Diffusion of e-health innovations in 'post-conflict' settings: a qualitative study on the personal experiences of health workers.

BACKGROUND: Technological innovations have the potential to strengthen human resources for health and improve access and quality of care in challenging 'post-conflict' contexts. However, analyses on the adoption of technology for health (that is, 'e-health') and whether and how e-health can strengthen a health workforce in these settings have been limited so far. This study explores the personal experiences of health workers using e-health innovations in selected post-conflict situations. METHODS: This study had a cross-sectional qualitative design. Telephone interviews were conducted with 12 health workers, from a variety of cadres and stages in their careers, from four post-conflict settings (Liberia, West Bank and Gaza, Sierra Leone and Somaliland) in 2012. Everett Roger's diffusion of innovation-decision model (that is, knowledge, persuasion, decision, implementation, contemplation) guided the thematic analysis. RESULTS: All health workers interviewed held positive perceptions of e-health, related to their beliefs that e-health can help them to access information and communicate with other health workers. However, understanding of the scope of e-health was generally limited, and often based on innovations that health workers have been introduced through by their international partners. Health workers reported a range of engagement with e-health innovations, mostly for communication (for example, email) and educational purposes (for example, online learning platforms). Poor, unreliable and unaffordable Internet was a commonly mentioned barrier to e-health use. Scaling-up existing e-health partnerships and innovations were suggested starting points to increase e-health innovation dissemination. CONCLUSIONS: Results from this study showed ICT based e-health innovations can relieve information and communication needs of health workers in post-conflict settings. However, more efforts and investments, preferably driven by healthcare workers within the post-conflict context, are needed to make e-health more widespread and sustainable. Increased awareness is necessary among health professionals, even among current e-health users, and physical and financial access barriers need to be addressed. Future e-health initiatives are likely to increase their impact if based on perceived health information needs of intended users

Current state of cannabis use, policies, and research across sixteen countries : cross-country comparisons and international perspectives

INTRODUCTION : Varying public views on cannabis use across countries may explain the variation in the prevalence of use, policies, and research in individual countries, and global regulation of cannabis. This paper aims to describe the current state of cannabis use, policies, and research across sixteen countries. METHODS : PubMed and Google Scholar were searched for studies published from 2010 to 2020. Searches were conducted using the relevant country of interest as a search term (e.g., “Iran”), as well as relevant predefined keywords such as “cannabis,” “marijuana,” “hashish,” “bhang “dual diagnosis,” “use,” “addiction,” “prevalence,” “co-morbidity,” “substance use disorder,” “legalization” or “policy” (in English and non-English languages). These keywords were used in multiple combinations to create the search string for studies’ titles and abstracts. Official websites of respective governments and international organizations were also searched in English and non-English languages (using countries national languages) to identify the current state of cannabis use, policies, and research in each of those countries. RESULTS : The main findings were inconsistent and heterogeneous reporting of cannabis use, variation in policies (e.g., legalization), and variation in intervention strategies across the countries reviewed. European countries dominate the cannabis research output indexed on PubMed, in contrast to Asian countries (Thailand, Malaysia, India, Iran, and Nepal). CONCLUSIONS : Although global cannabis regulation is ongoing, the existing heterogeneities across countries in terms of policies and epidemiology can increase the burden of cannabis use disorders disproportionately and unpredictably. There is an urgent need to develop global strategies to address these cross-country barriers to improve early detection, prevention, and interventions for cannabis use and related disorders.The Indian Council of Medical Research.https://www.scielo.br/j/trendsam2023Family Medicin

Introducing evidence based public health practice through a journal club for public health officers in Somaliland

Evidence based public health is one of the basic training tools of public health students and young officers in decision making. The training tools for early career specialists and trainees in public health is journal clubs (JC). It keeps the knowledge of professionals up to date and assist them in receiving information to design, plan, implement health care services, policies and strategies. The intention of the JC team was to raise awareness of methods for public health literature search, appraising it and applying this knowledge in their daily practices. A senior public health practitioner in Somaliland (the corresponding author) invited medical students and residents to have JCs as a part of their training. They did not accept the offer so the organizer invited practicing junior public health professionals instead. The JC team members were a general practitioner and 3 public health workers from Ministry of Health, public hospital physician, public health school and field public health officer. A weekly or twice weekly journal club took place to train them in critical appraisal. This continued for 15 months in a hybrid mentorship for the health care professionals. The team mentor selected a paper for discussion. Mentees choose a study design appraisal tool from the Critical Appraisal Skills Program (CASP) that matched the study to present. In the process of appraisal, a team member led the discussion using the checklist. The mentees presented their critical appraisal either orally or via a presentation. The checklist and paper were compared for assessing the study design and structure of the paper of the week. This approach of empowering junior public health officers in Somalia is a way forward for encouraging the professionals to use evidence based practice in their daily practices. This will improve their selection of research tools and translating the scientific work into their practice and services

Scaling Up Global Mental Health Services During the COVID-19 Pandemic and Beyond

Every health care system requires an adequate health care workforce, service delivery, financial support, and information technology. During the COVID-19 pandemic, global health systems were ill prepared to address the rising prevalence of mental health problems, especially in low-and middle-income countries (LMICs), thereby increasing treatment gaps. To close these gaps globally, task shifting and telepsychiatry should be made available and maximized, particularly in LMICs. Task shifting to nonspecialist health workers to improve essential mental health coverage and encourage effi-cient use of the available resources and technology has become the most viable strategy. Psychiatric Services 2022; 73:231-234; doi: 10.1176/appi.ps.20200077