A Central Role for the One Health Workforce

Funding Information: GHTM (UID/Multi/04413/2019) is Funded by the Portuguese Science Foundation (FCT).publishersversionpublishe

Purchasing power of civil servant health workers in Mozambique

Background: Health workers ’ purchasing power is an important consideration in the development of strategies for health workforce development. This work explores the purchasing power variation of Mozambican public sector health workers, between 1999 and 2007. In general, the calculated purchasing power increased for most careers under study, and the highest percentage increase was observed for the lowest remuneration careers, contributing in this way for a relative reduction in the difference between the higher and the lower salaries. Methods: This was done through a simple and easy-to-apply methodology to estimate salaries ’ capitalization rate, by means of the accumulated inflation rate, after taking wage revisions into account. All the career categories in the Ministry of Health and affiliated public sector institutions were considered. Results: Health workers ’ purchasing power is an important consideration in the development of strategies for health workforce development. This work explores the purchasing power variation of Mozambican public sector health workers, between 1999 and 2007. In general, the calculated purchasing power increased for most careers under study, and the highest percentage increase was observed for the lowest remuneration careers, contributing in this way for a relative reduction in the difference between the higher and the lower salaries. Conclusion: These results seem to contradict a commonly held assumption that health sector pay has deteriorated over the years, and with substantial damage for the poorest. Further studies appear to be needed to design a more accurate methodology to better understand the evolution and impact of public sector healt

Análise da materialidade: abordagens no planeamento sustentável em saúde

Os desafios da implementação da Agenda 2030 para o Desenvolvimento Sustentável têm gerado necessidades conceptuais e metodológicas específicas no âmbito do planeamento estratégico, na procura de modelos, nos vários setores da sociedade, baseados num referencial que integre os três pilares do desenvolvimento sustentável: ambiental, social e económico. A análise da materialidade é um dos métodos analíticos que apoiam o planeamento estratégico das organizações no âmbito do desenvolvimento sustentável. Com origem na área financeira, há vários anos que o conceito de materialidade tem sido alargado às áreas da sustentabilidade, sendo atualmente definido como o limiar a partir do qual as questões com potencial impacto na capacidade de uma organização para criar, preservar ou lesar o valor económico, ambiental e social para si própria, para os stakeholders e para a sociedade, se tornam suficientemente importantes para que passem a ser abordadas no respetivo planeamento estratégico. Largamente utilizada no setor empresarial, admite-se que a análise da materialidade possa contribuir para a integração das dimensões do desenvolvimento sustentável no planeamento em saúde. O objetivo desta comunicação é descrever as diferentes abordagens metodológicas da análise da materialidade e a sua potencial adequação ao setor da saúde.info:eu-repo/semantics/publishedVersio

Análise da materialidade: abordagens no planeamento sustentável em saúde

Os desafios da implementação da Agenda 2030 para o Desenvolvimento Sustentável têm gerado necessidades conceptuais e metodológicas específicas no âmbito do planeamento estratégico, na procura de modelos, nos vários setores da sociedade, baseados num referencial que integre os três pilares do desenvolvimento sustentável: ambiental, social e económico. A análise da materialidade é um dos métodos analíticos que apoiam o planeamento estratégico das organizações no âmbito do desenvolvimento sustentável. Com origem na área financeira, há vários anos que o conceito de materialidade tem sido alargado às áreas da sustentabilidade, sendo atualmente definido como o limiar a partir do qual as questões com potencial impacto na capacidade de uma organização para criar, preservar ou lesar o valor económico, ambiental e social para si própria, para os stakeholders e para a sociedade, se tornam suficientemente importantes para que passem a ser abordadas no respetivo planeamento estratégico. Largamente utilizada no setor empresarial, admite-se que a análise da materialidade possa contribuir para a integração das dimensões do desenvolvimento sustentável no planeamento em saúde. O objetivo desta comunicação é descrever as diferentes abordagens metodológicas da análise da materialidade e a sua potencial adequação ao setor da saúde.info:eu-repo/semantics/publishedVersio

uma visão de saúde para todos, além da prática médica

Sessão Solene - Cerimónia de investidura como Doutor Honoris Causapublishersversionpublishe

Measles in South Africa: a community health interpretation of the data

A dissertation submitted to the faculty of Medicine of the University of the Witwatersrand in partial fulfillment of the requirements for the Master of Medicine (Community Health) Johannesburg, October 1991.This dissertation reviews the international literature and South African literature and data on the epidemiology of Measles. The main purpose is to contribute to an understanding of the local epidemiology of the disease that will further the development of more targeted efforts for its control. [Abbreviated Abstract. Open document to view full version]MT201

Violence against health care workers in the workplace in Mozambique – An unrecognised managerial priority

Funding Information: We acknowledge support of the Niassa Provincial Health Directorate (provided administrative authorization and support for the research to be carried out). We are also thankful to all study participants for their time and effort by taking part in the study. Professor Inês Fronteira advised on the statistical analysis. The Research Center on Global Health and Tropical Medicine (GHTM) receives support from the Portuguese Science and Technology Foundation (grant GHTM UID/04413/2020). Publisher Copyright: © 2022 John Wiley & Sons Ltd.Introduction: Recognition of the relevance of violence against health workers in their work place has been growing around the world. In Mozambique, workplace violence in the health sector needs better documentation. Therefore, this article is part of a study that describes the typology and the perceived impact of violence against health care workers in their workplace at the Lichinga Provincial Hospital and at the Health Centre of the City of Lichinga in 2019. Method: This was an observational, descriptive, cross-sectional study. The study was carried out in a simple random sample of health workers victims of violence at the Provincial Hospital and the Health Centre of the City of Lichinga, in the Province of Niassa in northern Mozambique. The questionnaire applied was adapted from the original developed by the International Labour Organization, the International Council of Nurse, the World Health Organization and Public Services International and applied in Maputo, Mozambique during 2002. Statistical analysis was carried out with Statistical Package for the Social Sciences 20.0 and WinPepi 11.65. Results: Two hundred and 60 healthcare workers (HCW) were selected to participate, 180 agreed, 145 had inclusion criteria and five gave up participating in the study during the consent procedure. Thus, a total of 140 HCW answered the questionnaire. Predominant types of violence were: verbal threat/aggression 34% (n = 62/180); moral pressure/bullying/mobbing 30% (n = 54/180); ethnic discrimination 9% (n = 16/180); against personal property 6% (n = 10/180); physical 4% (n = 8/180); sexual harassment 4% (n = 8/180). One hundred and 37 victims reported 154 episodes of violence, where 7% (n = 13/180) reported more than one type of violence. Most victims reported no reaction (55%, n = 76/137) and few said that they confronted the offender (16%, n = 22/137, particularly victims of sexual harassment, 38%, n = 3/8). Most HCW reported non-existence (39%, n = 54/137) or unawareness (32%, n = 44/137) of procedures to report violence within the Institution. Most (80%, n = 33/41) of those knowing about the procedures, knew how to use them. More than half (55%; n = 76/137) of HCW said that they were discouraged to report acts of violence. Conclusions: Like for previous studies in Mozambique and elsewhere in Africa, the study confirms: a relatively high prevalence, a reluctance to talk about the issue and unawareness about procedures on how to report incidents. The findings reconfirm the necessity for the development and implementation of procedures to address violence incidents towards HCW, to develop support services for victims of health workplace violence. Like elsewhere in Africa, successive health workforce plans in Mozambique have failed to address this issue.publishersversionpublishe

COVID-19-related adolescent mortality and morbidity in nineteen European countries

Funding Information: Open access funding provided by FCT|FCCN (b-on). The present publication was funded by Fundação para a Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020). FCT e a Unidade de I&D CHRC—Comprehensive Health Research Centre (UI/BD/150908/2021). GHTM (UID/Multi/04413/2019) is funded by the Portuguese Science Foundation (FCT). Publisher Copyright: © 2023, The Author(s).Prior to the COVID-19 pandemic, adolescents in most countries experienced a syndemic of malnutrition, obesity, deprivation, mental health problems, inequalities, and the effects of climate change. Today, other factors have added to this burden during the pandemic, and it is important to have an updated reflection. We aimed to assess the risk and protective factors for COVID-19-related adolescent mortality and morbidity in the European region. Three double models were fitted to analyze the relationship between different factors with the number of diagnosed cases and deaths. The 1a and 1b use a multiple Poisson regression. The 2a and 2b are optimized models that use the same variables as prior models but with backward selection with a p value < 0.05 as the limit. Finally, the 3a and 3b models (backward stepwise multivariable Poisson regression) include the variable “fully vaccinated.” All models used the at-risk population (15–19 years or total population) as a regression covariate (offset). Increased access to quality healthcare (IRR 0.68; CI 0.55–0.84), increased private sector involvement (IRR 0.86; CI 0.82–0.90), Gini coefficient (IRR 0.93; CI 0.88–0.99), and full vaccination (IRR 0.94; CI 0.90–0.99) represent protective factors of COVID-19 mortality in this population. Additionally, a positive association between pollution and mortality was found. Conclusion: Being fully vaccinated and having access to quality medical care are protective factors against COVID-19 mortality in this age group. Interestingly, the more the pollution, the greater the risk of dying from COVID-19. We stress the great importance of coordination between the public and private sectors to address crises such as the current one. What is Known: • Compared to other age groups, adolescents have been little studied, and most studies focused on mental health during the COVID-19 pandemic. What is New: • In this study, we show how in 19 European countries, different factors interact, such as socio-demographic, environmental, health system, and control measures with morbidity and mortality by COVID-19, in a very little studied age group as teenagers.publishersversioninpres

Pandemics, epidemics, humanitarian crisis and human resources in health

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data from Guiné-Bissau

Background: In this article, we analyze data collected in the context of health workforce planning (HWFP) for Guiné-Bissau as part of the development of the third National Health Strategy, to study the relationship between educational achievement of parents and medical student characteristics and professional expectations. Methods: Cross-sectional analytical study of all first-year medical students in Guiné-Bissau during December 2016. Results: Our results confirm that the isolated effect of each parent is different as it is the combined education of both parents. Parental influence also seems to vary according to the sex of the offspring. The higher the education of the father, the stronger the urban background of the offspring. Level of education of parents is also important in relation to the decision to study medicine and the age of starting those studies. It is also an important influence as to expectation regarding place of future practice: the highest the educational level, particularly of the father, the highest the expectation for a future urban practice. Conclusions: Our main interest in medical education is to study it as a health system intervention in order to contribute to health system’s strengthening in fragile states. This is discussed in the context of two frameworks: the labor market framework and WHO’s health system strengthening framework. Our data and that of others, recognize that household characteristics are important regarding future training and a future career in the health sector. This recognition should be integrated into HWFP frameworks.publishersversionpublishe