Quality of life, vulnerability and resilience: a qualitative study of the tsunami impact on the affected population of Sri Lanka

AIM: This qualitative study is aimed at analysing the impact of the 2004 tsunami on the Quality of Life of the Sri Lankan population. It focused on the factors that have contributed to an increase in the people's susceptibility to the impact of hazards - their vulnerability - as well as of the natural ability to cope of the populations affected - their resilience. METHODOLOGY: The study is based on the conduction of 10 Focus Group discussions and 18 In-depth Interviews, then analysed through a qualitative analysis software. RESULTS AND CONCLUSIONS: The analysis shows that each factor involved in the interplay among the different processes that produced the changes in the affected people's quality of life is at the same time a damaged asset, a vulnerability factor and a resource to draw upon for coping. The complexity of this situation opens further speculation as to how disasters and relief interventions influence relationships and dynamics in society. This should thus be further investigated, together with the effects of individual and group trauma on society

Increased incidence of invasive meningococcal disease of serogroup C / clonal complex 11, Tuscany, Italy, 2015 to 2016

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Quality of life, vulnerability and resilience: a qualitative study of the tsunami impact on the affected population of Sri Lanka

AIM: This qualitative study is aimed at analysing the impact of the 2004 tsunami on the Quality of Life of the Sri Lankan population. It focused on the factors that have contributed to an increase in the people's susceptibility to the impact of hazards - their vulnerability - as well as of the natural ability to cope of the populations affected - their resilience. METHODOLOGY: The study is based on the conduction of 10 Focus Group discussions and 18 In-depth Interviews, then analysed through a qualitative analysis software. RESULTS AND CONCLUSIONS: The analysis shows that each factor involved in the interplay among the different processes that produced the changes in the affected people's quality of life is at the same time a damaged asset, a vulnerability factor and a resource to draw upon for coping. The complexity of this situation opens further speculation as to how disasters and relief interventions influence relationships and dynamics in society. This should thus be further investigated, together with the effects of individual and group trauma on society

Infant immunization coverage in Italy (2000-2016)

In Italy, national-level immunization polices are included in the National Immunization Prevention Plan (PNPV), whose latest edition - 2017-2019 PNPV - was finally approved in February 2017. Coverage rates are a key measure of immunization system performance; it can inform and support national and regional polices' implementation monitoring, as well as measure the impact of interventions aimed at increasing vaccine uptake

Coperture vaccinali in Italia e valutazione dell’attuazione del PNPV 2012-2014

INTRODUZIONE Il Piano Nazionale di Prevenzione vaccinale (PNPV 2012-2014) è stato emanato nel 2012 dal Ministero della Salute e dalla Conferenza Stato-Regioni con l’obiettivo di armonizzare le strategie di immunizzazione in tutto il Paese e di assicurare un accesso equo alla prevenzione delle malattie infettive a tutti i cittadini. Il Piano definisce gli standard di immunizzazione ai quali tutte le Regioni si sono impegnate ad aderire. OBIETTIVO A più di tre anni dall’approvazione e nell’imminenza dell’uscita del nuovo Piano, obiettivo del nostro studio è stato quello di: i)riassumere i contenuti del PNPV 2012-2014, ii) descriverne le declinazioni regionali e iii) presentare i più aggiornati dati di copertura, evidenziando gli obiettivi raggiunti e le criticità riscontrate. RISULTATI Dall’analisi dei dati raccolti dal Ministero della Salute emergono il calo delle coperture in quasi tutte le Regioni per le vaccinazioni dell’infanzia e nella popolazione anziana per il vaccino antinfluenzale; promettenti dati preliminari circa l’introduzione delle vaccinazioni antimeningococco e antipneumococco nelle schedule regionali, e coperture in aumento per tutte le coorti invitate alla vaccinazione anti-HPV - benché al di sotto dei target stabiliti nel Piano. CONCLUSIONI I nostri dati sottolineano che gli obiettivi del PNPV 2012-2014 sono stati raggiunti solo parzialmente a causa di diversi fattori, in particolare l’incremento dell’esitazione sui vaccini. Maggiori sforzi sono necessari per promuovere l’immunizzazione. Il nuovo Piano dovrà considerare i nuovi vaccini e l’estensione dell’offerta di quelli esistenti che già sono stati introdotti in alcune Regioni alla luce delle nuove evidenze scientifiche disponibili. Inoltre, interventi di informazione e comunicazione di provata efficacia dovranno essere realizzati per fronteggiare il fenomeno della esitazione sui vaccini e garantire il raggiungimento degli standard di copertura

Vaccine coverage in Italy and assessment of the 2012-2014 National Immunization Prevention Plan

BACKGROUND: In 2012, the ItalianMinistry of Health issued the National Immunization Prevention Plan (Piano Nazionale Prevenzione Vaccinale, or PNPV 2012-2014), with the aim of harmonizing immunization strategies across the country and ensuring equitable access to infectious disease prevention to all citizens. The Plan defines the immunization standards all regions should comply with. OBJECTIVE AND METHODS: As new evidence has accumulated in the field of immunization, and the new National Immunization Prevention Plan is about to be launched, the aim of the current study is to: i. present immunization coverage data (2000-2014) for 14 vaccines included in the PNPV to be offered to the general population, ii. assess to what extent the PNPV coverage targets and objectives have been met, and iii. report on how the PNPV was transposed into regional immunization programs. Data are also available for the eight regions that piloted varicella immunization. RESULTS: The 2012-2014 PNPV first introduced a "lifecourse" approach to vaccination at the institutional level, and has been a milestone for prevention in the Italian health policy agenda. However, infant vaccine coverage rates have been decreasing over the last years, as has influenza immunization in the elderly. HPV vaccine coverage has been increasing for all birth cohorts, but is still far below the targets set in the Plan. Promising preliminary data show that pneumococcal and meningococcal C conjugate vaccines were well introduced in regional immunization schedules. CONCLUSION: The 2012-2014 PNPV objectives have only been partially met, due to several factors, in particular increase in vaccine hesitancy. Strengthened efforts are needed to promote immunization. The new National Immunization Prevention Plan should introduce new vaccines and extend immunization programs to other target populations on the basis of the most recent scientific evidence available. It is of crucial importance that interventions of proven efficacy be planned and implemented to contrast the growing phenomenon of vaccine hesitancy and ultimately increase immunization uptake

Quality of primary health care in China:challenges and recommendations

China has substantially increased financial investment and introduced favourable policies for strengthening its primary health care system with core responsibilities in preventing and managing chronic diseases such as hypertension and emerging infectious diseases such as coronavirus disease 2019 (COVID-19). However, widespread gaps in the quality of primary health care still exist. In this Review, we aim to identify the causes for this poor quality, and provide policy recommendations. System challenges include: the suboptimal education and training of primary health-care practitioners, a fee-for-service payment system that incentivises testing and treatments over prevention, fragmentation of clinical care and public health service, and insufficient continuity of care throughout the entire health-care system. The following recommendations merit consideration: (1) enhancement of the quality of training for primary healthcare physicians, (2) establishment of performance accountability to incentivise high-quality and high-value care; (3) integration of clinical care with the basic public health services, and (4) strengthening of the coordination between primary health-care institutions and hospitals. Additionally, China should consider modernising its primary health-care system through the establishment of a learning health system built on digital data and innovative technologies