Ashti Doobay-Persaud, MD is Faculty Director for the Masters of Science in Global Health and Assistant Professor of Medicine at Northwestern University Feinberg School of Medicine. She has been a GHDonline Faculty Network member for five years, and has taught GHD's Cases in Global Health Delivery for three.
Several barriers challenge development, adoption and scale-up of diagnostics in low and middle income countries. An innovative global health discussion platform allows capturing insights from the global health community on factors driving demand and supply for diagnostics. We conducted a qualitative content analysis of the online discussion ‘Advancing Care Delivery: Driving Demand and Supply of Diagnostics’ organised by the Global Health Delivery Project (GHD) (http://www.ghdonline.org/) at Harvard University. The discussion, driven by 12 expert panellists, explored what must be done to develop delivery systems, business models, new technologies, interoperability standards, and governance mechanisms to ensure that patients receive the right diagnostic at the right time. The GHD Online (GHDonline) platform reaches over 19 000 members from 185 countries. Participants (N=99) in the diagnostics discussion included academics, non-governmental organisations, manufacturers, policymakers, and physicians. Data was coded and overarching categories analysed using qualitative data analysis software. Participants considered technical characteristics of diagnostics as smaller barriers to effective use of diagnostics compared with operational and health system challenges, such as logistics, poor fit with user needs, cost, workforce, infrastructure, access, weak regulation and political commitment. Suggested solutions included: health system strengthening with patient-centred delivery; strengthened innovation processes; improved knowledge base; harmonised guidelines and evaluation; supply chain innovations; and mechanisms for ensuring quality and capacity. Engaging and connecting different actors involved with diagnostic development and use is paramount for improving diagnostics. While the discussion participants were not representative of all actors involved, the platform enabled a discussion between globally acknowledged experts and physicians working in different countries.
For people with terminal illness in rural Guatemala, God and religion are ever present. God is a principal actor in their lives: God provides money and jobs; God provides food; God heals illnesses, either through doctors or in spite of them; God guides one down her path in life and knows the obstacles ahead; God carefully chooses the hour of her death.
As GHDonline's Lead Moderator, Tom Bauer supports GHDonline moderators to deliver valuable and important content to members. Tom has been a member of the … Read more about Tom Bauer, MBATom on GHDonline
I vividly remember the beginning of my trip to Madagascar to perform reproductive health research. At the end of providing an update to my mentor on my experiences from my first week in Madagascar, he responds, “If arranging (reproductive health) classes for both boys and girls is too difficult, just focus on the girls.” As I hang up the phone, I feel the frown develop on my face. His words did not sit right to me; reproductive health affects BOTH sexes.
The Lancet Commission on Global Surgery published a report on the state of global surgery in April 2015 reporting the staggering statistic that “5 billion people in the world lack access to safe, affordable surgical and anesthesia care when needed” . I vividly remember working at a busy public hospital in Arusha, Tanzania where this reality was dismally clear.
Access to health care for undocumented immigrants is, whether you are for it or against it, a popular news topic. However, in parallel with this, and largely unnoticed, is the challenge health care providers face, either treating or navigating care for this population in the clinical environment.
his is a statement released by the Red Cross, a not-for-profit 501(c)(3) organization, on its website shortly after a special report revealed that over $400 million of the aid money it received after the 2010 earthquake in Haiti was unaccounted for. Being one of the two largest recipients of donor money for disaster relief in Haiti – the other being the United Nations – it should come as no surprise that the Red Cross came under a lot of scrutiny for its use of aid money from US taxpayers.
Global health is often viewed as a collection of problems requiring a multifaceted and multidisciplinary response. Understanding how and why states conceptualize and respond to problems is thus critical to global health, especially with the prevailing rights-based discourse of the field. Social theory coupled with engaged and grounded ethnography of the state provides insights into why inequities persist and what we can do about it.
How do we achieve “evidence-based medicine” in global health delivery? Publications, abstracts, and comments (including my own) often cite a lack of data from low- and middle-income countries (LMICs). In my experience, many of the publications in global health often do not involve local stakeholders, and when they do, it is often in name only. In order to create a robust, inclusive body of knowledge contributing to evidence-based medicine relevant for global health, research must be context-specific.