Medical diaspora: an underused entity in low- and middle-income countries’ health system development

Background At present, over 215 million people live outside their countries of birth, many of which are referred to as diaspora—those that live in host countries but maintain strong sentimental and material links with their countries of origin, their homelands. The critical shortage of Human Resources for Health (HRH) in many developing countries remains a barrier to attaining their health system goals. Usage of medical diaspora can be one way to meet this need. A growing number of policy-makers have come to acknowledge that medical diaspora can play a vital role in the development of their homeland’s health workforce capacity. To date, no inventory of low- and middle-income countries (LMIC) medical diaspora organizations has been done. This paper intends to develop an inventory that is as complete as possible, of the names of the LMIC medical diaspora organizations in the United States of America, the United Kingdom, Canada, and Australia and addresses their interests and roles in building the health system of their country of origin. Methods The researchers utilized six steps for their research methodology: (1) development of rationale for choosing the four destination countries (the United States of America, the United Kingdom, Canada, and Australia); (2) identification of low- and middle-income countries (LMIC); (3) web search for the name of LMIC medical diaspora organization in the United States of America, the United Kingdom, Canada, and Australia through the search engines of PubMed, Scopus, Google, Google Scholar, and LexisNexis; (4) development of inclusion and exclusion criteria and creation of a medical diaspora organizations’ inventory list (Table 1) and corresponding maps (Figures 1, 2, and 3). Using decision criteria, reviewers narrowed the number to a final 89 organizations; (5) synthesis of information to collect the general as well as the unique roles the medical diaspora organizations play in building health systems; and (6) developing inventory of respective LMIC governments’ diaspora offices (Table 2) to identify units/departments that facilitate diaspora’s work. Result In total, the authors found 89 medical diaspora organizations in 4 main countries: in the United States of America 60, in the United Kingdom 24, in Australia 3, and in Canada 2. These medical diaspora organizations tend to have three focuses: providing healthcare services, training, and when needed humanitarian aid to their home country; creating a social or professional network of migrant physicians (i.e., simply to bring together people with an ethnic and professional commonality) and; supplying improved and culturally sensitive healthcare to the migrant population within the host country. Sixty-eight LMIC countries have established a diaspora office within their government office. It is also equally important to note that many policy-makers may lack knowledge of models for medical diaspora engagement or of valuable lessons learned by other governments about working with diaspora. Conclusions The medical diaspora remains an underutilized resource in both health systems policy formulation and program implementation

Diabetes Distress: The Role of Physician Assistants in Screening Adolescents and Young Adults Living with Type 1 Diabetes

Type 1 diabetes self-management involves complex psychosocial features such as social, environmental, behavioral, and emotional. Although self–management skills may be learned overtime to reduce the risk of complications, patients continue to live with “diabetes distress”. Physician assistants should be current on strategies including instrumental tools for screening diabetes-related distress. Improving type 1 diabetes self-management begins with identifying the psychosocial factors that create barriers to using the fundamental skills that have already been obtained for practical use to reduce serious health complications

Rents, loyalty, and the economy: How an unstable economy plays a role in the occurrence of coups d\u27état

This thesis examines why coups d’état still occur, regardless of institution type, in some states but not others. Building off Wintrobe’s and Hiroi and Omori’s observations, an elite theory is presented that attributes the success of avoiding coups lies in both the stability of economic growth and a system of internal incentives that create a direct link between the government and the people. Without either present, the elite in government are not constrained from engaging in undemocratic behavior and usurping power, ultimately resulting in coups. Using a zero-inflated negative binomial logistic regression, indicators of economic stability and internal loyalty systems are quantitatively analyzed with the occurrence of coups in several states during the period between 1946 and 2008. These findings may provide a new perspective on the dynamics and triggers of coups d’état

Building communities of practice: MEPI creates a commons

The Medical Education Partnership Initiative (MEPI) supports medical education capacity development, retention, and research in Sub-Saharan African institutions. Today, MEPI comprises more than 40 medical schools in Africa and 20 in the United States. Since 2011, the MEPI Coordinating Center, working with the MEPI schools and the U.S. government, has laid the groundwork and served as a catalyst for the creation and development of MEPI communities of practice (CoPs). These CoPs encompass seven components, some of which are virtual while others are tangible. They include technical working groups, principal investigator site visit exchanges, an annual symposium, a MEPI journal supplement, the MEPI Web site, newsletters, and webinars. Despite certain challenges and the question of sustainability, the presence within the MEPI network of an organization focused on promoting group consciousness and facilitating collaborative projects is an asset that is likely to continue to pay dividends for the foreseeable future

Building communities of practice: MEPI creates a commons

The Medical Education Partnership Initiative (MEPI) supports medical education capacity development, retention, and research in Sub-Saharan African institutions. Today, MEPI comprises more than 40 medical schools in Africa and 20 in the United States. Since 2011, the MEPI Coordinating Center, working with the MEPI schools and the U.S. government, has laid the groundwork and served as a catalyst for the creation and development of MEPI communities of practice (CoPs). These CoPs encompass seven components, some of which are virtual while others are tangible. They include technical working groups, principal investigator site visit exchanges, an annual symposium, a MEPI journal supplement, the MEPI Web site, newsletters, and webinars. Despite certain challenges and the question of sustainability, the presence within the MEPI network of an organization focused on promoting group consciousness and facilitating collaborative projects is an asset that is likely to continue to pay dividends for the foreseeable future

Coastal California Wastewater Effluent as a Resource for Seawater Desalination Brine Commingling

California frequently experiences water scarcity, especially in high population areas. This has generated increased interest in using the Pacific Ocean as a water resource, with seawater desalination becoming a popular solution. To mitigate the environmental impacts of the high salinity brine from seawater desalination, California recommends commingling brine with wastewater effluent before ocean discharge. Results reveal that throughout the California coast, approximately 4872 MLD (1287 MGD) of treated wastewater are discharged into the ocean and might be available as dilution water. Most of this dilution water resource is produced in Southern California (3161 MLD or 835 MGD) and the San Francisco Bay Area (1503 MLD or 397 MGD), which are also the areas with the highest need for alternative water sources. With this quantity of dilution water, in principle, over 5300 MLD (1400 MGD) of potable water could be produced in California through seawater desalination. Furthermore, this study provides a survey of the treatment levels and typical discharge violations of ocean wastewater treatment facilities in California.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]