that gives low priority to health in prisons. Conclusions To provide 'equivalence of care' for prisoners, primary care trusts need to implement full electronic clinical records in prisons and ensure staff have access to resources on the internet

Leaving no one behind in prison:Improving the health of people in prison as a key contributor to meeting the Sustainable Development Goals 2030

Worldwide, approximately 11 million people are currently being held in prison, a number that has steadily grown since the turn of the 21st century. The prison population is more likely to suffer from physical and mental ailments both during and prior to their imprisonment due to poverty, social exclusion and chaotic lifestyles. Recognition of people in prison is noticeably absent from the Sustainable Development Goals (SDGs), despite the goals' ethos of 'leaving no one behind'.We present the first analysis of how improving the health of people in prison can contribute to achieving 15 SDGs. Relevant indicators are proposed to fulfil these goals while meeting the existing international prison health standards. We also assess the political, economic and social challenges, alongside the unparalleled COVID-19 pandemic that can thwart the realisation of the SDGs. To reach the 'furthest behind first', prison health must be at the forefront of the SDGs.</p

Determinants of Appropriate Child Health and Nutrition Practices among Women in Rural Gambia

Health education and awareness involves providing knowledge about causes of illness and choices to promote a change in individual behaviour and, thus, improves survival of individuals. Studies have, however, shown that improved knowledge and awareness is not always translated into appropriate actions. This study aimed at exploring the factors determining mothers\u2019 choices of appropriate child health and nutrition practices in the Gambia. Eight focus-group discussions (FGDs) were held with 63 women whose children had been seen at the Keneba MRC Clinic within the 12 months preceding the study. The FGDs were analyzed using a thematic framework. Gender inequality, presence or absence of support networks, alternative explanatory models of malnutrition, and poverty were identified as the main factors that would determine the ability of a mother to practise what she knows about child health and nutrition. The findings highlight the need to consider the broader social, cultural and economic factors, including the value of involving men in childcare, when designing nutritional interventions

Interventions to increase vaccine uptake among people who live and work in prisons : a global multistage scoping review

The objective of this study is to examine interventions implemented to increase vaccine uptake among people who live and work in prisons around the world. Peer-reviewed and gray literature databases were searched systematically to identify relevant information published from 2012 to 2022. Publications were evaluated by two researchers independently and underwent quality assessment through established tools. Of the 11,281 publications identified through peer-reviewed (2607) and gray literature (8674) search, 17 met the inclusion criteria. In light of limited data, the identified interventions were categorized into two categories of educational and organizational interventions, and are discussed in the text. The lack of availability of vaccination services and interventions to increase vaccine uptake among people who live and work in prisons, worldwide, is a serious public health concern. These interventions reported in this review can be adapted and adopted to mitigate the burden of infectious diseases among people who live and work in prisons