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[New York, New York], Population Council, Frontiers in Reproductive Health, 2007 Jul.  p.Progress in the initial stages of the documentation process can be slow, though it gathers momentum over time. Successful communication channels such as email are important for maintaining the momentum. Familiarity with applying the GRIPP framework and process and having existing networks in the field adds value to the product. An initial lack of knowledge about stakeholders can slow down the documentation process. However, the documentation process can help discover who these stakeholders are and the usefulness of the study to them. Case study information is much easier to recall and richer when the research is still current or only recently concluded. A snowballing effect, which results in getting more stakeholder perspectives than originally thought, can occur during the process. A study may have clinical and social and other dimensions, which have very different processes and outcomes with relation to a given research study. Each needs to be followed up in order to fully understand the utilisation and effectiveness of the research. A well-positioned facilitator may be the best placed to assume a neutral position and document the research process. Many of the obstacles in relation to the documentation process that were encountered could be overcome if researchers built the documentation process into their research schedule. (excerpt)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S60-S65.The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) African site was Accra, Ghana. Its sample was drawn from 10 affluent residential areas where earlier research had demonstrated the presence of a child subpopulation with unconstrained growth. This subpopulation could be identified on the basis of the father's education and household income. The subjects for the longitudinal study were enrolled from 25 hospitals and delivery facilities that accounted for 80% of the study area's births. The cross-sectional sample was recruited at 117 day-care centers used by more than 80% of the targeted subpopulation. Public relations efforts were mounted to promote the study in the community. The large number of facilities involved in the longitudinal and cross-sectional components, the relatively large geographic area covered by the study, and the difficulties of working in a densely populated urban area presented special challenges. Conversely, the high rates of breastfeeding and general support for this practice greatly facilitated the implementation of the MGRS protocol. (author's)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S53-S59.The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) South American site was Pelotas, Brazil. The sample for the longitudinal component was drawn from three hospitals that account for approximately 90% of the city's deliveries. The cross-sectional sample was drawn from a community survey based on households that participated in the longitudinal sample. One of the criteria for site selection was the availability of a large, community based sample of children whose growth was unconstrained by socioeconomic conditions. Local work done in 1993 demonstrated that children of families with incomes at least six times the minimum wage had a stunting rate of 2.5%. Special public relations and implementation activities were designed to promote the acceptance of the study by the community and its successful completion. Among the major challenges of the site were serving as the MGRS pilot site, low baseline breastfeeding initiation and maintenance rates, and reluctance among pediatricians to acknowledge the relevance of current infant feeding recommendations to higher socioeconomic groups. (author's)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S66-S71.The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) Asian site was New Delhi, India. Its sample was drawn from 58 affluent neighborhoods in South Delhi. This community was selected to facilitate the recruitment of children who had at least one parent with 17 or more years of education, a key factor associated with unconstrained child growth in this setting. A door-to-door survey was conducted to identify pregnant women whose newborns were subsequently screened for eligibility for the longitudinal study, and children aged 18 to 71 months for the cross-sectional component of the study. A total of 111,084 households were visited over an 18-month period. Newborns were screened at birth at 73 sites. The large number of birthing facilities used by this community, the geographically extensive study area, and difficulties in securing support of pediatricians and obstetricians for the feeding recommendations of the study were among the unique challenges faced by the implementation of the MGRS protocol at this site. (author's)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S78-S83.The World Health Organization (WHO) Multicentre Growth Study (MGRS) Middle East site was Muscat, Oman. A survey in Muscat found that children in households with monthly incomes of at least 800 Omani Rials and at least four years of maternal education experienced unconstrained growth. The longitudinal study sample was recruited from two hospitals that account for over 90% of the city's births; the cross-sectional sample was drawn from the national Child Health Register. Residents of all districts in Muscat within the catchment area of the two hospitals were included except Quriyat, a remote district of the governorate. Among the particular challenges of the site were relatively high refusal rates, difficulty in securing adherence to the protocol's feeding recommendations, locating children selected for the cross-sectional component of the study, and securing the cooperation of the children's fathers. These and other challenges were overcome through specific team building and public relations activities that permitted the successful implementation of the MGRS protocol. (author's)
Increasing the relevance of education for health professionals. Report of a WHO Study Group on Problem-Solving Education for the Health Professions.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1993; (838):i-iv, 1-29.A consideration of current practices in problem-solving education for the health professions was the agenda of a World Health Organization (WHO) Study Group convened in Geneva, Switzerland, in October 1992. The group widened its concerns to provide a general outline of how health professional educational institutions (HPEIs) can influence health care delivery by redefining and expanding their role into the domain of health policy and service delivery. The committee's report presents information on such educational innovations as problem-based learning, student-centered education, community-based education, and community-oriented education. The effects of these innovations can be measured in terms of outcomes for the individual and outcomes for the HPEI, which include effects on the HPEIs themselves and effects on the community health sector. The report discusses 1) creating links with new partners by identifying and solving priority health problems in and with the community, 2) working in the community, 3) shaping health policy through the appropriate use of pharmaceuticals, 4) the effective use of health personnel, 5) the rational allocation of human resources, and 6) health-related legislation. The group addressed strategies for change as they apply to health systems and (HPEIs) including such barriers to changes as fear of a loss of control, failure to align innovation with the perceived needs of the HPEI or service, specific behavior on the part of innovators which jeopardized the change process, fear that change will erode professional excellence or undermine the reward system, and security considerations. Strategies for changes include encouraging broad participation, ensuring that all participating constituencies benefit, maintaining links with other innovative programs, and encouraging participation through a reward system. Organization and practical issues addressed in the committee report include factors involved with getting started, resource needs for curricular development, selecting community sites, and creating favorable administrative structures. The committee recommended that HPEIs review their mission statements, establish partnerships in the community, conduct action research, shift resources to health systems research, ensure the relevance of educational programs, evaluate programs in terms of their impact practice, ensure the use of problem-based learning techniques, and support longterm evaluation. WHO member states were advised to provide incentives and remove unnecessary barriers to collaboration, to use the potential of HPEIs to improve the health sector, to provide financial and administrative support for action research, and to ensure that research findings guide policy development. Finally, the group recommended that WHO encourage the development of guidelines and models to support action research, collaborate with HPEIs which express an interest in developing pilot collaborative projects, and encourage research efforts in HPEIs which have begun such collaboration.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1987; (746):1-89.A World Health Organization (WHO) Study Group on Community-based Education of Health Personnel met during November 1985 to clarify the meaning of the term community-based education, to determine its implications, to suggest how to put it into practice, and to recommend ways of fostering it. This report of the meeting defines terms and covers the following: the rationale of community-based education (a historical account, underlying principles, 6 reasons in support of community-based education, the organization of community-based educational programs, major problems and constraints, and quantitative and qualitative considerations); and the principles and issues (educational principles and issues, coordination between the health and educational systems, the intersectoral approach, community involvement, the health team, the competency-based learning approach, problem-based learning, performance assessment, and recapitulation of the action to be taken in implementing a community-based educational program). Recommendations to the WHO are included along with recommendations on how to start a community-based educational program and on how to foster an understanding of the concept of community-based education. An educational program, or curriculum, can be termed community-based if, for its entire duration, it consists of an appropriate number of learning activities in a balanced variety of educational settings, i.e., in both the community and a diversity of health care services at all levels. Participation in community-based educational activities gives the students a sense of social responsibility, enables the students to relate theoretical knowledge to practical training and makes them better prepared for life and their future integration into the working environment, helps to break down barriers between trained professionals and the lay public and to establish closer communication between educational institutions and the communities they serve, helps to keep the educational process current, helps students to acquire competency in areas relevant to community health needs, and is a powerful means of improving the quality of the community health services. A clear organizational design is needed to create a community-based educational program.
Manila, World Health Organization, Nov. 1976. 72 p.Add to my documents.