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global health

Ian Barker: Why we should all move to an opt-out system for organ donation

22 May, 15 | by BMJ

ian_barkerOn 1 December 2015, Wales will be the first country in the UK to introduce an opt-out system for organ donation. This means that patients will need to actively opt out of organ and tissue donation—otherwise consent will be assumed. This change is significant and one to be welcomed. As an advocate of organ donation, I hope the rest of the UK soon follows suit, having witnessed the benefit of transplantation and the solace it can bring to families involved. more…

Tamzin Furtado: What Global Health Trials has taught us about research capacity building

19 May, 15 | by BMJ

Recently the research community, Global Health Trials, celebrated its fifth anniversary. In five years, Global Health Trials has evolved dramatically as the needs of its audience emerged, and today we reflect on what this process has taught us about the concept of research capacity building in low and middle income countries (LMICs).


Aser García Rada: Migrant access to healthcare in Spain

15 May, 15 | by BMJ

Aser García Rada_BMJAfter two and a half years, Mariano Rajoy´s conservative People´s Party (PP) government in Spain has partially amended their irrational decision to exclude undocumented migrants and other groups from public healthcare access in Spain. Imminent regional and local elections and general elections scheduled for later this year might allow migrants to get some access to healthcare. But not much.

Although Alfonso Alonso, the new minister of health, announced on 31 March that migrants again be granted access to primary care again, they won’t have access to specialized care nor to publicly funded prescription drugs. That means GPs will be able to diagnose cancer, hypertension, or diabetes, but will not be able to offer patients any treatment. more…

Chris​ Simms: Canada’s murdered and missing aboriginals

12 May, 15 | by BMJ

Chris_simsHow would you know and what would it matter if the invisible disappeared? The self-described “invisible” are Canada’s aboriginal women, and the “disappeared” are the 1189 aboriginal women and girls who have been murdered or gone missing since 1980—young aboriginal women being five times more likely to die as a result of violence than non-aboriginal women of the same age.

As to who knows and who cares, grieving families claim few take notice and most don’t care. They cite Prime Minister Steven Harper as a case in point; although he made “safe streets and safe communities” and “putting victims first” top priorities, they do not seem to apply to aboriginals. When asked about the murdered and missing, many of them children, he told national television: “Um, to be honest it’s not high on our radar”—as if to confirm they were literally “invisible.” more…

Violet Shivutse: A seat at the table for caregivers in Kenya

12 May, 15 | by BMJ

A new report from UN Women, Progress of the World’s Women 2015-2016: Transforming Economies, Realizing Rights, calls for radical reforms to the global policy agenda thinking which will transform economies and make women’s rights and equality a reality. Included is a series of case studies from all over the world which illustrate how governments, organizations, and individuals are working to transform the economic landscape for women.

Violet Shivutse, a 47 year old farmer and founder of Kenya’s branch of the Home Based Care Alliance, describes how she applied the lessons of farming to grow an entire network of effective, organized caregivers. more…

Paul Auerbach: The Nepal Ambulance Service

8 May, 15 | by BMJ

With the help of Rebecca Walker, a faculty member within the Division of Emergency Medicine at Stanford and a very active participant in Stanford Emergency Medicine International (SEMI), I am writing about the Nepal Ambulance Service (NAS), which has survived trial by fire in the aftermath of the Nepal earthquake.

A loyal and energized group of Nepali emergency medical responders in Kathmandu is still hard at work saving limbs and lives. NAS is the only functioning prehospital (ambulance) service in Nepal. more…

David Oliver: Minding our language around care for older people and why it matters

7 May, 15 | by BMJ

david_oliver_2015I love to plough through the newspapers, with radio or TV news on in the background. My enjoyment can be punctured by annoyances. Recurring candidates for this personal “room 101” are ageist language and attitudes. Comparing 2015 with my youth, I’ve seen a welcome sea change in the language deemed acceptable regarding race, sexuality, or disability—whether in the street or in the media. Yet ageist terminology remains far from taboo.

Older people are occasionally vilified, often mocked, and usually patronised. In media representations they are either invisible (“out of sight out of mind” when it comes to, for instance, care home residents or the housebound); portrayed as vulnerable and victims; or “allowed in” if they are “spritely” or “good for their age.” As for demeaning language? It’s often used unwittingly or with kindly intentions. But it embodies and shapes values and attitudes and, in turn, the services we provide. more…

Paul Auerbach on the public health needs in Nepal

7 May, 15 | by BMJ

I am on my way back to the US now, and getting information from people who are in Nepal. Because I am inundated with requests to provide information from people who have read my previous posts, I will keep writing, but only if there is something useful to report. Please let me emphasize that this is no longer firsthand, but rather, based on communications from persons in Nepal whom I very much trust. They are working really hard, so it is “above and beyond” (and very much appreciated) that they find time to keep us all informed. more…

Financial incentives for childhood immunisation in Australia

7 May, 15 | by BMJ

peter_mcintyrePeter McIntyre, National Centre for Immunisation Research and Surveillance, Kids Research Institute and University of Sydney.




kristine_macartneyKristine Macartney, National Centre for Immunisation Research and Surveillance, Kids Research Institute and University of Sydney.




julia_leaskJulie Leask, University of Sydney.




Australia’s approach to improving low childhood vaccine coverage began with the “Immunise Australia” campaign launched by then Health Minister Wooldridge in 1997. A unique element was linkage of eligibility for social security payments to immunisation status, beginning in 1998 with eligibility for a single $200 payment, later escalated to include child care rebates, and in 2012 other family payments. Immunise Australia included other initiatives, such as incentives for general practitioners (GPs) to give and report vaccines and the Australian Childhood Immunisation Register (ACIR), making it difficult to disentangle effects on uptake – an early study suggested  linkage to child care payments was influential. Reported coverage for all vaccines included in the fully funded National Immunisation Program has been stable at around 92% since 2002, but is persistently up to 20% lower in small geographic areas. In 2013, reports of coverage down to postcode level were made publicly available for the first time. This created intense media interest, with one dominant theme being low coverage in more affluent areas, leading to “no jab, no play” – a newspaper campaign to allow childcare centres to ban unvaccinated children and for the federal government to stop paying family assistance payments to vaccine refusers. more…

Paul Auerbach: Continuing the relief effort in Nepal

6 May, 15 | by BMJ

The last few days have been action packed, and my work in Nepal is coming to a close. As an emergency physician, my skills will soon be much less needed than those of orthopedic and plastic surgeons, and primary care and infectious disease specialists. Because of the incredible outpouring of active interest from people who are friends of Nepal, many healthcare professionals have arrived, and more are on the way. The government of Nepal has recommended that all people, particularly those in large groups or teams, wishing to help by coming to Nepal do so under the auspices of government approved organizations. This is important to maintain an effective response and deploy resources where they are most needed. more…

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