Investing in healthier lives: Pathways to healthcare financing reform in Australia

The George Institute for Global Healt

Repurposing NGO data for better research outcomes: A scoping review of the use and secondary analysis of NGO data in health policy and systems research

Background Non-government organisations (NGOs) collect and generate vast amounts of potentially rich data, most of which are not used for research purposes. Secondary analysis of NGO data (their use and analysis in a study for which they were not originally collected) presents an important but largely unrealised opportunity to provide new research insights in critical areas including the evaluation of health policy and programmes. Methods A scoping review of the published literature was performed to identify the extent to which secondary analysis of NGO data has been used in health policy and systems research (HPSR). A tiered analytic approach provided a comprehensive overview and descriptive analyses of the studies which: 1) used data produced or collected by or about NGOs; 2) performed secondary analysis of the NGO data (beyond use of an NGO report as a supporting reference); 3) used NGO-collected clinical data. Results Of the 156 studies which performed secondary analysis of NGO-produced or collected data, 64% (n=100) used NGO-produced reports (e.g. to critique NGO activities and as a contextual reference) and 8% (n=13) analysed NGO-collected clinical data.. Of the studies, 55% investigated service delivery research topics, with 48% undertaken in developing countries and 17% in both developing and developed. NGO-collected clinical data enabled HPSR within marginalised groups (e.g. migrants, people in conflict-affected areas), with some limitations such as inconsistencies and missing data. Conclusion We found evidence that NGO-collected and produced data are most commonly perceived as a source of supporting evidence for HPSR and not as primary source data. However, these data can facilitate research in under-researched marginalised groups and in contexts that are hard to reach by academics, such as conflict-affected areas. NGO–academic collaboration could help address issues of NGO data quality to facilitate their more widespread use in research. Their use could enable relevant and timely research in the areas of health policy, programme evaluation and advocacy to improve health and reduce health inequalities, especially in marginalised groups and developing countries

Development of risk models for the prediction of new or worsening acute kidney injury on or during hospital admission: a cohort and nested study

Background: Acute kidney injury (AKI) is a common clinical problem with significant morbidity and mortality. All hospitalised patients are at risk. AKI is often preventable and reversible; however, the 2009 National Confidential Enquiry into Patient Outcome and Death highlighted systematic failings of identification and management, and recommended risk assessment of all emergency admissions. Objectives: To develop three predictive models to stratify the risk of (1) AKI on arrival in hospital; (2) developing AKI during admission; and (3) worsening AKI if already present; and also to (4) develop a clinical algorithm for patients admitted to hospital and explore effective methods of delivery of this information at the point of care. Study design: Quantitative methodology (1) to formulate predictive risk models and (2) to validate the models in both our population and a second population. Qualitative methodology to plan clinical decision support system (CDSS) development and effective integration into clinical care. Data analysis: Quantitative – both traditional and Bayesian regression methods were used. Traditional methods were performed using ordinal logistic regression with univariable analyses to inform the development of multivariable analyses. Backwards selection was used to retain only statistically significant variables in the final models. The models were validated using actual and predicted probabilities, an area under the receiver operating characteristic (AUROC) curve analysis and the Hosmer–Lemeshow test. Qualitative – content analysis was employed

Challenges towards renewable energy : an exploratory study from the Arabian Gulf region

Considering the importance of energy for social and economic development, access to clean, affordable and reliable energy has been adopted as one of the United Nations sustainable development goals that all countries aim to achieve by 2030. However, much of the world's energy is still produced from fossil fuels and thus the progress towards clean and renewable energy is slow. This paper explores the key challenges towards renewable energy in Gulf Cooperation Council countries blessed with plenty of oil and gas reserves. The key challenges identified through literature review were ranked using a quantitative approach through the data collected from a selective sample across the six countries. These challenges in order of importance were found to be policies and regulations, manpower experience and competencies, renewable energy education, public awareness, costs and incentives for renewable energy and government commitment. The findings could be helpful to decision makers and government organisations in the region to develop strategies to overcome these identified challenges

Optimising the cataract surgical pathway: A Health Services Approach

The Australian healthcare system is struggling to keep up with the rising incidence of cataract. The growing backlog of surgical candidates at public hospitals is leading to growing number of older people with unoperated cataract in society. As surgery remains only effective treatment method in cataract patients to restore or maintain vision, attention must be focused on finding more efficient ways of providing this service. This thesis focuses on identifying the gaps and inefficiencies of the current Australian cataract surgical system.Using a health services research approach; four independent studies were conducted on different areas of the current patient pathway to cataract surgery, focusing on the public healthcare sector. A cross-sectional study investigated the referral criteria used by primary eyecare clinicians in the community. A separate hospital-based study examined the scope and accuracy of cataract referral letter content in providing adequate information to triage referrals ahead of clinic assessment. A discrete choice experiment was administered to gain insight into considerations that inform patient choice on where to access surgical services. Finally, a prospective cohort study investigated whether patient-reported outcomes (i.e. visual disability, satisfaction and quality of life) could be predicted using a comprehensive range of preoperative, intraoperative and postoperative factors.Deficiencies in service provision and delivery of care were noted at multiple points of the current pathway to cataract surgery. Referrals to public hospitals are poorly targeted and the information is insufficient to triage patients ahead of their clinic assessment. The total wait for surgery (from referral to procedure) is increasing, being closer to two years for the majority of patients. Highly valued attributes of cataract surgical services are not available to patients in the public system, despite a willingness to pay these features. Dissatisfaction with postsurgical outcomes was present in up to one-quarter of patients. Prediction of patients likely to be dissatisfied was possible using the following preoperative factors: anisometropia, mood, gender and visual disability. The findings presented in this thesis expand our understanding of the context of cataract surgery in Australia and can inform best use of available resources and optimal management of cataract patients

Transcripts and workshop notes from Zanzibar Arts for Children's Eyesight (ZANZI-ACE) to build the Theory of Change model and co-create arts-based eye education

A 2½-day stakeholders workshop to develop the ZANZI-ACE intervention that aimed at utilising music performances in eye health education to improve child eye health service uptake in Zanzibar was conducted. Subsequently, a Zanzibar-wide music competition was launched to encourage local participation and followed by a judging session to select three pieces as the ZANZI-ACE intervention materials. These outcomes included i) mutli-perspectival, informed understandings of, and proposed solutions to address, socio-cultural barriers to uptake of child eye health services, ii) determination of stakeholders' preferences for the content of eye health messages and the arts-based form for the eye health education strategy, and iii) development of the intervention and implementation strategy, underpinned by an agreed Theory of Change