Feeds:
Posts
Comments

Archive for the ‘Uncategorized’ Category

I and my wife have been adopting strict social distancing practices for a week. We are both in the group that has been told that it needs to be shielded for at least 12 weeks.

I have been following the evidence about Covid19 very closely and because of my assessment of the literature, I and my wife started strict social distancing shortly before it became national policy.

Part of my response to a feeling of some helplessness as a pensioner confined to home has been to ensure that I have contributed on-line to the professional debate about how to combat the pandemic. My portfolio career in retirement has included roles with the Faculty – I am the Treasurer – and with the BMA on many committees and this has facilitated this aforementioned activity. Indeed I agreed today to join another BMA committee on Covid19. Gradually my diary which had been a sea of cancelled meetings is being replaced by on-line (unpaid) work!

I am deeply appreciative of the work done by PHE and other public health staff in planning for the epidemic and attempting to control it. The pressure on the public health and national health service will be immense over the coming weeks and months but I am confident they will rise to the challenge.

The goodwill shown by my local community in suburban London has been heartwarming. It looks like we may have secured a mechanism to reliably receive a home delivery of food. My wife and I were quite emotional about the support that has been arranged by the United Synagogue and offered to all sheltered members in its community.

Social isolation is a real issue. I have made a point of trying to contact all people we know who are also in the moderate to high risk groups requiring sheltering. I am preparing for seeing many repeats on TV.!

My wife is a pianist and musician and thought she may not be able to continue working. However virtually all the people she teaches have already agreed to have their lessons by Skype or Facebook! Maybe her choirs might also be able to reform!?

My sons and their partners live some distance away but are in regular contact. My 5 year old granddaughter whose school closes tomorrow, has begun regularly calling us from Leeds after she returns from school. Seeing her happy face is always a comfort.
Ellis Friedman
March 19 2020

Read Full Post »

So I have made it through DAY 1 of social isolation…

This followed heavy pressure from our (grown up) children that we should not come back to London to fulfil various commitments or attend meetings that we had in London this week – so here we are in Lyme Regis.

All this because of COVID-19, now designated a pandemic by WHO.

As a retired public health doctor I am proud of the fantastic work public health professionals are doing to try to get on top of things and to protect the public. Similarly as a Non-Executive Director of an NHS Foundation Trust, I am proud of what the NHS is doing to prepare for this epidemic; one of the benefits of the ‘command and control’ system that we have in the NHS – even though in normal times we mutter about lack of autonomy.

We are fortunate that for the past 20 years we have divided our time between London and Lyme Regis in Dorset and we have homes in each, so we have decamped for now to the ‘country’.

Day 1 was ok, for one thing we had some sunshine, so we did some gardening; planted some seeds, tidied up the vegetable beds and sat in the sun. Later on we went for a walk by the sea, getting chillier but still nice and we got some exercise and improved our mental health – alas the ice cream shop was not open or we could have indulged!

And now the news tonight – 16th March 2020 – and government reiterating that we/ I am in the ‘vulnerable group’ and that more draconian measures are needed and we must self-isolate and reduce social contacts; everyone to avoid pubs, restaurants, theatres and non-essential travel, work from home if they can, more flights cancelled. Goodness knows what will happen to the economy.

And all us oldies (over 70) and ‘vulnerable’ may need to go into self-isolation and be ‘shielded’ from social contacts for 3 months!

Jigsaw opened, and one of our children signed us up for Netflix!

We will just have to take it a day at a time…

Sue Atkinson
16.3.20

Read Full Post »

Social media is ever present in today’s society, and levels of interest in the use of social media to support action to promote and protect health, alongside understanding and protecting against potential harms is growing. To help harness social media to support health we need to better understand who, and how, people engage with the platforms available to them, and the impact of those actions.

In 2018 in Wales, Public Health Wales in collaboration with Bangor University, carried out a nationally representative survey amongst adults (aged 16 years and above). The household survey was delivered face to face and collected the views from over 1,200 people on their access and use of digital technologies, including social media, and demographics and levels of health and wellbeing.

Our findings were surprising. Overall, 77% of the adult population in Wales reported using social media, with 65% using it on a daily basis (weighted to the demographic distribution of the Welsh population). The most frequently used platforms were Facebook, followed by WhatsApp, and YouTube. Of those remaining, approximately 10% had access to the internet but did not engage with social media, and a further 10% did not have access to the internet at all.

Digital exclusion (not having access, skills or digital literacy needed to use internet enabled technology) has been highlighted before in Wales and across the UK, and is recognised to be higher amongst older populations those in more deprived areas, and in poorer health. Given the increasing reliance on internet and technology across society, digital exclusion could be considered as a new social determinant of health.  The continued efforts of many organisations such as Digital Communities Wales to support everyone to have the opportunity, skills and capability to engage with online platforms is essential – ensuring a progress on digital is not inadvertently widening inequalities.

Back to our survey – where our findings challenged the preconception that social media is only for the young. We found that, amongst those who do have access to the internet, use did decrease with increasing age but a high proportion of the older age groups were using social media – 76% of those aged 60-69 years and 60% aged 70+ years. We also found higher engagement with social media amongst women than men – but differences across platforms. For example, more women used social networking, photo content and messaging platforms, whereas a higher proportion of men used video content platforms.

When considering differences by health status, we found that people with lower self-reported health and those who engaged in health-harming behaviours (smoking, inactivity and/or high levels of alcohol consumption) were less likely to engage with social media. Many studies have explored how social media offers people the opportunity to communicate and interact with others and find and receive information about health conditions – but not all may be interested or able to engage.

Collectively, these findings highlight the importance of understanding the audience, where they are (or not) on digital platforms, to inform and target relevant information.

alisha1

Lastly, we found that engagement in social media was similar across deprivation quintiles (see figure below), with the exception of Twitter and Whatsapp which had a lower level of engagement in those least affluent. The potential for social media to reach more deprived populations has also been reported elsewhere, and warrants further exploration to better understand how we can use social media to reach and engage all communities in health.

alisha2

Back to my question – can social media offer a way to engage across social groups?

Possibly.

First there is the challenge of digital exclusion, recognised to be higher in more deprived areas, older populations and those in poorer health.  There remains the need to overcome structural, educational and behavioural barriers contributing to digital exclusion. Should this be achieved then our findings pose some interesting areas for further exploration, given that we found no difference in engagement in some social media platforms across deprivation groups.

However, in this short blog I have somewhat simplified a complex challenge, and one that includes questions of trust, quality and reliability of information online, better understanding the relationship with well-being, and the need to build in evaluation – all in a fast-paced environment.

There remains much to learn about the role of social media in health, both beneficial and harmful. But as public services move to digital channels, continued efforts are needed to understand and address inequalities in access, alongside recognising that social media may offer a platform to reach a wider audiences and engage differently with populations about health.

 

Written by Dr. Alisha Davies FFPH PhD  Head of Research & Evaluation, Public Health Wales

NOTE:

This report is the second in a series called Population health in a digital age, the first published in 2019 and explored the use of digital technology to support and monitor health in Wales.  Both reports and infographics are available here

Read Full Post »

Health in All Policies (HiAP) is a way of working with policy makers in other sectors that aims to build the social, economic and physical conditions that support good health and prevent health inequalities. Healthy Lives, Fairer Futures, the call to action from the Committee of the Faculty of Public Health in Scotland, calls for a strong commitment to this approach to ensure that all public policies help everyone in Scotland to realise their Right to Health. As partnerships in several areas of Scotland are using HiAP, several colleagues attended a workshop in early December to share our experiences. The workshop was organised by the Scottish Health and Inequalities Impact Assessment Network, which is part of the Scottish Public Health Network.

WHO describes Health in All Policies as ‘an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies and avoids harmful health impacts, in order to improve population health and health equity’. In public health we often work with partners to address defined public health priorities. HiAP differs from this because the starting point is a proposed policy and the aim is to identify all the likely effects on health, rather than focusing on one priority issue. This can help identify how to achieve the best overall health outcome from the policy. It often involves a formal approach like Health Impact Assessment, integrating health into other assessments or using other tools. The approach fits well with Scotland’s National Performance Framework, which places Wellbeing as a central purpose of government and recognises the contribution of the other national outcomes to that purpose.

Participants at the workshop shared their experiences of HiAP so far and discussed what is needed to develop and support this work. The group recognised that HiAP should be based on good working relationships and an openness to build understanding of constraints and opportunities in all policy areas. Every local authority area in Scotland has a Community Planning Partnership that brings together public, private and third sectors to agree how to meet the needs of their communities. These are an excellent platform for HiAP and other forms of partnership working and some Community Planning Partnerships have now developed formal governance structures to support HiAP in their areas. We also discussed the place of HiAP within the developing Whole System Approach being taken to the Scottish Public Health Priorities, and noted the need for alignment of national and local approaches and policies.

The workshop identified enthusiasm and commitment to this way of working across partnerships in Scotland. Participants agreed to continue to share experiences and develop our understanding of how use HiAP to achieve better outcomes. The Faculty can also support this, by continuing to advocate for Health in All Policies, at both local and national levels, and encourage Faculty members to adopt this approach. We are optimistic that by working collectively we can create public policies that allow people to thrive, improve health and reduce social and health inequalities.

Written by Dr Margaret Douglas, University of Edinburgh

Further information

Faculty of Public Health in Scotland (2017) Healthy Lives Fairer Futures: a call to action    https://www.fph.org.uk/about-fph/board-and-committees/a-call-to-action/

WHO (2013) Helsinki Statement on Health in All Policies https://www.who.int/healthpromotion/conferences/8gchp/8gchp_helsinki_statement.pdf

Scottish Government (undated) National Performance Framework                     https://nationalperformance.gov.scot/

Scottish Government and Confederation of Scottish Local Authorities (2019) Public Health Reform. Scotland’s Public Health Priorities – Local Partnerships and Whole System Approach                                        https://publichealthreform.scot/media/1570/whole-system-approach-for-the-public-health-priorities.pdf

Scottish Health and Inequalities Impact Assessment Network resources on HiAP and HIA: https://www.scotphn.net/networks/scottish-health-and-inequalities-impact-assessment-network-shiian/shiian-resources-information/reports/

Read Full Post »

Time is running out.

There is a climate emergency and we have only a few years left to keep global warming at safer levels, beyond which we may cross tipping points and activate feedback loops it is near impossible to reverse.

2019 may well be the year the world’s collective consciousness was finally awoken to the reality of the climate and ecological emergency and the pressing need to act decisively. Many social movements have begun to appear and raise their voices to protest at the lack of political leadership on this, the defining issue of our time. This includes an increasing number of health professionals, who are clear that the climate emergency is a health emergency and are demanding decisive action from organisations and political leaders. Impacts of climate change, including extreme weather events, the spread of infectious diseases, and food and water insecurity, will affect the vulnerable the most.

Whilst the UK government has declared a climate emergency, the underpinning policy ambition to respond to this remains unclear and ill-defined. The UK is not on target to meet its international obligations under the Paris Agreement. There is a strong social justice argument that due to high historic emissions, the UK should go faster and further on its commitment to achieve net zero.

The next few years may be the last in which we, and our political representatives, still have the opportunity take decisive and timely action on the climate emergency.

We are a group of UK health professionals who have come together to highlight the link between health and climate. We have worked to scrutinise manifestos of the main political parties in England, Scotland, and Wales and score them on their commitments relating to climate and health. With reference to the Lancet Countdown and UK Health Alliance on Climate Change policy recommendations, we developed a list of policy areas, which was refined through discussion and a shortlist agreed. Each manifesto was scored independently on our final five criteria of clean air, low carbon economy, transport, food and farming, and green homes. We have produced an infographic demonstrating how party manifesto commitments fare on plans to tackle the climate and health emergency.

CLIMATECHANGE

Good health for our families, our patients, our communities, and our population depend on a stable climate and healthy ecosystems. The next Government’s policies must reflect these pressing concerns and we must hold them to account for any promises made in their manifestos.

Blog written by Dr Sarah Gentry and Dr Ruth Speare in conjuction with Dr Yas Barzin, Dr Isobel Braithwaite, Dr Anya Göpfert, Dr Chris Newman, Alexander Crane, Michael Baldwin, Dr Oytun Babacan (Imperial College London) and Dr Iain Staffell (Imperial College London)

Read Full Post »

jacqui

Jacquie White, NHS England Director, explains why Public Health teams are needed at the top table of Integrated Care System discussions on Population Health

“The physicians surely are the natural advocates of the poor and the social problem largely falls within their scope.”

Reading this lovely quote from Rudolf Virchow on the front of the Faculty of Public Health’s Curriculum for Medical Schools made me think how many more opportunities we now have to tackle the fundamental issues impacting on our health and wellbeing by working together in Integrated Care Systems.

While local health and care teams are faced with the reality and consequences of ill-health daily, the partnerships in local systems are enabling and encouraging collective responsibility and action to start to solve some of the underlying determinants driving this.

And I believe we’re starting to see fresh shoots.

The NHS England and Improvement Population Health Management programme is trying to move our shared efforts in that direction and we really need your help.

The aim of the programme is to support local health and care systems and their emerging Primary Care Networks to work in partnership to improve care, and consequently to improve people’s lives, by designing local solutions to address the needs of local people.

I’m inspired daily by the enthusiasm and wealth of skills in public health teams who are driving a focus on proactive, preventative approaches to improve outcomes and reduce inequalities.

To help people struggling with health problems stemming from societal issues such as employment, environmental issues like air pollution, and behaviours like smoking, we need to learn from what’s already been achieved in public health.

With this in mind, the new Population Health Advisory Board, which includes your faculty’s President Maggie Rae and other public health expertise, will be key to guiding the programme and its ambitions over the coming months and years.

So much work has already been done, and the advent of Integrated Care Systems means we can now go further faster bringing together more skills in these partnerships and expanding our collective capacity.

With the NHS, councils, VCSE and other public services all around the table looking at new and very rich linked datasets and predictive analyses we’ve got a huge opportunity to tackle common problems together to maximise the impact and reduce duplication of already stretched resources. It allows systems to have a shared understanding of who their population are, and what is best for them in the long term.

For anyone not familiar with the NHS England and Improvement PHM programme, it’s the NHS’ commitment to working with local authorities and particularly public health colleagues to understand current, and predict future, health and care needs.  

It aims to help local systems and their providers design and deliver anticipatory and personalised care and support for individuals, more joined up and sustainable health and care services for local populations and make better use overall of public resources.

It’s the first time we’ve been able to bring together and analyse the right data to generate  local discussions in systems by the right groups of people about improving the health and well-being of communities. This includes health professionals, managers, commissioners, providers, data analysts, business intelligence, social care and of course public health colleagues.

So far, wave 1 of the programme has made some fantastic and very speedy achievements locally with more than 1,000 people being better supported, teams designing and starting to deliver new models of care for populations and inspiring the local workforce to feel re-energised about their jobs.

In Lancashire and South Cumbria for example, they focused on the wider determinants of people’s health using their links with the community and borough councils.

Primary Care Networks (PCNs) with their wider multi-disciplinary teams initially segmented their population and then asked analysts to bring in further insight – for example on assisted wheelie bin collections or where people are living in houses of multiple occupation – to help narrow down a specific at risk and impactable cohort of patients for initial action.

From the data – and following further predictive modelling on costed population segments –  they found people with needs not met by existing models of care, who are likely to experience a greater deterioration in health than others within similar population groups and who are likely to account for significant utilisation of health and care services in the next few years. They then worked together with local communities to design and agree a proactive tailored care model, including support for health, psychological and social needs.

The Public Health teams at LSC have been leading this work and were a fundamental part of its delivery.

Given that the potential for opportunity is greatest in influencing the wider determinants – and that we know only a small fraction of the factors that impact our health come down to our access to health services – we need more leaders from public health to help us in this mission. To succeed we must connect this work in systems with local teams and communities, and the leadership and expertise from Public Health is invaluable.

If your area is taking part in our programme or beginning to join up action on PHM then please get involved – we want this to be the kind of social movement Rudolf Virchow would be proud of.

Join the PHM Academy for lots more information and news on the development of PHM around the country.

Read Full Post »

“Refugees are mothers, fathers, sisters, brothers, children, with the same hopes and ambitions as us – except a twist of fate has bound their lives to a global refugee crisis on an unprecedented scale.” Khaled Hosseini

larablogpic

 

According to data from UNHCR, displacement has risen to the highest level ever recorded, with an unprecedented 70.8 million people being forced from their homes and 25.9 million living as refugees.1 A growing number of people are living long-term in settlements; raising families, seeking jobs and attending school. Furthermore, NCDs such as cancer, diabetes and heart disease are rising, contributing to 80% of deaths in LMICs.2 This sheds light on the need to develop effective approaches to respond to, and treat the needs of, these populations. Recognising this need, an exploratory study was developed in collaboration with the International Rescue Committee (IRC) to investigate effective interventions for NCD prevention in LMICs, exploring opportunities for such interventions in a refugee setting. This May I spent time in a refugee settlement in northern Uganda conducting research for this study and I want to highlight three personal takeaways from my experience in the camp.

Getting off the small propeller plane in Arua with my colleague to await our vehicle, I wasn’t quite sure what to expect. While I had spent time in Africa before, this would be my first time in a refugee camp. Walking through the Ebola check point I stood still as the worker took my temperature. Next, our bags were loaded, and I hopped in the car as we set off on the hour journey to BidiBidi, one of the largest refugee camps in the world.

It was hard to tell where the town ended and where BidiBidi actually began. But as we neared the centre aid worker flags clearly defined the space. Every person we encountered, from the driver and NGO workers, to the refugees, were kind and welcoming. Eager to start our work, my colleague and I quickly started making plans. However, I was soon to learn the first of my three key lessons!

  1. You will need to be adaptable

While having a plan is nice, you need to have a plan B, C and D and be prepared to think on your feet. Much of the nature of working in international development is dealing with setbacks and this was just as true with my research. In a refugee camp food rations are distributed on certain days, therefore if someone you are meant to interview is due to pick up food, that will be their priority. Additionally, locations will be moved due to other meetings taking place and time works a bit differently. When we wanted to hold our first focus group at 11:00am the health officer would happily tell the participants to meet at 9:00am. However, with a good attitude and entertaining colleagues, the underlying chaos ended up being my favourite part of the experience, as this was a true reflection of the reality.

  1. Context is key

Much of my research was around addressing risk factors such as tobacco and alcohol use, unhealthy diets and lack of physical activity. Therefore, it was critical to understand the population; what are the drivers behind behaviours, what is the availability and accessibility and are there mechanisms in place for regulation? In BidiBidi the majority of the population are South Sudanese refugees who are Muslim; mostly women and children with little education. Shadowing a community health worker as he went into the villages gave me insight on the daily lives of the refugees and how to adapt research findings for this particular context.

  1. Community is everything

Lastly, and most importantly, community is everything. Many of the people I spoke with escaped from war-torn South Sudan, witnessed violence and experienced discrimination. But the way the community remains cohesive, supports each other and stays positive, despite all circumstances, is inspiring. The doctors, health officers and community health workers are a united team working to break barriers and tackle challenges. Hopefully as new research and new technology emerges, it can be introduced in settings like BidiBidi. An advantage of working with the IRC is that they are an implementing organisation; research is put to practice and the people they are serving have a voice. While the current statistics are daunting, the people have the will and the capacity to introduce effective interventions which can prevent NCDs among the refugee community, creating better health for all.

 

Blog written by Lara Kontos, MSc Global Health

 

References

  1. UNHCR (2019) Figures at a Glance. Available at: https://www.unhcr.org/uk/figures-at-a-glance.html (Accessed 14 August 2019).
  2. World Health Organization (2018) Noncommunicable diseases. Available at: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases (Accessed: 18 July 2019).

Read Full Post »

Hertfordshire has led the way in improving levels of physical activity in older adults via a social marketing campaign ‘Never Too Late’ which has seen almost 4000 people sign up – 4 times our target.

Never too late photo

The 12-week campaign with a budget of £20,000 launched in April 2018 across social media, local Daily Mile schools (with children inviting older adults to join them for their Daily Mile), and through a wide range of partner organisations.

The campaign formed part of Hertfordshire’s Year of Physical Activity. It reached three quarters of a million people and generated nearly 30,000 hits to our webpage. The evaluation found that of those who reported doing no physical activity at the start of the campaign, 93% reported doing at least 30 minutes of physical activity per week at the end of the campaign. Overall, 79% of participants reported moving from doing less than 90 minutes of physical activity to doing more than 90 minutes per week by the end of the campaign. Just over half of those completing our post-campaign survey have reported meeting or exceeding their physical activity goals.

It targeted over-55s but messaging was tailored for specific behaviours, informed by insight from local focus groups and Sport England research. Key barriers (anxiety, lacking role models, thinking they do enough exercise already) and motivations (keeping up with grandchildren, healthy mind/body, social belonging, confidence, getting more from life) were central to messaging, which also promoted easy ways to fit ten minute activities into everyday life.

In Hertfordshire 42% of 65+ year olds are inactive and 58% do not meet national recommendations for physical activity. We used evidence-based behavioural science techniques (based on the COM-B Model) to encourage behaviour change:

  • Action-planning/progressive tasks: an activity planner enabled people to move from intention to action
  • Behavioural practice: personalised support from trained staff offered in a way that best suited participants’ needs
  • Prompts: twice-weekly text/email messages, targeted by key motivation (health, social, mobility, enjoyment)
  • Incentivisation: free activity pass and entry into prize draw for all participants
  • Nudge theory: sign-up to resident e-newsletter provided ongoing contact beyond campaign

We used a range of tactics and channels to target residents:

  • All traffic driven to webpage, which hosted case studies, information and registration survey. Through this we captured baseline and follow-up data to evaluate success.
  • Creation and sharing of a suite of insight-led online content tailored to different groups, in particular tapping into the over-55s growing love for Facebook. We reviewed and updated regularly to keep fresh and promote best-performing content.
  • Blitzing local and regional media, developing stories and media packages across the county.
  • Developing unique and impactful relationships with partners to maximise reach and success.
  • Identifying key periods of activity (our successful media launch and the 40+ school launch events) and supplementing these with ongoing activity across our own and partners’ communications channels. We cascaded messages, using key hooks and milestones to celebrate success and sharing pictures/videos from events.

Hertfordshire County Council’s director of Public Health, Prof. Jim McManus, said: “This campaign has demonstrated effective use of behaviour science techniques to help older people get closer to the guideline of 150 minutes of physical activity per week. This is an important element of our prevention agenda”.

“As a result of this success, we’ll be running the campaign again from 5th May 2020 in the lead up to the Tokyo Olympics”.

Case study

One person who found the campaign of benefit was Jim Furman who is 69 years old and retired. “I am much more positive than I was, both mentally and physically. I always feel better after any kind of physical activity, especially when it is enjoyable, which the activities I’ve discovered through this campaign are”. He heard about the campaign through the Council’s email newsletter and was very interested in the free day trial offer. “It has made a big difference to activity levels for both my wife and I. She has signed up to be a regular member of Stevenage leisure centre as a result of the free trial and we both now play badminton there together every week. I was very impressed with the gym. I was amazed at the whole set up, the equipment and facilities – I hadn’t realised how good they were. There was one particular activity I really enjoyed – a walking machine with a TV screen – and I’d love to go back to try that again, it was fun and made me feel really positive about exercising”.

 

Written by Nicola Ainsworth, Specialty Registrar (ST3), Hertfordshire County Council

Read Full Post »

“The earth is sick. It has a temperature. We know the diagnosis. It needs treatment. If it is not treated it will become sicker – its temperature will go on increasing until it dies. We may have reached a tipping point. Urgent action is needed.”

Following the global launch of the Manifesto to Secure a Healthy Planet for All, Prof. Jo Nurse gave this warning at a recent event in Wessex to support local councils in taking emergency action on climate change.

pic1

With so many local authorities declaring a climate emergency, Prof Nurse collaborated with the University of Winchester and the Wessex Global Health Network to provide an afternoon of speakers and workshops designed to assist councils in taking climate action.

Prof Joy Carter, Vice-Chancellor, was well placed to give the opening address given that Winchester is the University for Sustainability and Social Justice and has itself declared a climate emergency. Dame Yvonne Moores, former Chief Nursing Officer, chaired the event which had over 60 attendees ranging from Public Health consultants to emergency planning officers, local Councillors and NHS representatives.

The scale of the challenge facing local government was illustrated by speakers from Hampshire County Council, Winchester District and from the new unitary authority of Bournemouth, Christchurch and Poole. These were followed by presentations giving practical advice on the steps that authorities can take including 50 actions from Friends of the Earth and Ashden’s co-benefits toolkit.

The afternoon included workshops designed to highlight the key issues and then bring the discussion onto actions to prevent and mitigate climate change.

As a Public Health Registrar, currently working in global health, I found it inspiring to see the enthusiasm and commitment of my local authority colleagues despite the many challenges and barriers to tackling climate change. The scale of the emergency is daunting, and it is easy to feel overwhelmed and helpless. Nevertheless, local areas are coming up with innovative solutions and there is a strong will to engage with the public, particularly with influential grassroots organisations and with young people.

pic2.jpg

In the workshop that I attended, there was a focus on the role of behaviour change; local authorities were asking for support from national experts in the social marketing of climate change actions. I was struck that the Public Health community has a strong track record in framing messages in a way that promotes behaviour change and, therefore, this is one area where our profession can really support council colleagues.

Going forward in Wessex, it is hoped that stronger networks will facilitate cross-sector action by allowing the skills and expertise of many different disciplines to come together; Public Health professionals with their competencies in engagement, influencing and behaviour change should be key players in the response to the climate emergency.

Written by Rebecca Wilkinson, Public Health Registrar on placement with the Wessex Global Health Network

Read Full Post »

Unlike most visits to Ghana, this trip was particularly special and a “mission” rather than a reunion with friends and family. My yearning to make this a success had me constantly refreshing myself on the terms of reference and action plans for the trip, which, I guess, was the culmination of a partnership ‘journey’ that started in the latter part of 2018 involving various emails, teleconferences, text messages and phone calls!

My first day (and first time) at LEKMA hospital, started with some personal observations (and to have a moment to myself).  Afterwards, on the way to see the Medical Superintendent, Dr. Ameh, I saw one of the pharmacists that I recognised from one video conference call. I called him by his ‘English’ rather than Ghanaian name, thereby giving away who I was, but more reassuring was when he mentioned they were expecting me (as did Dr. Ameh when we met).  This bode well for the visiting team.  With initial introductions over, I went into planning times for the Global Point Prevalence Survey (GPPS) which took place over subsequent days with two Pharmacist colleagues.

Samantha arrived a few days later. The rest of the team arrived after Samantha, but the excitement made me go to the airport. Waiting like it was Christmas!  The next morning, we all met for the first time and were driven to LEKMA Hospital.

Our first day LEKMA was extremely pleasant with the usual warm Ghanaian hospitality.  The enthusiasm was apparent from the get-go.  We ran through the agenda for that day and duration of the visit followed by ward/departmental visits.

 

pic1FPH Africa SIG Ghana Visiting Team (left to right)

  • Mr Edwin Panford-Quainoo, Public Health Pharmacist, Liverpool School of Tropical Medicine
  • Dr Rajesh Rajendran, Consultant Microbiologist, East Cheshire NHS Trust
  • Dr Valérie Decraene, Consultant Epidemiologist, PHE Field Service
  • Dr Sam Ghebrehewet, Head of Health Protection, Public Health England, North West (FPH Ghana Visiting Team and Partnership Project Lead)
  • Dr Saran Shantikumar, Clinical Lecturer in Public Health, University of Warwick
  • Ms Samantha Walker, Lead Nurse – Infection Prevention and Control, Countess of Chester Hospital NHS Foundation Trust
  • Mrs Indu Das, Antimicrobial Specialist Pharmacist, East Cheshire NHS Trust

 

The second day had workshops on Antimicrobial Resistance (AMR), Antimicrobial Stewardship (AMS) and Infection Prevention and Control (IPC), with a fully engaged hospital team who gave frank and honest opinions about their hospital IPC practices and improvements needed. Workshop evaluation provided invaluable information that was consistent with observations.

pic2   pic3

On the Saturday, we visited the hospital to get a sense of the out-of-hours services [accident and emergency and out-patient departments (OPD)]. We used this opportunity to review OPD antibiotic prescriptions of the day (revealing interesting findings).  We visited three community pharmacies within walking distance of LEKMA Hospital who had been informed of the project and were fully engaged in completing a knowledge, attitude and practice survey.

We spent the Sunday recapping and reflecting on the previous days’ events in the idyllic setting of Sogakope. Even on our day off, the team could not help but be productive and were able to record a podcast, prepare a WHO grant application for implementing delayed/back-up prescribing at LEKMA Hospital and learn about Ghanaian music.

pic4.jpg

Monday was the advisory committee meeting, chaired by Prof. Afari. The morning of Tuesday 18th June, was feedback session with the LEKMA management and Ghana Public Health Association (GPHA).

In summary we were able to deliver:

  1. Agreed and signed off a Memorandum of Understanding and ToR;
  2. Established an AMS Advisory Committee;
  3. Completed a Global Point Prevalence Survey;
  4. Completed a healthcare workers Knowledge, Attitude and Practice survey;
  5. Initiated IPC guidelines review based on the WHO infection prevention control and hand hygiene assessment tools;
  6. Initiated discussion around prescribing guidelines (national) with the view of having simpler and more accessible local prescribing guidelines, i.e. within the context of the National AMR Plan and Prescribing Guidelines;
  7. Initiated the discussion around laboratory data surveillance processes and regular production surveillance outputs, with a focus on drug-resistant organisms;
  8. Agreed to implement delayed/back-up prescribing in the out-patient department of LEKMA Hospital.

We left Ghana with nothing but fond memories of a magnitude that we could not put into words and look forward to our next visit to Ghana.

Blog written by Edwin Panford-Quainoo, Liverpool School of Tropical Medicine

Read Full Post »

« Newer Posts - Older Posts »