Reforming sanitary-epidemiological service in Central and Eastern Europe and the former Soviet Union: an exploratory study

<p>Abstract</p> <p>Background</p> <p>Public health services in the Soviet Union and its satellite states in Central and Eastern Europe were delivered through centrally planned and managed networks of sanitary-epidemiological (san-epid) facilities. Many countries sought to reform this service following the political transition in the 1990s. In this paper we describe the major themes within these reforms.</p> <p>Methods</p> <p>A review of literature was conducted. A conceptual framework was developed to guide the review, which focused on the two traditional core public health functions of the san-epid system: communicable disease surveillance, prevention and control and environmental health. The review included twenty-two former communist countries in the former Soviet Union (fSU) and in Central and Eastern Europe (CEE).</p> <p>Results</p> <p>The countries studied fall into two broad groups. Reforms were more extensive in the CEE countries than in the fSU. The CEE countries have moved away from the former centrally managed san-epid system, adopting a variety of models of decentralization. The reformed systems remain mainly funded centrally level, but in some countries there are contributions by local government. In almost all countries, epidemiological surveillance and environmental monitoring remained together under a single organizational umbrella but in a few responsibilities for environmental health have been divided among different ministries.</p> <p>Conclusions</p> <p>Progress in reform of public health services has varied considerably. There is considerable scope to learn from the differing experiences but also a need for rigorous evaluation of how public health functions are provided.</p

Study of Stress Variation in the Lithosphere by Multidisciplinary Monitoring

მიწისძვრის წინამორბედების გამოვლინება წარმოადგენს გლობალურ ამოცანას. სტატიაში განხილულია მიწისძვრის მომზადების პროცესში გამოვლენილი ანომალიები. ამ მიზნით დამუშავებულ იქნა ჰიდროდინამიური მომიტორინგის ქსელიდან მიღებული წყლის დონისა და ატმოსფერული წნევის მონაცემები, ასევე დუშეთის გეომაგნიტური ობსერვატორიის მონაცემები. შედეგად, გამოვლინდა მიწისძვრების წინამორბედი ანომალიები და დადასტურდა შემუშავებული დამუშავების მეთოდის მაღალი მგრძნობელობა გეოდინამიკური პროცესების მიმართ.Determination of earthquake precursors is a task of global importance. The article deals about detected anomalies during preparation of average grade earthquake. For this purpose was developed data of the water level and atmospheric pressure from the Hydrodynamic monitoring network, as well as data from Dusheti geomagnetic observatory. Has fixed the hidrogeodeformation field variation caused by the earthquake preparation process and reflection of the critical stress in the water level and abnormal variations of the magnetic field. As a result, have been identified preliminary anomalies and has been confirmed high sensitivity to the geodynamic processes

Towards tuberculosis elimination: an action framework for low-incidence countries

This paper describes an action framework for countries with low tuberculosis (TB) incidence (<100 TB cases per million population) that are striving for TB elimination. The framework sets out priority interventions required for these countries to progress first towards "pre-elimination" (<10 cases per million) and eventually the elimination of TB as a public health problem (less than one case per million). TB epidemiology in most low-incidence countries is characterised by a low rate of transmission in the general population, occasional outbreaks, a majority of TB cases generated from progression of latent TB infection (LTBI) rather than local transmission, concentration to certain vulnerable and hard-to-reach risk groups, and challenges posed by cross-border migration. Common health system challenges are that political commitment, funding, clinical expertise and general awareness of TB diminishes as TB incidence falls. The framework presents a tailored response to these challenges, grouped into eight priority action areas: 1) ensure political commitment, funding and stewardship for planning and essential services; 2) address the most vulnerable and hard-to-reach groups; 3) address special needs of migrants and cross-border issues; 4) undertake screening for active TB and LTBI in TB contacts and selected high-risk groups, and provide appropriate treatment; 5) optimise the prevention and care of drug-resistant TB; 6) ensure continued surveillance, programme monitoring and evaluation and case-based data management; 7) invest in research and new tools; and 8) support global TB prevention, care and control. The overall approach needs to be multisectorial, focusing on equitable access to high-quality diagnosis and care, and on addressing the social determinants of TB. Because of increasing globalisation and population mobility, the response needs to have both national and global dimensions